The Possible Protective Effect of Metformin in COVID-19 Infection

Journal of Advances in Medical and Pharmaceutical Sciences ◽

10.9734/jamps/2020/v22i830185 ◽

2020 ◽

pp. 1-5

Author(s):

Waleed K. Abdulsahib

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Converting Enzyme ◽

Obese Women ◽

Women Patients ◽

Angiotensin Converting Enzyme 2 ◽

Beneficial Effects ◽

First Choice

Coronavirus 2019 (COVID-19) infections with more than 30 million confirmed cases are increasing rapidly, requiring urgent and safe treatment. Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), a virus responsible for the infection of COVID-19. Metformin (M) is a biguanide drug used as a first choice for the management of hyperglycemia in type 2 diabetes mellitus (T2DM). Furthermore, it is safe and currently available. It is speculated that metformin can be used for T2DM patients with COVID-19, because in addition to its hypoglycemic effect, this biguanide also shows many beneficial effects, including anti-inflammatory effects and cardiopulmonary protection especially by angiotensin converting enzyme 2 (ACE2) targeting. Therefore, the reasons for the use of metformin in COVID-19 patients were discussed in this study. Metformin has a promising role in treatment of COVID-19 in T2DM and obese women patients.

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METFORMIN USE IN DIABETES PRIOR TO HOSPITALIZATION: EFFECTS ON MORTALITY IN COVID-19

Endocrine Practice ◽

10.4158/ep-2020-0466 ◽

2020 ◽

Vol 26 (10) ◽

pp. 1166-1172

Author(s):

Jinghong Li ◽

Qi Wei ◽

Willis X. Li ◽

Karen C. McCowen ◽

Wei Xiong ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Severe Acute Respiratory Syndrome ◽

Angiotensin Converting Enzyme ◽

Clinical Data ◽

Laboratory Data ◽

Converting Enzyme ◽

Angiotensin Converting Enzyme 2

Objective: Although type 2 diabetes mellitus (T2DM) has been reported as a risk factor for coronavirus disease 2019 (COVID-19), the effect of pharmacologic agents used to treat T2DM, such as metformin, on COVID-19 outcomes remains unclear. Metformin increases the expression of angiotensin converting enzyme 2, a known receptor for severe acute respiratory syndrome coronavirus 2. Data from people with T2DM hospitalized for COVID-19 were used to test the hypothesis that metformin use is associated with improved survival in this population. Methods: Retrospective analyses were performed on de-identified clinical data from a major hospital in Wuhan, China, that included patients with T2DM hospitalized for COVID-19 during the recent epidemic. One hundred and thirty-one patients diagnosed with COVID-19 and T2DM were used in this study. The primary outcome was mortality. Demographic, clinical characteristics, laboratory data, diabetes medications, and respiratory therapy data were also included in the analysis. Results: Of these 131 patients, 37 used metformin with or without other antidiabetes medications. Among the 37 metformin-taking patients, 35 (94.6%) survived and 2 (5.4%) did not survive. The mortality rates in the metformin-taking group versus the non-metformin group were 5.4% (2/37) versus 22.3% (21/94). Using multivariate analysis, metformin was found to be an independent predictor of survival in this cohort ( P = .02). Conclusion: This study reveals a significant association between metformin use and survival in people with T2DM diagnosed with COVID-19. These clinical data are consistent with potential benefits of the use of metformin for COVID-19 patients with T2DM. Abbreviations: ACE2 = angiotensin-converting enzyme 2; AMPK = AMP-activated protein kinase; BMI = body mass index; COVID-19 = coronavirus disease 2019; SARSCoV-2 = severe acute respiratory syndrome coronavirus 2; T2DM = type 2 diabetes mellitus

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