Metformin is associated with reduced COVID-19 severity in patients with prediabetes

Lauren E. Chan; Elena Casiraghi; Bryan Laraway; Ben Coleman; Hannah Blau; Adnin Zaman; Nomi L. Harris; Kenneth Wilkins; Blessy Antony; Michael Gargano; Giorgio Valentini; David Sahner; Melissa Haendel; Peter N. Robinson; Carolyn Bramante; Justin Reese

doi:10.1016/j.diabres.2022.110157

Metformin is associated with reduced COVID-19 severity in patients with prediabetes

Lauren E. Chan, Elena Casiraghi, Bryan Laraway, Ben Coleman, Hannah Blau, Adnin Zaman, Nomi L. Harris, Kenneth Wilkins, Blessy Antony, Michael Gargano, Giorgio Valentini, David Sahner, Melissa Haendel, Peter N. Robinson, Carolyn Bramante, Justin Reese

Medicine - Geriatrics, Palliative and Primary Care (GPPC)

Research output: Contribution to journal › Article › peer-review

Abstract

Aims: Studies suggest that metformin is associated with reduced COVID-19 severity in individuals with diabetes compared to other antihyperglycemics. We assessed if metformin is associated with reduced incidence of severe COVID-19 for patients with prediabetes or polycystic ovary syndrome (PCOS), common diseases that increase the risk of severe COVID-19. Methods: This observational, retrospective study utilized EHR data from 52 hospitals for COVID-19 patients with PCOS or prediabetes treated with metformin or levothyroxine/ondansetron (controls). After balancing via inverse probability score weighting, associations with COVID-19 severity were assessed by logistic regression. Results: In the prediabetes cohort, when compared to levothyroxine, metformin was associated with a significantly lower incidence of COVID-19 with “mild-ED” or worse (OR [95% CI]: 0.636, [0.455–0.888]) and “moderate” or worse severity (0.493 [0.339–0.718]). Compared to ondansetron, metformin was associated with lower incidence of “mild-ED” or worse severity (0.039 [0.026–0.057]), “moderate” or worse (0.045 [0.03–0.069]), “severe” or worse (0.183 [0.077–0.431]), and “mortality/hospice” (0.223 [0.071–0.694]). For PCOS, metformin showed no significant differences in severity compared to levothyroxine, but was associated with a significantly lower incidence of “mild-ED” or worse (0.101 [0.061–0.166]), and “moderate” or worse (0.094 [0.049–0.18]) COVID-19 outcome compared to ondansetron. Conclusions: Metformin use is associated with less severe COVID-19 in patients with prediabetes or PCOS.

Original language	English (US)
Article number	110157
Journal	Diabetes Research and Clinical Practice
Volume	194
DOIs	https://doi.org/10.1016/j.diabres.2022.110157
State	Published - Dec 2022

Bibliographical note

Funding Information:
This work was supported by NCATS U24 TR002306. Additionally, Justin T. Reese and Nomi L. Harris were supported by the Director, Office of Science, Office of Basic Energy Sciences of the U.S. Department of Energy Contract No. DE-AC02-05CH11231; Justin T. Reese, Melissa Haendel, Peter N. Robinson, and Nomi L. Harris were supported by National Human Genome Research Institute awards 7RM1HG010860-02 and 2R24-OD011883-10A1; Adnin Zaman was supported by NIH NIDDK grant F32 DK123878. Melissa Haendel was supported by the Marsico Family at the University of Colorado Anschutz Medical Campus; Elena Casiraghi and Giorgio Valentini were supported by Università degli Studi di Milano, Piano di sviluppo di ricerca, grant 2015-17 PSR2015-17.

Funding Information:
The analyses described in this publication were conducted with data or tools accessed through the NCATS N3C Data Enclave (covid.cd2h.org/enclave) and supported by CD2H - The National COVID Cohort Collaborative (N3C) IDeA CTR Collaboration 3U24TR002306-04S2 NCATS U24 TR002306, DUR: RP-7BE1AC. This research was possible because of the patients whose information is included within the data from participating organizations (covid.cd2h.org/dtas) and the organizations and scientists (covid.cd2h.org/duas) who have contributed to the on-going development of this community resource 27 The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or the N3C program. The N3C data transfer to NCATS is performed under a Johns Hopkins University Reliance Protocol #IRB00249128 or individual site agreements with NIH. The N3C Data Enclave is managed under the authority of the NIH; information can be found at https://ncats.nih.gov/n3c/resources.

