In a new study, the drug metformin significantly reduced the risk of death from COVID-19 in people with diabetes.
- When analyzing data from a diverse patient population, the researchers found that people who took metformin, a drug used for type 2 diabetes, were less likely to die from COVID-19 than those who did not receive metformin.
- Their study also highlighted the fact that black people made up a disproportionately large number of those who tested positive for COVID-19.
- According to the researchers, this inequality is likely due to socio-economic factors, lack of access to health care, and a higher risk of SARS-CoV-2 exposure among black populations.
Researchers have found that people with diabetes who undergo treatment with the drug metformin have a significantly lower risk of death from COVID-19 than people who do not take 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 the risk factors that increase the likelihood that a person will either get SARS-CoV-2 infection or die of COVID-19 if they develop it.
SARS-CoV-2 is a novel coronavirus, and while it shares some similarities with other coronaviruses, researchers still have a lot to find out about how and why it affects some people more than others and how the risks can be reduced.
Studies have begun to establish the connections between specific health problems, demographic characteristics and the chances of developing SARS-CoV-2 or dying from COVID-19. This research supports early anecdotal evidence and observational studies.
The more studies convincingly prove these relationships, the more robust the overall results. Meta-analyzes of the available scientific literature can then show the big picture.
In the present study, researchers were interested in examining patient characteristics associated with COVID-19 in populations of the United States, which included many blacks.
The researchers note that blacks tend to be at higher risk of major comorbidities that could increase their chances of developing COVID-19, including diabetes.
The researchers also highlight that COVID-19 disproportionately affects African Americans as well as various marginalized groups – results that reflect pre-existing widespread health inequalities resulting from systemic racism.
Researchers conducted a retrospective observational study examining 25,326 people tested for COVID-19 between February 25 and June 22, 2020 at the University of Alabama at Birmingham Hospital (UAB).
The researchers looked at 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 believe is a relatively low rate. They speculate that this could be due to the number of asymptomatic hospital staff and patients who receive voting procedures that have been tested.
The authors point out that despite the fact that 26% of the Alabama population is black, they represented 52% of those who tested positive for COVID-19.
However, the death rate from COVID-19 in black patients was not significantly different from that in white patients.
Prof. Anath Shalev, director of the UAB’s Comprehensive Diabetes Center and head of the study, said: “In our cohort, being African-American appeared to be a primary risk factor for contracting COVID-19, rather than mortality. This suggests that the racial differences observed are likely due to exposure risk and external socio-economic factors, including access to adequate health care. “
Of the people who tested positive for COVID-19, 70% had high blood pressure, 61% were obese, and 40% had diabetes.
Of the patients who tested positive for COVID-19, 11% died. In 93% of the cases, the person who died was over 50 years old.
The researchers also found that masculinity and high blood pressure were linked to an increased risk of death from COVID-19.
People with diabetes accounted for 67% of deaths, suggesting that this condition had a particularly significant impact on the risk of death.
The researchers then analyzed the data to consider possible covariates that may affect other risk factors. They identified age, gender, and diabetes as key independent risk factors for death from COVID-19.
Finally, the researchers took a closer look at people with diabetes. They found that those who tested positive and were taking metformin – a drug that doctors use to treat diabetes – had an 11% risk of death, the same as the general population. In comparison, people with diabetes who did not take metformin had a 24% risk of death.
Prof. Shalev notes: “This positive effect persisted even after correcting for age, gender, race, obesity and high blood pressure or chronic kidney disease and heart failure.”
“Since then, similar results have been seen in different populations around the world – including China, France and a [UnitedHealth] Analysis – This suggests that the observed reduction in mortality risk associated with metformin use in patients with type 2 diabetes and COVID-19 may be generalizable. “
– Prof. Anath Shalev
The researchers couldn’t confirm why metformin might have these effects. As a diabetes treatment, it could improve blood sugar control or improve obesity.
However, among diabetics who took metformin, body mass index (BMI), blood sugar levels, and hemoglobin A1C levels were no higher in the deceased than in the survivors.
As a result, Prof. Shalev suggests that “[t]The mechanisms may include the anti-inflammatory and antithrombotic effects of metformin described above. “
To further develop the results, the researchers suggest that future research should investigate why metformin can have this protective effect, and the risks and benefits of prescribing the drug to protect against COVID-19.
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