Yufeng Yuan, Xuewei Huang, Ke-Qiong Deng, Xu Cheng, Ze Chen, Feng Zhou, Lijin Lin, Xiang Wei, Jingjing Cai, Ming-Ming Chen, Xiao-Jing Zhang, Xiaodong Huang, Jiahong Xia, Juan-Juan Qin, Weiming Mao, Xiaohui Song, Weifang Liu, Zhi-Gang She, Ye-Mao Liu, Peng Zhang, Meng Xia, Bing-Hong Zhang, Hongliang Li, Ping Ye, Yibin Wang, Jiao Guo, Juan Yang, Fang Lei, Yan-Xiao Ji, Xin-Liang Ma, Haomiao Li, Zhibing Lu, Xin Zhang, Qingbo Xu, and Lihua Zhu
Summary The safety and efficacy of anti-diabetic drugs are critical for maximizing the benefical 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., Graphical Abstract, Highlight ● A retrospective study of 1,213 patients on metformin with COVID-19 was performed ● Metformin was associated with increased incidence of acidosis in such patients ● Metformin was not associated with increased 28-day all-cause mortality in the patients ● Metformin was significantly associated with reduced heart failure and inflammation, In a cohort of 1,213 hospitalized patients with COVID-19 and pre-existing type 2 diabetes, Cheng et al. show that metformin use is significantly associated with higher incidence of acidosis, particularly in cases with severe COVID-19, but not with 28-day all-cause mortality. They also found that metformin use is significantly associated with reduced heart failure and inflammation.