Publisher Copyright:
© 2022

Keywords

COVID-19
Glycemia
Metformin
Polycystic ovary syndrome
Prediabetes

PubMed: MeSH publication types

Observational Study
Journal Article

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Publisher link

10.1016/j.diabres.2022.110157

Find It

Find It at U of M Libraries

Cite this

Chan, L. E., Casiraghi, E., Laraway, B., Coleman, B., Blau, H., Zaman, A., Harris, N. L., Wilkins, K., Antony, B., Gargano, M., Valentini, G., Sahner, D., Haendel, M., Robinson, P. N., Bramante, C., & Reese, J. (2022). Metformin is associated with reduced COVID-19 severity in patients with prediabetes. Diabetes Research and Clinical Practice, 194, [110157]. https://doi.org/10.1016/j.diabres.2022.110157

Chan, LE, Casiraghi, E, Laraway, B, Coleman, B, Blau, H, Zaman, A, Harris, NL, Wilkins, K, Antony, B, Gargano, M, Valentini, G, Sahner, D, Haendel, M, Robinson, PN, Bramante, C & Reese, J 2022, 'Metformin is associated with reduced COVID-19 severity in patients with prediabetes', Diabetes Research and Clinical Practice, vol. 194, 110157. https://doi.org/10.1016/j.diabres.2022.110157

@article{a09103c0ac2e4c99932c02850ba4de41,

title = "Metformin is associated with reduced COVID-19 severity in patients with prediabetes",

abstract = "Aims: Studies suggest that metformin is associated with reduced COVID-19 severity in individuals with diabetes compared to other antihyperglycemics. We assessed if metformin is associated with reduced incidence of severe COVID-19 for patients with prediabetes or polycystic ovary syndrome (PCOS), common diseases that increase the risk of severe COVID-19. Methods: This observational, retrospective study utilized EHR data from 52 hospitals for COVID-19 patients with PCOS or prediabetes treated with metformin or levothyroxine/ondansetron (controls). After balancing via inverse probability score weighting, associations with COVID-19 severity were assessed by logistic regression. Results: In the prediabetes cohort, when compared to levothyroxine, metformin was associated with a significantly lower incidence of COVID-19 with “mild-ED” or worse (OR [95% CI]: 0.636, [0.455–0.888]) and “moderate” or worse severity (0.493 [0.339–0.718]). Compared to ondansetron, metformin was associated with lower incidence of “mild-ED” or worse severity (0.039 [0.026–0.057]), “moderate” or worse (0.045 [0.03–0.069]), “severe” or worse (0.183 [0.077–0.431]), and “mortality/hospice” (0.223 [0.071–0.694]). For PCOS, metformin showed no significant differences in severity compared to levothyroxine, but was associated with a significantly lower incidence of “mild-ED” or worse (0.101 [0.061–0.166]), and “moderate” or worse (0.094 [0.049–0.18]) COVID-19 outcome compared to ondansetron. Conclusions: Metformin use is associated with less severe COVID-19 in patients with prediabetes or PCOS.",

keywords = "COVID-19, Glycemia, Metformin, Polycystic ovary syndrome, Prediabetes",

author = "Chan, {Lauren E.} and Elena Casiraghi and Bryan Laraway and Ben Coleman and Hannah Blau and Adnin Zaman and Harris, {Nomi L.} and Kenneth Wilkins and Blessy Antony and Michael Gargano and Giorgio Valentini and David Sahner and Melissa Haendel and Robinson, {Peter N.} and Carolyn Bramante and Justin Reese",

