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Open Access Publications from the University of California

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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