Evidence map›Paper›PMID 33309936›Full record

Observational studyDiabetes & metabolism2021

Metformin use is associated with a reduced risk of mortality in patients with diabetes hospitalised for COVID-19.

Jean-Daniel Lalau, Abdallah Al-Salameh, Samy Hadjadj, Thomas Goronflot, Nicolas Wiernsperger, Matthieu Pichelin, Ingrid Allix, Coralie Amadou, Olivier Bourron, Thierry Duriez and 24 more

Open access · greenAbstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Diabetes & metabolism, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 61 papers, 12 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
61citing papers in PubMed, 12 pooled it
9.9field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

61 citing papers in PubMed, 12 syntheses or guidelines pooled it, 93 citations in OpenAlex.

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  20. Coordination chemistry suggests that independently observed benefits of metformin and ZnBiometals : an international journal on the role of metal ions in biology, biochemistry, and medicine · 2024
    Article

1 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

34 authors at 20 institutions in 2 countries.

Jean-Daniel LalauDepartment of Endocrinology, Diabetes Mellitus and Nutrition, Amiens University Hospital, 80054 Amiens, France; PériTox = UMR_I 01, University of Picardie Jules Verne, Amiens, France. Electronic address: Lalau.Jean-Daniel@chu-amiens.fr.
Abdallah Al-SalamehDepartment of Endocrinology, Diabetes Mellitus and Nutrition, Amiens University Hospital, 80054 Amiens, France; PériTox = UMR_I 01, University of Picardie Jules Verne, Amiens, France. Electronic address: Al-Salameh.Abdallah@chu-amiens.fr.
Samy HadjadjDépartement d'Endocrinologie, Diabétologie et Nutrition, l'institut du Thorax, Inserm, CNRS, UNIV Nantes, CHU Nantes, Hôpital Guillaume et René Laennec, 44093 Nantes Cedex 01, France.
Thomas GoronflotData Clinic, INSERM, CIC 1413, PHU 11, Nantes University Hospital, Nantes, France.
Nicolas WiernspergerAssociation REMEDES, Ville-sur-Jarnioux, France.
Matthieu PichelinDépartement d'Endocrinologie, Diabétologie et Nutrition, l'institut du Thorax, Inserm, CNRS, UNIV Nantes, CHU Nantes, Hôpital Guillaume et René Laennec, 44093 Nantes Cedex 01, France.
Ingrid AllixDépartement d'Endocrinologie, Diabétologie, Nutrition, CHU Angers, Angers, France.
Coralie AmadouDépartement de Diabétologie, Centre Hospitalier Sud Francilien, Corbeil Essonne, France.
Olivier BourronSorbonne Université, Assistance Publique Hôpitaux de Paris, Département de Diabétologie, CHU La Pitié Salpêtrière-Charles Foix, Inserm, UMR_S 1138, Centre de Recherche des Cordeliers, Paris 06, Institute of Cardiometabolism and Nutrition ICAN, Paris, France.
Thierry DuriezService D'Endocrinologie, Diabétologie, CH Cholet, Cholet, France.
Jean-François GautierDépartement Diabète et Endocrinologie, Hôpital Lariboisière, Assistance Publique Hôpitaux de Paris, Paris, France.
Anne DutourDépartement d'Endocrinologie et de Diabétologie, Hôpital Nord, Assistance Publique Hôpitaux de Marseille, Marseille, France.
Céline GonfroyService d'Endocrinologie, Diabétologie, CH de Pontoise, Pontoise, France.
Didier GouetService de Diabétologie, Endocrinologie, Centre Hospitalier de la Rochelle, La Rochelle, France.
Michael JoubertService Diabétologie-endocrinologie, CHU Caen, Caen, France.
Ingrid JulierCH de Ales, Ales, France.
Etienne LargerUniversité de Paris and AP-HP, Centre Hospitalier Universitaire de Paris, Cochin Hospital, Paris, France.
Lucien MarchandDépartement d'Endocrinologie et de Diabétologie, Centre Hospitalier St. Joseph - St. Luc, Lyon, France.
Michel MarreClinique Ambroise Paré Neuilly-sur-Seine, Centre de Recherches des Cordelier, Université Paris Diderot, Paris, France.
Laurent MeyerService d'Endocrinologie, Diabète et Nutrition, HUS - Hôpital Civil, Strasbourg, France.
Frédérique OlivierService de Diabétologie, Centre Hospitalier de Cahors, Cahors, France.
Gaëtan PrevostDépartement d'Endocrinologie, Diabétologie et Maladies Métaboliques, CHU de Rouen, Université de Rouen, Rouen, France.
Pascale QuiniouCHU de Brest, Brest, France.
Christelle Raffaitin-CardinCH Robet Boulin de Libourne, Libourne, France.
Ronan RousselDépartement d'Endocrinologie, Diabétologie et Nutrition, Hôpital Bichat, Assistance Publique Hôpitaux de Paris, Centre de Recherche des Cordeliers, Inserm, U-1138, Université de Paris, Paris, France.
Pierre-Jean SaulnierCentre d'Investigation Clinique CIC 1402, Université de Poitiers, Inserm, CHU de Poitiers, Poitiers, France.
Dominique Seret-BegueService de Diabétologie, CH Gonesse, Gonesse, France.
Charles ThivoletCentre du Diabète DIAB-eCARE, Hospices Civils de Lyon et Laboratoire CarMeN, Inserm, INRA, INSA, Université Claude Bernard Lyon 1, Lyon, France.
Camille VatierAssistance Publique Hôpitaux de Paris, Saint-Antoine Hospital, Reference Center of Rare Diseases of Insulin Secretion and Insulin Sensitivity (PRISIS), Department of Endocrinology, Paris, France.
Rachel DesailloudDepartment of Endocrinology, Diabetes Mellitus and Nutrition, Amiens University Hospital, 80054 Amiens, France; PériTox = UMR_I 01, University of Picardie Jules Verne, Amiens, France.
Matthieu WargnyData Clinic, INSERM, CIC 1413, PHU 11, Nantes University Hospital, Nantes, France.
Pierre GourdyDépartement d'Endocrinologie, Diabétologie et Nutrition, CHU Toulouse, Institut des Maladies Métaboliques et Cardiovasculaires, UMR1048 Inserm/UPS, Université de Toulouse, Toulouse, France.
Bertrand CariouDépartement d'Endocrinologie, Diabétologie et Nutrition, l'institut du Thorax, Inserm, CNRS, UNIV Nantes, CHU Nantes, Hôpital Guillaume et René Laennec, 44093 Nantes Cedex 01, France.
CORONADO investigators
Inserm · FRCentre National de la Recherche Scientifique · FRAssistance Publique – Hôpitaux de Paris · FRCentre Hospitalier Universitaire Amiens-Picardie · FRUniversité Paris Cité · FRADIR Association · FRAssistance Publique Hôpitaux de Marseille · FRBP (France) · FRCentre Hospitalier de Gonesse · FRCentre Hospitalier de La Rochelle · FRCentre Hospitalier de Lens · FRCentre Hospitalier Régional Universitaire de Brest · FRCentre Hospitalier Saint-Joseph Saint-Luc · FRCentre Hospitalier Sud Francilien · FRCentre Hospitalier Universitaire d'Angers · FRCentre Hospitalier Universitaire de Caen Normandie · FRHôpital Civil, Strasbourg · FRIMT Mines Alès · FRLeTourneau University · USPérinatalité & Risques Toxiques · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsMetformin exerts anti-inflammatory and immunosuppressive effects. We addressed the impact of prior metformin use on prognosis in patients with type 2 diabetes hospitalised for COVID-19.

