In a new study, the drug metformin significantly reduced the risk of death from COVID-19 in people with diabetes.
- By analyzing data from a diverse patient population, the researchers found that individuals taking metformin, a type 2 diabetes medication, were less likely to die from COVID-19 than those not taking metformin.
- The study also highlighted the fact that blacks constituted a disproportionate number of people who tested positive for COVID-19.
- According to the researchers, this disparity is probably due to socioeconomic factors, lack of access to healthcare and an increased risk of exposure to SARS-CoV-2 among black populations.
The researchers found that people with diabetes being treated with the drug metformin are at significantly lower risk of death from COVID-19 compared to those who are not taking the drug.
The study, which appears in the journal Frontiers in Endocrinology, also found that African American study participants were disproportionately more likely to contract the virus than white participants.
A critical area of COVID-19 research has focused on risk factors that can make a person more likely to contract a SARS-CoV-2 infection or die from COVID-19 if it develops.
SARS-CoV-2 is a new coronavirus and, although it has some similarities to other coronaviruses, there is still much that researchers still need to find out about how and why it affects some people more than others and how to mitigate the risks.
Studies have started to emerge showing associations between specific health problems, demographic characteristics and the chances of contracting SARS-CoV-2 or dying of COVID-19. This research supports anecdotal evidence and previous observational studies.
The more studies that provide convincing evidence for these links, the more robust the overall conclusions will be. Meta-analyzes of the available scientific literature can then demonstrate the big picture.
In the present study, the researchers were interested in exploring the characteristics of patients associated with COVID-19 in populations in the United States that included many blacks.
The researchers note that blacks tend to be at higher risk for major comorbidities that may make them more likely to develop COVID-19, including diabetes.
The researchers also point out that COVID-19 disproportionately affects African Americans, as well as several marginalized groups – findings that reflect the widespread health inequalities that already exist as a result of systemic racism.
The researchers conducted a retrospective observational study, looking at 25,326 people who took the test for COVID-19 at the University of Alabama at Birmingham (UAB) Hospital between February 25 and June 22, 2020.
The researchers analyzed data from unidentified electronic health records to provide demographic and medical information for each person.
A total of 604 people tested positive for COVID-19, which the researchers found to be a relatively low rate. They speculate that this may be due to the number of asymptomatic hospital staff and patients receiving elective procedures that have undergone examinations.
The authors point out that, despite the fact that blacks constitute 26% of the population of Alabama, they represented 52% of those who tested positive for COVID-19.
However, the mortality rate due to COVID-19 in black patients was not significantly different than in white patients.
According to the teacher. Anath Shalev, director of the UAB Comprehensive Diabetes Center and study leader: “In our cohort, being African-American seemed to be primarily a risk factor for contracting COVID-19, rather than mortality. This suggests that any racial disparities observed are likely due to the risk of exposure and external socioeconomic factors, including access to adequate health care. “
Of the people who tested positive for COVID-19, 70% had hypertension, 61% obesity and 40% diabetes.
Of the patients who tested positive for COVID-19, 11% died. In 93% of cases, the person who died was over 50 years old.
The researchers also found that being male and having hypertension were associated with an increased risk of death from COVID-19.
People with diabetes were responsible for 67% of deaths, suggesting that this condition had a particularly significant effect on the risk of death.
The researchers then analyzed the data to take into account potential covariates that may affect other risk factors. They identified age, sex and diabetes as the main independent risk factors for death due to COVID-19.
Finally, the researchers looked more closely at people with diabetes. They found that those with a positive test who took metformin – a drug that doctors use to treat diabetes – had an 11% risk of dying, the same as that of the general population. In comparison, those with diabetes who did not take metformin had a 24% risk of dying.
Prof Shalev notes: “This beneficial effect remained, even after correcting for age, sex, race, obesity and hypertension or chronic kidney disease and heart failure”.
“Since similar results have been obtained in different populations around the world – including China, France and a [UnitedHealth] analysis – this suggests that the observed reduction in the risk of mortality associated with the use of metformin in individuals with type 2 diabetes and COVID-19 may be generalizable. “
– Prof. Anath Shalev
The researchers could not confirm why metformin may be having these effects. As a treatment for diabetes, it can improve glycemic control or obesity.
However, among those with diabetes who took metformin, body mass index (BMI), blood glucose levels and hemoglobin A1C levels were not higher in people who died than in those who survived.
As a consequence, Prof. Shalev suggests that “[t]The mechanisms may involve the previously described anti-inflammatory and antithrombotic effects of metformin. “
To further develop the results, the researchers suggest that future research should examine why metformin may have this protective effect and the possible risks and benefits of prescribing the drug to protect against COVID-19.
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