Clinical characteristics and short-term prognosis of in-patients with diabetes and COVID-19: A retrospective study from an academic center in Belgium

Orioli, Laura; Servais, Thomas; Belkhir, Leïla; Laterre, Pierre François; Thissen, Jean Paul; Vandeleene, Bernard; Maiter, Dominique; Yombi, Jean Cyr; Hermans, Michel P.

doi:10.1016/j.dsx.2020.12.020

Cited by 35 publications

(33 citation statements)

References 34 publications

(77 reference statements)

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“…The details regarding excluded articles can be seen in Appendix A. As a result, 9 studies were included in this meta-analysis [21][22][23][24][25][26][27][28][29] with an overall of 19,660 Covid-19 patients with diabetes mellitus (Fig. 1).…”

Section: Study Selection and Characteristicsmentioning

confidence: 99%

Pre-admission glucagon-like peptide-1 receptor agonist (GLP-1RA) and mortality from coronavirus disease 2019 (Covid-19): A systematic review, meta-analysis, and meta-regression

Hariyanto

Intan

Hananto

et al. 2021

Diabetes Research and Clinical Practice

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Aims GLP-1RA has many beneficial properties, including anti-inflammatory, anti-obesogenic, pulmonary protective effects as well as beneficial impact on gut microbiome. However, the evidence regarding the benefit of GLP-1RA in Covid-19 patients with diabetes is still unclear. This study sought to analyze the benefit of pre-admission use of GLP-1RA in altering the mortality outcomes of coronavirus disease 2019 (Covid-19) patients with diabetes mellitus. Methods Using specific keywords, we comprehensively searched the potential articles on PubMed, Europe PMC, and medRxiv database until June 12 th , 2021. All published studies on Covid-19 and GLP-1RA were retrieved. Statistical analysis was conducted using Review Manager 5.4 and Comprehensive Meta-Analysis version 3 software. Results A total of 9 studies with 19,660 diabetes mellitus patients who were infected by SARS-CoV-2 were included in the meta-analysis. Our data suggested that pre-admission use of GLP-1RA was associated with reduction in mortality rate from Covid-19 in patients with diabetes mellitus (OR 0.53; 95%CI: 0.43 – 0.66, p <0.00001, I 2 = 0%, random-effect modelling). Further analysis showed that the associations were not influenced by age ( p =0.213), gender (p=0.421), hypertension (p=0.131), cardiovascular disease (p=0.293), nor the use of metformin (p=0.189) and insulin (p=0.117). Conclusions Our study suggests that pre-admission use of GLP-1RA may offer beneficial effects on Covid-19 mortality in patients with diabetes mellitus. However, more randomized clinical trials are required to confirm this conclusion.

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Section: Study Selection and Characteristicsmentioning

confidence: 99%

Pre-admission glucagon-like peptide-1 receptor agonist (GLP-1RA) and mortality from coronavirus disease 2019 (Covid-19): A systematic review, meta-analysis, and meta-regression

Hariyanto

Intan

Hananto

et al. 2021

Diabetes Research and Clinical Practice

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“…Out of 946 potentially relevant articles, and following application of inclusion criteria, 32 studies were retained including a total of 44306 participants. The included studies were conducted in Austria [14], Belgium [15], China [16][17][18][19][20][21][22][23][24], France [25][26][27], Hong Kong [28], Iraq [29], Italy [30,31], Russia [32]which determines the high relevance of risk factor analysis for outcomes in DM patients to substantiate the strategy for this category of patients. AIM: To assess the effect of clinical and demographic parameters (age, gender, body mass index (BMI, South Korea [33,34], Spain [35,36], UK [37][38][39][40][41] and USA [42][43][44][45].…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…The severity criteria of the included studies (15) were intensive care unit (ICU) admission (7 studies), acute respiratory distress syndrome (2), mechanical ventilation (3), and CT image / ICU admission / mechanical ventilation (3) (Table 1). And as shown in Figure 3, metformin was not significantly associated with disease severity (OR = 0.85, 95% CI: 0.71-1.02, P = 0.077; 15 studies).…”

Section: Metformin and Risk Of Severe Sars-cov-2 Infectionmentioning

confidence: 99%

Metformin therapy and severity and mortality of SARS-CoV-2 infection: a meta-analysis

