Abstract
AimsWe conducted a systematic review and meta-analysis to assess various antidiabetic agents’ association with mortality in patients with type 2 diabetes (T2DM) who have coronavirus disease 2019 (COVID-19).MethodsWe performed comprehensive literature retrieval from the date of inception until February 2, 2021, in medical databases (PubMed, Web of Science, Embase, and Cochrane Library), regarding mortality outcomes in patients with T2DM who have COVID-19. Pooled OR and 95% CI data were used to assess relationships between antidiabetic agents and mortality.ResultsEighteen studies with 17,338 patients were included in the meta-analysis. Metformin (pooled OR, 0.69; P=0.001) and sulfonylurea (pooled OR, 0.80; P=0.016) were associated with lower mortality risk in patients with T2DM who had COVID-19. However, patients with T2DM who had COVID-19 and received insulin exhibited greater mortality (pooled OR, 2.20; P=0.002). Mortality did not significantly differ (pooled OR, 0.72; P=0.057) between DPP-4 inhibitor users and non-users.ConclusionsMetformin and sulfonylurea could be associated with reduced mortality risk in patients with T2DM who have COVID-19. Furthermore, insulin use could be associated with greater mortality, while DPP-4 inhibitor use could not be. The effects of antidiabetic agents in patients with T2DM who have COVID-19 require further exploration.Systematic Review RegistrationPROSPERO (identifier, CRD42021242898).
Highlights
Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, is a serious global public health problem that has affected more than 100 million people worldwide [1]
Metformin and sulfonylurea could be associated with reduced mortality risk in patients with Type 2 diabetes mellitus (T2DM) who have COVID-19
Insulin use could be associated with greater mortality, while DPP-4 inhibitor use could not be
Summary
Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, is a serious global public health problem that has affected more than 100 million people worldwide (as of January 26, 2021) [1]. SARS-CoV-2 exhibits high infectivity, causing rapid spread and associated outbreaks; the mortality of COVID-19 was 61.5% at the onset of the epidemic [2]. Diabetes, characterized by hyperglycemia, is an increasingly common illness worldwide; it is associated with the onset of various complications, including infections. Especially those who have COVID-19, are vulnerable to the onset of severe disease. In a study of 1000 COVID-19 patients, diabetes was present in 16.2% of patients with severe disease; the final outcomes of these patients were mechanical ventilation and/or mortality [5]
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