Metformin is associated with reduced COVID-19 severity in patients with prediabetes

Lauren E. Chan, Elena Casiraghi, Bryan Laraway, Ben Coleman, Hannah Blau, Adnin Zaman, Nomi L. Harris, Kenneth Wilkins, Blessy Antony, Michael Gargano, Giorgio Valentini, David Sahner, Melissa Haendel, Peter N. Robinson, Carolyn Bramante, Justin Reese

Research output: Contribution to journalArticlepeer-review

Abstract

Aims: Studies suggest that metformin is associated with reduced COVID-19 severity in individuals with diabetes compared to other antihyperglycemics. We assessed if metformin is associated with reduced incidence of severe COVID-19 for patients with prediabetes or polycystic ovary syndrome (PCOS), common diseases that increase the risk of severe COVID-19. Methods: This observational, retrospective study utilized EHR data from 52 hospitals for COVID-19 patients with PCOS or prediabetes treated with metformin or levothyroxine/ondansetron (controls). After balancing via inverse probability score weighting, associations with COVID-19 severity were assessed by logistic regression. Results: In the prediabetes cohort, when compared to levothyroxine, metformin was associated with a significantly lower incidence of COVID-19 with “mild-ED” or worse (OR [95% CI]: 0.636, [0.455–0.888]) and “moderate” or worse severity (0.493 [0.339–0.718]). Compared to ondansetron, metformin was associated with lower incidence of “mild-ED” or worse severity (0.039 [0.026–0.057]), “moderate” or worse (0.045 [0.03–0.069]), “severe” or worse (0.183 [0.077–0.431]), and “mortality/hospice” (0.223 [0.071–0.694]). For PCOS, metformin showed no significant differences in severity compared to levothyroxine, but was associated with a significantly lower incidence of “mild-ED” or worse (0.101 [0.061–0.166]), and “moderate” or worse (0.094 [0.049–0.18]) COVID-19 outcome compared to ondansetron. Conclusions: Metformin use is associated with less severe COVID-19 in patients with prediabetes or PCOS.

Original languageEnglish (US)
Article number110157
JournalDiabetes Research and Clinical Practice
Volume194
DOIs
StatePublished - Dec 2022
Externally publishedYes

Keywords

  • COVID-19
  • Glycemia
  • Metformin
  • Polycystic ovary syndrome
  • Prediabetes

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

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