tetano
Editor, Senior Moderator
Arch Med Res
. 2021 Aug 9;S0188-4409(21)00167-3.
doi: 10.1016/j.arcmed.2021.08.002. Online ahead of print.
The Association Between Anti-diabetic Agents and Clinical Outcomes of COVID-19 in Patients with Diabetes: A Systematic Review and Meta-Analysis
Tiantian Han[SUP] 1 [/SUP], Shaodi Ma[SUP] 1 [/SUP], Chenyu Sun[SUP] 2 [/SUP], Huimei Zhang[SUP] 1 [/SUP], Guangbo Qu[SUP] 1 [/SUP], Yue Chen[SUP] 3 [/SUP], Ce Cheng[SUP] 4 [/SUP], Eric L Chen[SUP] 5 [/SUP], Mubashir Ayaz Ahmed[SUP] 5 [/SUP], Keun Young Kim[SUP] 5 [/SUP], Raveena Manem[SUP] 5 [/SUP], Mengshi Chen[SUP] 6 [/SUP], Zhichun Guo[SUP] 7 [/SUP], Hongru Yang[SUP] 7 [/SUP], Yue Yan[SUP] 7 [/SUP], Qin Zhou[SUP] 8 [/SUP]
Affiliations
Abstract
Background and aims: During the current Coronavirus Disease 2019 (COVID-19) pandemic, patients with diabetes face disproportionately more. This study was performed to clarify anti-inflammatory effects of anti-diabetic agents on COVID-19 in patients with diabetes.
Methods and results: Relevant literature was searched on 15 databases up to November 14, 2020 and was updated on April 13, 2021. The pooled ORs along with 95% CIs were calculated to evaluate combined effects. 31 studies with 66,914 patients were included in qualitative and quantitative synthesis. Meta-analysis showed that metformin was associated with a statistically significant lower mortality (pooled OR = 0.62, 95% CI, 0.50-0.76, p = 0.000) and poor composite outcomes (pooled OR = 0.83, 95% CI, 0.71-0.97, p = 0.022) in diabetic patients with COVID-19. Significance of slight lower mortality remained in sulfonylurea/glinides (pooled OR = 0.93, 95% CI, 0.89-0.98, p = 0.004), but of poor composite outcomes was not (pooled OR = 1.48, 95% CI, 0.61-3.60, p = 0.384). Dipeptidyl peptidase-4 inhibitors (DPP-4 inhibitors) were associated with statistically non-significant lower mortality (pooled OR = 0.95, 95% CI, 0.72-1.26, p = 0.739) or poor composite outcomes (pooled OR = 1.27, 95% CI, 0.91-1.77, p = 0.162) of COVID-19 in diabetic patients.
Conclusion: Metformin might be beneficial in decreasing mortality and poor composite outcomes in diabetic patients infected with SARS-CoV-2. DPP-4 inhibitors, sulfonylurea/glinides, SGLT-2 inhibitors, and GLP-1RA would not seem to be adverse. There was insufficient evidence to conclude effects of other anti-diabetic agents. Limited by retrospective characteristics, with relative weak capability to verify causality, more prospective studies, especially RCTs are needed. Registration number: PROSPERO-CRD42020221951.
Keywords: Anti-diabetic agents; DPP-4 inhibitors COVID-19; Diabetes; Meta-analysis; Metformin.
. 2021 Aug 9;S0188-4409(21)00167-3.
doi: 10.1016/j.arcmed.2021.08.002. Online ahead of print.
The Association Between Anti-diabetic Agents and Clinical Outcomes of COVID-19 in Patients with Diabetes: A Systematic Review and Meta-Analysis
Tiantian Han[SUP] 1 [/SUP], Shaodi Ma[SUP] 1 [/SUP], Chenyu Sun[SUP] 2 [/SUP], Huimei Zhang[SUP] 1 [/SUP], Guangbo Qu[SUP] 1 [/SUP], Yue Chen[SUP] 3 [/SUP], Ce Cheng[SUP] 4 [/SUP], Eric L Chen[SUP] 5 [/SUP], Mubashir Ayaz Ahmed[SUP] 5 [/SUP], Keun Young Kim[SUP] 5 [/SUP], Raveena Manem[SUP] 5 [/SUP], Mengshi Chen[SUP] 6 [/SUP], Zhichun Guo[SUP] 7 [/SUP], Hongru Yang[SUP] 7 [/SUP], Yue Yan[SUP] 7 [/SUP], Qin Zhou[SUP] 8 [/SUP]
Affiliations
- PMID: 34412904
- DOI: 10.1016/j.arcmed.2021.08.002
Abstract
Background and aims: During the current Coronavirus Disease 2019 (COVID-19) pandemic, patients with diabetes face disproportionately more. This study was performed to clarify anti-inflammatory effects of anti-diabetic agents on COVID-19 in patients with diabetes.
Methods and results: Relevant literature was searched on 15 databases up to November 14, 2020 and was updated on April 13, 2021. The pooled ORs along with 95% CIs were calculated to evaluate combined effects. 31 studies with 66,914 patients were included in qualitative and quantitative synthesis. Meta-analysis showed that metformin was associated with a statistically significant lower mortality (pooled OR = 0.62, 95% CI, 0.50-0.76, p = 0.000) and poor composite outcomes (pooled OR = 0.83, 95% CI, 0.71-0.97, p = 0.022) in diabetic patients with COVID-19. Significance of slight lower mortality remained in sulfonylurea/glinides (pooled OR = 0.93, 95% CI, 0.89-0.98, p = 0.004), but of poor composite outcomes was not (pooled OR = 1.48, 95% CI, 0.61-3.60, p = 0.384). Dipeptidyl peptidase-4 inhibitors (DPP-4 inhibitors) were associated with statistically non-significant lower mortality (pooled OR = 0.95, 95% CI, 0.72-1.26, p = 0.739) or poor composite outcomes (pooled OR = 1.27, 95% CI, 0.91-1.77, p = 0.162) of COVID-19 in diabetic patients.
Conclusion: Metformin might be beneficial in decreasing mortality and poor composite outcomes in diabetic patients infected with SARS-CoV-2. DPP-4 inhibitors, sulfonylurea/glinides, SGLT-2 inhibitors, and GLP-1RA would not seem to be adverse. There was insufficient evidence to conclude effects of other anti-diabetic agents. Limited by retrospective characteristics, with relative weak capability to verify causality, more prospective studies, especially RCTs are needed. Registration number: PROSPERO-CRD42020221951.
Keywords: Anti-diabetic agents; DPP-4 inhibitors COVID-19; Diabetes; Meta-analysis; Metformin.