TY - JOUR
T1 - Preadmission use of antidiabetic medications and mortality among patients with COVID-19 having type 2 diabetes
T2 - A meta-analysis
AU - Nguyen, Nam Nhat
AU - Ho, Dung Si
AU - Nguyen, Hung Song
AU - Ho, Dang Khanh Ngan
AU - Li, Hung Yuan
AU - Lin, Chia Yuan
AU - Chiu, Hsiao Yean
AU - Chen, Yang Ching
N1 - Funding Information:
This manuscript was edited by Wallace Academic Editing. We gratefully acknowledge Ngan Khanh Nguyen for her expertise and assistance in designing the graphical abstract. Data were extracted from published research papers, all of which are available and accessible. All datasets generated during the current study are available upon reasonable request from the corresponding authors. The study protocol has been published (PROSPERO ID: CRD42021293064; www.crd.york.ac.uk/PROSPERO/) and is unrestrictedly available. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Publisher Copyright:
© 2022
PY - 2022/6
Y1 - 2022/6
N2 - Background: Diabetes is an independent predictor of poor outcomes in patients with COVID-19. We compared the effects of the preadmission use of antidiabetic medications on the in-hospital mortality of patients with COVID-19 having type 2 diabetes. Methods: A systematic search of PubMed, EMBASE, Scopus and Web of Science databases was performed to include studies (except case reports and review articles) published until November 30, 2021. We excluded papers regarding in-hospital use of antidiabetic medications. We used a random-effects meta-analysis to calculate the pooled OR (95% CI) and performed a sensitivity analysis to confirm the robustness of the meta-analyses. Main findings: We included 61 studies (3,061,584 individuals), which were rated as having low risk of bias. The OR (95% CI) indicated some medications protective against COVID-related death, including metformin [0.54 (0.47–0.62), I2 86%], glucagon-like peptide-1 receptor agonist (GLP-1RA) [0.51 (0.37–0.69), I2 85%], and sodium–glucose transporter-2 inhibitor (SGLT-2i) [0.60 (0.40–0.88), I2 91%]. Dipeptidyl peptidase-4 inhibitor (DPP-4i) [1.23 (1.07–1.42), I2 82%] and insulin [1.70 (1.33–2.19), I2 97%] users were more likely to die during hospitalization. Sulfonylurea, thiazolidinedione, and alpha-glucosidase inhibitor were mortality neutral [0.92 (95% CI 0.83–1.01, I2 44%), 0.90 (95% CI 0.71–1.14, I2 46%), and 0.61 (95% CI 0.26–1.45, I2 77%), respectively]. The sensitivity analysis indicated that our findings were robust. Conclusions: Metformin, GLP-1RA, and SGLT-2i were associated with lower mortality rate in patients with COVID-19 having type 2 diabetes. DPP-4i and insulin were linked to increased mortality. Sulfonylurea, thiazolidinedione, and alpha-glucosidase inhibitors were mortality neutral. These findings can have a large impact on the clinicians' decisions amid the COVID-19 pandemic.
AB - Background: Diabetes is an independent predictor of poor outcomes in patients with COVID-19. We compared the effects of the preadmission use of antidiabetic medications on the in-hospital mortality of patients with COVID-19 having type 2 diabetes. Methods: A systematic search of PubMed, EMBASE, Scopus and Web of Science databases was performed to include studies (except case reports and review articles) published until November 30, 2021. We excluded papers regarding in-hospital use of antidiabetic medications. We used a random-effects meta-analysis to calculate the pooled OR (95% CI) and performed a sensitivity analysis to confirm the robustness of the meta-analyses. Main findings: We included 61 studies (3,061,584 individuals), which were rated as having low risk of bias. The OR (95% CI) indicated some medications protective against COVID-related death, including metformin [0.54 (0.47–0.62), I2 86%], glucagon-like peptide-1 receptor agonist (GLP-1RA) [0.51 (0.37–0.69), I2 85%], and sodium–glucose transporter-2 inhibitor (SGLT-2i) [0.60 (0.40–0.88), I2 91%]. Dipeptidyl peptidase-4 inhibitor (DPP-4i) [1.23 (1.07–1.42), I2 82%] and insulin [1.70 (1.33–2.19), I2 97%] users were more likely to die during hospitalization. Sulfonylurea, thiazolidinedione, and alpha-glucosidase inhibitor were mortality neutral [0.92 (95% CI 0.83–1.01, I2 44%), 0.90 (95% CI 0.71–1.14, I2 46%), and 0.61 (95% CI 0.26–1.45, I2 77%), respectively]. The sensitivity analysis indicated that our findings were robust. Conclusions: Metformin, GLP-1RA, and SGLT-2i were associated with lower mortality rate in patients with COVID-19 having type 2 diabetes. DPP-4i and insulin were linked to increased mortality. Sulfonylurea, thiazolidinedione, and alpha-glucosidase inhibitors were mortality neutral. These findings can have a large impact on the clinicians' decisions amid the COVID-19 pandemic.
KW - Antidiabetic medication
KW - COVID-19
KW - Type 2 diabetes mellitus
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U2 - 10.1016/j.metabol.2022.155196
DO - 10.1016/j.metabol.2022.155196
M3 - Article
C2 - 35367460
AN - SCOPUS:85127481251
SN - 0026-0495
VL - 131
JO - Metabolism: Clinical and Experimental
JF - Metabolism: Clinical and Experimental
M1 - 155196
ER -
