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Published July 2021 | Version v1.0.0
Journal Article Open

Outpatient metformin use is associated with reduced severity of COVID-19 disease in adults with overweight or obesity

Creators

  • 1. ROR icon University of Minnesota
  • 2. ROR icon University of North Carolina at Chapel Hill
  • 3. ROR icon Miami University
  • 4. ROR icon UnitedHealth Group (United States)
  • 5. ROR icon Northwestern University
  • 6. ROR icon Duke University
  • 7. ROR icon University of Colorado Health
  • 8. ROR icon The University of Texas Southwestern Medical Center
  • 9. ROR icon Johns Hopkins University
  • 10. ROR icon Cornell University
  • 11. Alameda County

Abstract

Observational studies suggest outpatient metformin use is associated with reduced mortality from coronavirus disease-2019 (COVID-19). Metformin is known to decrease interleukin-6 and tumor-necrosis factor-alpha, which appear to contribute to morbidity in COVID-19. We sought to understand whether outpatient metformin use was associated with reduced odds of severe COVID-19 disease in a large US healthcare data set. Retrospective cohort analysis of electronic health record (EHR) data that was pooled across multiple EHR systems from 12 hospitals and 60 primary care clinics in the Midwest between March 4, 2020 and December 4, 2020. Inclusion criteria: data for body mass index (BMI) > 25 kg/m(2) and a positive SARS-CoV-2 polymerase chain reaction test; age >= 30 and <= 85 years. Exclusion criteria: patient opt-out of research. Metformin is the exposure of interest, and death, admission, and intensive care unit admission are the outcomes of interest. Metformin was associated with a decrease in mortality from COVID-19, OR 0.32 (0.15, 0.66; p = .002), and in the propensity-matched cohorts, OR 0.38 (0.16, 0.91; p = .030). Metformin was associated with a nonsignificant decrease in hospital admission for COVID-19 in the overall cohort, OR 0.78 (0.58-1.04, p = .087). Among the subgroup with a hemoglobin HbA1c available (n = 1193), the adjusted odds of hospitalization (including adjustment for HbA1c) for metformin users was OR 0.75 (0.53-1.06, p = .105). Outpatient metformin use was associated with lower mortality and a trend towards decreased admission for COVID-19. Given metformin's low cost, established safety, and the mounting evidence of reduced severity of COVID-19 disease, metformin should be prospectively assessed for outpatient treatment of COVID-19.

Other

original_citation: Bramante CT, Buse J, Tamaritz L, Palacio A, Cohen K, Vojta D, Liebovitz D, Mitchell N, Nicklas J, Lingvay I, Clark JM, Aronne LJ, Anderson E, Usher M, Demmer R, Melton GB, Ingraham N, Tignanelli CJ. Outpatient metformin use is associated with reduced severity of COVID-19 disease in adults with overweight or obesity. Journal of Medical Virology. 2021;93(7):4273-4279.

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Journal of Medical Virology - 2021 - Bramante - Outpatient metformin use is associated with reduced severity of COVID19.pdf

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Additional details

Identifiers

PMID
33580540

Related works

Is related to
https://onlinelibrary.wiley.com/doi/10.1002/jmv.26873 (URL)

Funding

Minnesota Learning Health System Mentored Career Development Program (MN-LHS) 5K12HS026379
Agency for Healthcare Research and Quality
Rapid Response Covid Grant UM 2020-2231
University of Minnesota
Iterative development and pilot testing of a mobile health intervention to increase postpartum weight loss in women at increased risk for cardiometabolic disease 1K23HL133604
National Heart Lung and Blood Institute (NHLBI)
Award number T32HL07741 T32HL07741
National Heart Lung and Blood Institute (NHLBI)
Fairview Health Services
Institutional Career Development Core KL2TR002492
National Center for Advancing Translational Sciences (NCATS)
University of Minnesota Clinical and TranslationalmScience Institute (UMN CTSI) UL1TR002494
National Center for Advancing Translational Sciences (NCATS)

Dates

Created
2021-07
When the item was originally created.