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Metformin Is Associated with Higher Incidence of Acidosis, but Not Mortality, in Individuals with COVID-19 and Pre-existing Type 2 Diabetes.

  • Author(s): Cheng, Xu;
  • Liu, Ye-Mao;
  • Li, Haomiao;
  • Zhang, Xin;
  • Lei, Fang;
  • Qin, Juan-Juan;
  • Chen, Ze;
  • Deng, Ke-Qiong;
  • Lin, Lijin;
  • Chen, Ming-Ming;
  • Song, Xiaohui;
  • Xia, Meng;
  • Huang, Xuewei;
  • Liu, Weifang;
  • Cai, Jingjing;
  • Zhang, Xiao-Jing;
  • Zhou, Feng;
  • Zhang, Peng;
  • Wang, Yibin;
  • Ma, Xinliang;
  • Xu, Qingbo;
  • Yang, Juan;
  • Ye, Ping;
  • Mao, Weiming;
  • Huang, Xiaodong;
  • Xia, Jiahong;
  • Zhang, Bing-Hong;
  • Guo, Jiao;
  • Zhu, Lihua;
  • Lu, Zhibing;
  • Yuan, Yufeng;
  • Wei, Xiang;
  • She, Zhi-Gang;
  • Ji, Yan-Xiao;
  • Li, Hongliang
  • et al.

The safety and efficacy of anti-diabetic drugs are critical for maximizing the beneficial impacts of well-controlled blood glucose on the prognosis of individuals with COVID-19 and pre-existing type 2 diabetes (T2D). Metformin is the most commonly prescribed first-line medication for T2D, but its impact on the outcomes of individuals with COVID-19 and T2D remains to be clarified. Our current retrospective study in a cohort of 1,213 hospitalized individuals with COVID-19 and pre-existing T2D indicated that metformin use was significantly associated with a higher incidence of acidosis, particularly in cases with severe COVID-19, but not with 28-day COVID-19-related mortality. Furthermore, metformin use was significantly associated with reduced heart failure and inflammation. Our findings provide clinical evidence in support of continuing metformin treatment in individuals with COVID-19 and pre-existing T2D, but acidosis and kidney function should be carefully monitored in individuals with severe COVID-19.

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