Oscanoa

Amado

Vidal³

et al. 2021

Clinical Diabetology

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background. It has been postulated that metformin could have anti-SARS-CoV-2 action. this raises the hypothesis that people who take metformin may have lower SARS-CoV-2 severity and/or mortality. Objectives. to conduct a meta-analysis of the association between the use of Metformin and risk of severity and mortality in SARS-CoV-2 infection. Methods. We searched PubMed, EMbASE, Google scholar, the Cochrane Database of Systematic Reviews and preprint servers (medRxiv and Research Square) for studies published between December 2019 and January 2021. Data was extracted on study location, year of publication, design, number of participants, sex, age at baseline, body mass index, and exposure and outcome definition. Effect statistics were pooled using random effects models with 95% confidence intervals (CI). the quality of included studies was assessed with the Newcastle-Ottawa Scale (NOS). Results. thirty-two observational studies were included, combining to a total sample of 44306 participants. the mean NOS score of included studies was 7.9. Results suggested that metformin use was associated with a reduced risk of SARS-CoV-2 mortality (OR = 0.56, 95% CI: 0.46-0.68, P < 0.001; 22 studies) but not with disease severity (OR = 0.85, 95% CI: 0.71-1.02, P = 0.077; 15 studies). In the subgroup analysis, metformin reduces the risk of mortality (OR = 0.69, 95% CI: 0.55-0.88; P = 0.002) and severity (OR = 0.83, 95% CI: 0.70-0.97, P = 0.023) in patients aged 70 and above. Conclusions. the use of metformin was associated to lower risk of mortality from SARS-CoV-2 infection. this association does not imply causation and further research is required to clarify potential mechanisms.

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“…Other Chines study indicated that pre-metformin use associated with reduction in ICU admission in a dose-dependent way [ 34 ]. In a Belgium Centre the body mass index had no influences in outcome, while the use of metformin on admission had increased survival [ 15 ]. In French patients, the use of metformin prior to admission was lower in patients who died (OR = 0.59), while insulin was found to be associated with death of patients (OR = 1.71) [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

Outcome and death risk of diabetes patients with Covid-19 receiving pre-hospital and in-hospital metformin therapies

Tamura

Said

Freitas

et al. 2021

Diabetol Metab Syndr

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Background COVID-19 has stroke Brazil harshly, deaths by COVID-19 in Brazil represent almost 13% of the total deaths by COVID-19 in the world, even though Brazilian population represents only 2.6% of the world population. Our aim in this study was to evaluate death and intubation outcomes and risk factors associated with COVID-19, and treatment options focusing on diabetes patients and the use of metformin pre-admission and during hospitalization. Methods In this Brazilian single-center study we evaluated 1170 patients hospitalized due to COVID-19. Diabetes patients (n = 188) were divided based on their use of pre-hospital and in-hospital metformin (non-met-group and met-group). Results In the total cohort most comorbidities were risk factors for orotracheal intubation and death. The use of chloroquine/hydroxychloroquine was significantly associated with increased death and intubation risk in uni- and multivariate analysis. Diabetes patients showed worst clinical feature compared with non-diabetes patients. In-hospital non-met-group had increased mortality (20.5%) compared to met-group (3.5%) (p = 0.0002) and univariable cox proportion hazard regression indicated in-hospital metformin reduced mortality (HR = 0.325, p = 0.035). Patients that used pre-hospital metformin showed lower severity parameters at hospital admission. (met-group: 2.45 ± 2.5; non-met-group: 4.25 ± 3.4). In all the groups older patients showed more severe clinical conditions and high risk of death and intubation. Conclusion Even though this is a single-center study, results from other reports have shown a similar trend, indicating that patients that used metformin during hospitalization have a better prognosis and reduced risk of death.

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Clinical characteristics and short-term prognosis of in-patients with diabetes and COVID-19: A retrospective study from an academic center in Belgium

Cited by 35 publications

References 34 publications

Pre-admission glucagon-like peptide-1 receptor agonist (GLP-1RA) and mortality from coronavirus disease 2019 (Covid-19): A systematic review, meta-analysis, and meta-regression

Pre-admission glucagon-like peptide-1 receptor agonist (GLP-1RA) and mortality from coronavirus disease 2019 (Covid-19): A systematic review, meta-analysis, and meta-regression

Metformin therapy and severity and mortality of SARS-CoV-2 infection: a meta-analysis

Outcome and death risk of diabetes patients with Covid-19 receiving pre-hospital and in-hospital metformin therapies

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