note = "Funding Information: This work was supported by NCATS U24 TR002306. Additionally, Justin T. Reese and Nomi L. Harris were supported by the Director, Office of Science, Office of Basic Energy Sciences of the U.S. Department of Energy Contract No. DE-AC02-05CH11231; Justin T. Reese, Melissa Haendel, Peter N. Robinson, and Nomi L. Harris were supported by National Human Genome Research Institute awards 7RM1HG010860-02 and 2R24-OD011883-10A1; Adnin Zaman was supported by NIH NIDDK grant F32 DK123878. Melissa Haendel was supported by the Marsico Family at the University of Colorado Anschutz Medical Campus; Elena Casiraghi and Giorgio Valentini were supported by Universit{\`a} degli Studi di Milano, Piano di sviluppo di ricerca, grant 2015-17 PSR2015-17. Funding Information: The analyses described in this publication were conducted with data or tools accessed through the NCATS N3C Data Enclave (covid.cd2h.org/enclave) and supported by CD2H - The National COVID Cohort Collaborative (N3C) IDeA CTR Collaboration 3U24TR002306-04S2 NCATS U24 TR002306, DUR: RP-7BE1AC. This research was possible because of the patients whose information is included within the data from participating organizations (covid.cd2h.org/dtas) and the organizations and scientists (covid.cd2h.org/duas) who have contributed to the on-going development of this community resource 27 The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or the N3C program. The N3C data transfer to NCATS is performed under a Johns Hopkins University Reliance Protocol #IRB00249128 or individual site agreements with NIH. The N3C Data Enclave is managed under the authority of the NIH; information can be found at https://ncats.nih.gov/n3c/resources. Publisher Copyright: {\textcopyright} 2022",

year = "2022",

month = dec,

doi = "10.1016/j.diabres.2022.110157",

language = "English (US)",

volume = "194",

journal = "Diabetes Research and Clinical Practice",

issn = "0168-8227",

publisher = "Elsevier Ireland Ltd",

}

TY - JOUR

T1 - Metformin is associated with reduced COVID-19 severity in patients with prediabetes

AU - Chan, Lauren E.

AU - Casiraghi, Elena

AU - Laraway, Bryan

AU - Coleman, Ben

AU - Blau, Hannah

AU - Zaman, Adnin

AU - Harris, Nomi L.

AU - Wilkins, Kenneth

AU - Antony, Blessy

AU - Gargano, Michael

AU - Valentini, Giorgio

AU - Sahner, David

AU - Haendel, Melissa

AU - Robinson, Peter N.

AU - Bramante, Carolyn

AU - Reese, Justin

N1 - Funding Information: This work was supported by NCATS U24 TR002306. Additionally, Justin T. Reese and Nomi L. Harris were supported by the Director, Office of Science, Office of Basic Energy Sciences of the U.S. Department of Energy Contract No. DE-AC02-05CH11231; Justin T. Reese, Melissa Haendel, Peter N. Robinson, and Nomi L. Harris were supported by National Human Genome Research Institute awards 7RM1HG010860-02 and 2R24-OD011883-10A1; Adnin Zaman was supported by NIH NIDDK grant F32 DK123878. Melissa Haendel was supported by the Marsico Family at the University of Colorado Anschutz Medical Campus; Elena Casiraghi and Giorgio Valentini were supported by Università degli Studi di Milano, Piano di sviluppo di ricerca, grant 2015-17 PSR2015-17. Funding Information: The analyses described in this publication were conducted with data or tools accessed through the NCATS N3C Data Enclave (covid.cd2h.org/enclave) and supported by CD2H - The National COVID Cohort Collaborative (N3C) IDeA CTR Collaboration 3U24TR002306-04S2 NCATS U24 TR002306, DUR: RP-7BE1AC. This research was possible because of the patients whose information is included within the data from participating organizations (covid.cd2h.org/dtas) and the organizations and scientists (covid.cd2h.org/duas) who have contributed to the on-going development of this community resource 27 The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or the N3C program. The N3C data transfer to NCATS is performed under a Johns Hopkins University Reliance Protocol #IRB00249128 or individual site agreements with NIH. The N3C Data Enclave is managed under the authority of the NIH; information can be found at https://ncats.nih.gov/n3c/resources. Publisher Copyright: © 2022

