Diabetes, Metformin and the Clinical Course of Covid-19: Outcomes, Mechanisms and Suggestions on the Therapeutic Use of Metformin

Bailey, Clifford J.; Gwilt, Mike

doi:10.3389/fphar.2022.784459

Cited by 36 publications

(28 citation statements)

References 134 publications

(251 reference statements)

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“…Therefore, metformin is not the proper therapy in patients with severe respiratory distress, renal impairment, or heart failure. The evidence supports the use of metformin when COVID-19 infection is not severe (95). In critically ill patients with COVID-19, metformin should be discontinued (95,98).…”

Section: Metforminmentioning

confidence: 81%

“…The evidence supports the use of metformin when COVID-19 infection is not severe (95). In critically ill patients with COVID-19, metformin should be discontinued (95,98).…”

Section: Metforminmentioning

confidence: 81%

“…The mechanism is not clear, but several hypotheses have been proposed. First, it increases the expression and phosphorylation of ACE2, a change that decreases SARS-CoV-2 binding to ACE2 (95). Indeed, AMPK, a target of metformin, acts on the expression and stability of ACE2 (118).…”

Section: Metforminmentioning

confidence: 99%

“…In a retrospective study, Li et al reported that the use of metformin both prior to hospitalization and during treatment in hospital is significantly associated with lower mortality in COVID-19 patients with type 2 diabetes (97). Similarly, treatment with metformin at the time of hospitalization with COVID-19 infection appears to have better outcomes in terms of reduced need for intensive care (95). It is important to note that metformin presents several side effects…”

Section: Metforminmentioning

confidence: 99%

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COVID-19 and diabetes—Two giants colliding: From pathophysiology to management

et al. 2022

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Since December 2019, a new coronavirus, called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread around the world, causing the coronavirus 2019 (COVID-19) pandemic. From the beginning, SARS-CoV-2 has put a strain on the health system. In fact, many patients have had severe forms of the disease with the need for hospitalization due to respiratory failure. To contain the pandemic, the most widely used approach has been lockdowns. Social restrictions have been reduced thanks to the development of vaccines and targeted therapies. However, fatal events still occur among people at high risk of serious infection, such as patients with concomitant diabetes. Different mechanisms have been proposed to explain the poor prognosis of patients with diabetes and COVID-19, but the specific cause is unclear. It is now known that insulin resistance, inflammation, and cytokine storm are involved. Moreover, SARS-CoV-2 uses the angiotensin-converting enzyme 2 receptors to enter cells. This receptor is expressed on pancreatic beta cells and, during infection, it appears that receptor involvement may induce hyperglycemia in patients with or without diabetes. In this study, we discuss the mechanisms underlying the poor prognosis in people with COVID-19 and diabetes and what may improve the outcome in these patients.

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Section: Metforminmentioning

confidence: 81%

“…The evidence supports the use of metformin when COVID-19 infection is not severe (95). In critically ill patients with COVID-19, metformin should be discontinued (95,98).…”

Section: Metforminmentioning

confidence: 81%

Section: Metforminmentioning

confidence: 99%

Section: Metforminmentioning

confidence: 99%

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COVID-19 and diabetes—Two giants colliding: From pathophysiology to management

et al. 2022

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“… 113 This suggestion is indeed supported by several retrospective analyses that showed metformin reduced admission into intensive care, and mortality, especially in diabetic women. 114–116 …”

Section: Immunomodulatorsmentioning

confidence: 99%

Current Strategies in Treating Cytokine Release Syndrome Triggered by Coronavirus SARS-CoV-2

Wang¹,

Wang²

2022

ITT

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Since the beginning of the SARS-CoV-2 pandemic, the treatments and management of the deadly COVID-19 disease have made great progress. The strategies for developing novel treatments against COVID-19 include antiviral small molecule drugs, cell and gene therapies, immunomodulators, neutralizing antibodies, and combination therapies. Among them, immunomodulators are the most studied treatments. The small molecule antiviral drugs and immunoregulators are expected to be effective against viral variants of SARS-CoV-2 as these drugs target either conservative parts of the virus or common pathways of inflammation. Although the immunoregulators have shown benefits in reducing mortality of cytokine release syndrome (CRS) triggered by SARS-CoV-2 infections, extensive investigations on this class of treatment to launch novel therapies that substantially improve efficacy and reduce side effects are still warranted. Moreover, great challenges have emerged as the SARS-CoV-2 virus quickly, frequently, and continuously evolved. This review provides an update and summarizes the recent advances in the treatment of COVID-19 and in particular emphasized the strategies in managing CRS triggered by SARS-CoV-2. A brief perspective in the battle against the deadly disease was also provided.

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Investigating the impact of metformin on severity of COVID‐19 in patients with Type 2 diabetes mellitus: Focusing on laboratory findings

Taheri

Shahrokhi

Amjadi

et al. 2023

Endocrino Diabet & Metabol

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BackgroundIn the terrifying pandemic caused by SARS‐CoV‐2, diabetic patients exhibiting more severe outcomes and mortality rate is high among them. Based on recent studies, metformin as the most prescribed drug for T2DM treatment may improve severe outcomes in diabetic patients infected with SARS‐CoV‐2. On the other hand, abnormal laboratory findings can help to differentiate between the severe and non‐severe form of COVID‐19. According to the mentioned issues, the effect of metformin on severity of COVID‐19 was examined in T2DM patients with SARS‐CoV‐2 infection.MethodsThe study included 187 individuals diagnosed with COVID‐19, 104 patients were diabetic and divided into two groups according to their anti‐diabetic drugs: patients who were treated only with metformin and patients who were treated with other anti‐diabetic drugs. The other participants were non‐diabetic and diagnosed with COVID‐19. Biochemical parameters were measured by routine laboratory methods before, during and after SARS‐CoV‐2 infection.ResultsDuring infection, FBS, creatinine, ALT, AST, Ferritin and LDH were significantly lower in metformin users than non‐users (p‐value: .02, .01, .03, .04, .0009 and .01, respectively). Also, after recovery, there were statistically significant differences between metformin users and non‐users with respect to most of the study parameters, except FBS, BUN and ALP (p‐value: .51, .28 and .35, respectively).ConclusionOur result suggested that metformin might be associated with better outcomes in diabetic patients infected with SARS‐CoV‐2.

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Diabetes, Metformin and the Clinical Course of Covid-19: Outcomes, Mechanisms and Suggestions on the Therapeutic Use of Metformin

Cited by 36 publications

References 134 publications

COVID-19 and diabetes—Two giants colliding: From pathophysiology to management

COVID-19 and diabetes—Two giants colliding: From pathophysiology to management

Current Strategies in Treating Cytokine Release Syndrome Triggered by Coronavirus SARS-CoV-2

Investigating the impact of metformin on severity of COVID‐19 in patients with Type 2 diabetes mellitus: Focusing on laboratory findings

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