Jingya Wang1, Jennifer M Cooper1, Krishna Gokhale1, Dionisio Acosta-Mena2, Samir Dhalla3, Nathan Byne2, Joht Singh Chandan1, Astha Anand1, Kelvin Okoth1, Anuradhaa Subramanian1, Mansoor N Bangash4,5, Thomas Jackson6, Dawit Zemedikun1, Tom Taverner1, Wasim Hanif7, Sandip Ghosh7, Parth Narendran7,8, Konstantinos A Toulis1, Abd A Tahrani7,9,10, Rajendra Surenthirakumaran11, Nicola J Adderley1, Shamil Haroon1, Kamlesh Khunti12, Christopher Sainsbury1,13, G Neil Thomas1, Krishnarajah Nirantharakumar1,9,14. 1. Institute of Applied Health Research, University of Birmingham, Birmingham, UK. 2. Cegedim Health Data, Cegedim Rx, London, UK. 3. The Health Improvement Network (THIN), London, UK. 4. Institute of Clinical Sciences, University of Birmingham, Birmingham, UK. 5. Department of Critical Care, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK. 6. Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK. 7. Department of Diabetes and Endocrinology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK. 8. Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK. 9. Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK. 10. Centre for Endocrinology, Diabetes and Metabolism (CEDAM), Birmingham Health Partners, Birmingham, UK. 11. Department of Community and Family Medicine, Faculty of Medicine, University of Jaffna, Jaffna, Sri Lanka. 12. Diabetes Research Centre, University of Leicester, Leicester. 13. Department of Diabetes, Gartnavel General Hospital, NHS Greater Glasgow and Clyde, Glasgow, UK. 14. Midlands Health Data Research UK, Birmingham, UK.
Abstract
OBJECTIVE: Diabetes has emerged as an important risk factor for mortality from COVID-19. Metformin, the most commonly prescribed glucose-lowering agent, has been proposed to influence susceptibility to and outcomes of COVID-19 via multiple mechanisms. We investigated whether, in patients with diabetes, metformin is associated with susceptibility to COVID-19 and its outcomes. RESEARCH DESIGN AND METHODS: We performed a propensity score-matched cohort study with active comparators using a large UK primary care dataset. Adults with type 2 diabetes patients and a current prescription for metformin and other glucose-lowering agents (MF+) were compared to those with a current prescription for glucose-lowering agents that did not include metformin (MF-). Outcomes were confirmed COVID-19, suspected/confirmed COVID-19, and associated mortality. A negative control outcome analysis (back pain) was also performed. RESULTS: There were 29 558 and 10 271 patients in the MF+ and MF- groups, respectively, who met the inclusion criteria. In the propensity score-matched analysis, the adjusted hazard ratios for suspected/confirmed COVID-19, confirmed COVID-19, and COVID-19-related mortality were 0.85 (95% CI 0.67, 1.08), 0.80 (95% CI 0.49, 1.30), and 0.87 (95% CI 0.34, 2.20) respectively. The negative outcome control analysis did not suggest unobserved confounding. CONCLUSION: Current prescription of metformin was not associated with the risk of COVID-19 or COVID-19-related mortality. It is safe to continue prescribing metformin to improve glycemic control in patients with.
OBJECTIVE: Diabetes has emerged as an important risk factor for mortality from COVID-19. Metformin, the most commonly prescribed glucose-lowering agent, has been proposed to influence susceptibility to and outcomes of COVID-19 via multiple mechanisms. We investigated whether, in patients with diabetes, metformin is associated with susceptibility to COVID-19 and its outcomes. RESEARCH DESIGN AND METHODS: We performed a propensity score-matched cohort study with active comparators using a large UK primary care dataset. Adults with type 2 diabetes patients and a current prescription for metformin and other glucose-lowering agents (MF+) were compared to those with a current prescription for glucose-lowering agents that did not include metformin (MF-). Outcomes were confirmed COVID-19, suspected/confirmed COVID-19, and associated mortality. A negative control outcome analysis (back pain) was also performed. RESULTS: There were 29 558 and 10 271 patients in the MF+ and MF- groups, respectively, who met the inclusion criteria. In the propensity score-matched analysis, the adjusted hazard ratios for suspected/confirmed COVID-19, confirmed COVID-19, and COVID-19-related mortality were 0.85 (95% CI 0.67, 1.08), 0.80 (95% CI 0.49, 1.30), and 0.87 (95% CI 0.34, 2.20) respectively. The negative outcome control analysis did not suggest unobserved confounding. CONCLUSION: Current prescription of metformin was not associated with the risk of COVID-19 or COVID-19-related mortality. It is safe to continue prescribing metformin to improve glycemic control in patients with.
Authors: James D Lewis; Rita Schinnar; Warren B Bilker; Xingmei Wang; Brian L Strom Journal: Pharmacoepidemiol Drug Saf Date: 2007-04 Impact factor: 2.890