PY - 2022/12

Y1 - 2022/12

N2 - Aims: Studies suggest that metformin is associated with reduced COVID-19 severity in individuals with diabetes compared to other antihyperglycemics. We assessed if metformin is associated with reduced incidence of severe COVID-19 for patients with prediabetes or polycystic ovary syndrome (PCOS), common diseases that increase the risk of severe COVID-19. Methods: This observational, retrospective study utilized EHR data from 52 hospitals for COVID-19 patients with PCOS or prediabetes treated with metformin or levothyroxine/ondansetron (controls). After balancing via inverse probability score weighting, associations with COVID-19 severity were assessed by logistic regression. Results: In the prediabetes cohort, when compared to levothyroxine, metformin was associated with a significantly lower incidence of COVID-19 with “mild-ED” or worse (OR [95% CI]: 0.636, [0.455–0.888]) and “moderate” or worse severity (0.493 [0.339–0.718]). Compared to ondansetron, metformin was associated with lower incidence of “mild-ED” or worse severity (0.039 [0.026–0.057]), “moderate” or worse (0.045 [0.03–0.069]), “severe” or worse (0.183 [0.077–0.431]), and “mortality/hospice” (0.223 [0.071–0.694]). For PCOS, metformin showed no significant differences in severity compared to levothyroxine, but was associated with a significantly lower incidence of “mild-ED” or worse (0.101 [0.061–0.166]), and “moderate” or worse (0.094 [0.049–0.18]) COVID-19 outcome compared to ondansetron. Conclusions: Metformin use is associated with less severe COVID-19 in patients with prediabetes or PCOS.

AB - Aims: Studies suggest that metformin is associated with reduced COVID-19 severity in individuals with diabetes compared to other antihyperglycemics. We assessed if metformin is associated with reduced incidence of severe COVID-19 for patients with prediabetes or polycystic ovary syndrome (PCOS), common diseases that increase the risk of severe COVID-19. Methods: This observational, retrospective study utilized EHR data from 52 hospitals for COVID-19 patients with PCOS or prediabetes treated with metformin or levothyroxine/ondansetron (controls). After balancing via inverse probability score weighting, associations with COVID-19 severity were assessed by logistic regression. Results: In the prediabetes cohort, when compared to levothyroxine, metformin was associated with a significantly lower incidence of COVID-19 with “mild-ED” or worse (OR [95% CI]: 0.636, [0.455–0.888]) and “moderate” or worse severity (0.493 [0.339–0.718]). Compared to ondansetron, metformin was associated with lower incidence of “mild-ED” or worse severity (0.039 [0.026–0.057]), “moderate” or worse (0.045 [0.03–0.069]), “severe” or worse (0.183 [0.077–0.431]), and “mortality/hospice” (0.223 [0.071–0.694]). For PCOS, metformin showed no significant differences in severity compared to levothyroxine, but was associated with a significantly lower incidence of “mild-ED” or worse (0.101 [0.061–0.166]), and “moderate” or worse (0.094 [0.049–0.18]) COVID-19 outcome compared to ondansetron. Conclusions: Metformin use is associated with less severe COVID-19 in patients with prediabetes or PCOS.

KW - COVID-19

KW - Glycemia

KW - Metformin

KW - Polycystic ovary syndrome

KW - Prediabetes

UR - http://www.scopus.com/inward/record.url?scp=85142127374&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85142127374&partnerID=8YFLogxK

U2 - 10.1016/j.diabres.2022.110157

DO - 10.1016/j.diabres.2022.110157

M3 - Article

C2 - 36400170

AN - SCOPUS:85142127374

VL - 194

JO - Diabetes Research and Clinical Practice

JF - Diabetes Research and Clinical Practice

SN - 0168-8227

M1 - 110157

ER -

Metformin is associated with reduced COVID-19 severity in patients with prediabetes

Abstract

Bibliographical note

Keywords

PubMed: MeSH publication types

UN SDGs

Publisher link

Find It

Other files and links

Fingerprint

Cite this