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Kuwahara M, Otagaki H, Imanaka H. Three Cases of Lactic Acidosis Caused by Biguanides. Cureus 2022; 14:e31419. [DOI: 10.7759/cureus.31419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2022] [Indexed: 11/14/2022] Open
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Li J, Wei Q, Li WX, McCowen KC, Xiong W, Liu J, Jiang W, Marin T, Thomas RL, He M, Gongol B, Hepokoski M, Yuan JXJ, Shyy JYJ, Xiong N, Malhotra A. Metformin Use in Diabetes Prior to Hospitalization: Effects on Mortality in Covid-19. Endocr Pract 2020; 26:1166-1172. [PMID: 33471718 PMCID: PMC7834011 DOI: 10.4158/ep-2020-0466] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Accepted: 09/15/2020] [Indexed: 12/25/2022]
Abstract
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.
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Affiliation(s)
- Jinghong Li
- From the Department of Medicine, University of California, San Diego, La Jolla, California
| | - Qi Wei
- the Department of Endocrinology, Wuhan Red Cross Hospital, Wuhan, Hubei, China
| | - Willis X Li
- From the Department of Medicine, University of California, San Diego, La Jolla, California
| | - Karen C McCowen
- From the Department of Medicine, University of California, San Diego, La Jolla, California
| | - Wei Xiong
- the Department of Endocrinology, Wuhan Red Cross Hospital, Wuhan, Hubei, China
| | - Jiao Liu
- the Department of Endocrinology, Wuhan Red Cross Hospital, Wuhan, Hubei, China
| | - Wenlijun Jiang
- the Department of Endocrinology, Wuhan Red Cross Hospital, Wuhan, Hubei, China
| | - Traci Marin
- the Department of Health Sciences, Victor Valley College, Victorville, California
| | - Robert L Thomas
- From the Department of Medicine, University of California, San Diego, La Jolla, California
| | - Ming He
- From the Department of Medicine, University of California, San Diego, La Jolla, California
| | - Brendan Gongol
- From the Department of Medicine, University of California, San Diego, La Jolla, California
| | - Mark Hepokoski
- From the Department of Medicine, University of California, San Diego, La Jolla, California
| | - Jason X-J Yuan
- From the Department of Medicine, University of California, San Diego, La Jolla, California
| | - John Y-J Shyy
- From the Department of Medicine, University of California, San Diego, La Jolla, California.
| | - Nian Xiong
- the Department of Endocrinology, Wuhan Red Cross Hospital, Wuhan, Hubei, China; the Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China..
| | - Atul Malhotra
- From the Department of Medicine, University of California, San Diego, La Jolla, California
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