Evidence mapPaperPMID 39299975Full record

ArticleJournal of general internal medicine2024

Preadmission Metformin Use Is Associated with Reduced Mortality in Patients with Diabetes Mellitus Hospitalized with COVID-19.

David C Harmon, Jacqueline A Levene, Christine L Rutlen, Elizabeth S White, Ilana R Freeman, Jodi A Lapidus

Abstract read
In one paragraph

Article in Journal of general internal medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
field-weighted citation impact
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

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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

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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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

6 authors.

David C Harmon *Department of Medicine, Oregon Health & Science University, Portland, OR, USA. harmodav@ohsu.edu.ORCID 0000-0002-4181-0179
Jacqueline A Levene *Department of Medicine, Oregon Health & Science University, Portland, OR, USA.
Christine L RutlenDepartment of Medicine, Oregon Health & Science University, Portland, OR, USA.
Elizabeth S WhiteOregon Health & Science University - Portland State University (OHSU-PSU) School of Public Health, Portland, OR, USA.
Ilana R FreemanOregon Health & Science University - Portland State University (OHSU-PSU) School of Public Health, Portland, OR, USA.
Jodi A LapidusOregon Health & Science University - Portland State University (OHSU-PSU) School of Public Health, Portland, OR, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundObservational studies have reported an association between metformin and improved outcomes in COVID-19, but most have been small and with significant limitations.

objectiveTo evaluate the association between preadmission metformin exposure and mortality in patients with diabetes mellitus hospitalized with coronavirus disease 2019 (COVID-19) infection.

designRetrospective cohort analysis using electronic health records extracted from the American Heart Association COVID-19 Registry.

participantsAdults (n = 11,993) with diabetes mellitus but without chronic kidney disease (CKD) or need for hemodialysis who were hospitalized with COVID-19 between January 25, 2020, and February 9, 2022. MAIN MEASURES: We used propensity score modeling to address differences between metformin and non-metformin users prior to multivariable log-binomial models to examine the association between metformin use at time of hospital admission for COVID-19 infection and in-hospital death; composite of in-hospital death or discharge to hospice; composite of in-hospital death, discharge to hospice, or ICU admission; and composite of in-hospital death, discharge to hospice, ICU admission, or mechanical ventilation. KEY

resultsCompared to metformin non-use, pre-admission metformin use was associated with lower risk of in-hospital death (risk ratio (RR) 0.81 [95% CI 0.75-0.90]); composite of in-hospital death or discharge to hospice (RR 0.79 [95% CI 0.74-0.87]); composite of in-hospital death, discharge to hospice, or ICU admission (RR 0.90 [95% CI 0.86-0.95]); and composite of in-hospital death, discharge to hospice, ICU admission, or mechanical ventilation (RR 0.9 [95% CI 0.84-0.98]). Metformin use was also associated with lower risk of death due to respiratory cause (RR 0.86 [95% CI 0.74-0.97]) but not cardiovascular (RR 0.84 [95% CI 0.58-1.2]) or other (RR 0.78 [95% CI 0.60-1.0]) causes.

conclusionsPre-admission metformin use was associated with lower risk of in-hospital mortality and markers of disease severity among adults with diabetes mellitus without CKD and not requiring hemodialysis who were hospitalized with COVID-19 infection.

Indexed as

COVID-19Diabetes MellitusHospitalizationHospital MortalityHypoglycemic AgentsMetforminAgedAged, 80 and overFemaleHumansMaleMiddle AgedRetrospective StudiesSARS-CoV-2Hypoglycemic AgentsMetforminCOVID-19diabetes mellitusmetforminmortality

Identifiers

PMID39299975
PMCPMC11618542

What Socratic holds

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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.