methodsCORONADO is a nationwide observational study that included patients with diabetes hospitalised for COVID-19 between March 10 and April 10, 2020 in 68 French centres. The primary outcome combined tracheal intubation and/or death within 7 days of admission. A Kaplan-Meier survival curve was reported for death up to day 28. The association between metformin use and outcomes was then estimated in a logistic regression analysis after applying a propensity score inverse probability of treatment weighting approach.

resultsAmong the 2449 patients included, 1496 were metformin users and 953 were not. Compared with non-users, metformin users were younger with a lower prevalence of diabetic complications, but had more severe features of COVID-19 on admission. The primary endpoint occurred in 28.0% of metformin users (vs 29.0% in non-users, P =  0.6134) on day 7 and in 32.6% (vs 38.7%, P = 0.0023) on day 28. The mortality rate was lower in metformin users on day 7 (8.2 vs 16.1%, P <  0.0001) and on day 28 (16.0 vs 28.6%, P < 0.0001). After propensity score weighting was applied, the odds ratios for primary outcome and death (OR [95%CI], metformin users vs non-users) were 0.838 [0.649-1.082] and 0.688 [0.470-1.007] on day 7, then 0.783 [0.615-0.996] and 0.710 [0.537-0.938] on day 28, respectively.

conclusionMetformin use appeared to be associated with a lower risk of death in patients with diabetes hospitalised for COVID-19.

Indexed as

AgedAged, 80 and overCOVID-19Diabetes Mellitus, Type 2FemaleHospitalizationHumansHypoglycemic AgentsMaleMetforminMiddle AgedPropensity ScoreRespiration, ArtificialHypoglycemic AgentsMetforminCOVID-19DeathMechanical ventilationMetforminPropensity scoreType 2 diabetes

Identifiers

PMID33309936
PMCPMC7832745
OpenAlexW3111023021

What Socratic holds

Texttitle and abstract
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.