Article Sidebar

Submitted
5 July 2023
Accepted
13 November 2023
Published
10 September 2023
Download
PDF
Statistic
Read Counter : 187 Download : 106

Main Article Content

Abstract

Highlights:


1. As there is a scarcity of publications on the use of metformin for COVID-19 in Indonesia, the findings of this present study may contribute more insight to the existing body of research and provide data specific to the Southeast Asian population.
2. This study revealed a decreased mortality rate associated with metformin use in diabetic patients with mild to moderate COVID-19 infection.
3. This study suggests that diabetic patients may continue metformin treatment during a COVID-19 infection as the medication has sustained therapeutic effects.


 


Abstract


COVID-19 patients with comorbidities, such as type 2 diabetes (T2DM), have a higher mortality rate compared to those without any comorbidities. T2DM patients usually receive metformin as their first-line treatment. However, the effectiveness of metformin in reducing mortality rates still requires further analysis. The objective of this study was to analyze the effectiveness of metformin in reducing mortality rates among COVID-19 patients with T2DM. An analytic observational design with a retrospective cohort approach was used in this study. Samples were acquired from hospitalized COVID-19 patients with T2DM medical records at Fatmawati Central General Hospital, Jakarta, Indonesia, throughout 2020–2021. The samples were collected using a purposive sampling technique and analyzed using Chi-square test (p<0.05; RR<1). This study comprised 137 samples, with 56 samples receiving metformin and 81 not receiving metformin. The mortality rate in the sample group that received metformin was lower (19.6%) compared to the group that was not given the medication (38.3%). The Chi-square test results indicated a statistically significant relationship between metformin treatment and a lower mortality rate among COVID-19-contracted individuals with T2DM (p=0.020; RR=0.513). Therefore, this study concludes that the administration of metformin treatment reduces mortality among COVID-19 patients with T2DM.

Keywords

Comorbidity COVID-19 Metformin Mortality Type 2 Diabetes Mellitus

Article Details

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

Author Biographies

Yudivaniel Zihono, Faculty of Medicine, Universitas Pembangunan Nasional “Veteran” Jakarta, Jakarta, Indonesia

 

 

 

Hany Yusmaini, Department of Pharmacology, Faculty of Medicine, Universitas Pembangunan Nasional “Veteran” Jakarta, Jakarta, Indonesia

 

 

Uswatun Hasanah, Department of Molecular Biology, Faculty of Medicine, Universitas Pembangunan Nasional “Veteran” Jakarta, Jakarta, Indonesia

 

 

 

Erna Harfiani, Faculty of Medicine Universitas Pembangunan Nasional "Veteran" Jakarta

 

 

 

Md Ikhsan Mokoagow, Division of Endocrinology, Metabolism, and Diabetes, Department of Internal Medicine, Fatmawati Central General Hospital, Jakarta, Indonesia

 

 

 

How to Cite
Yudivaniel Zihono, Hany Yusmaini, Uswatun Hasanah, Erna Harfiani, Md Ikhsan Mokoagow, & Dicky Budiman. (2023). Metformin Effectiveness in Reducing Mortality among Covid-19 Patients with Type 2 Diabetes Mellitus at a Tertiary Hospital in Indonesia. Folia Medica Indonesiana, 59(3), 267–273. https://doi.org/10.20473/fmi.v59i3.46944
Download Citation
Endnote/Zotero/Mendeley (RIS)
BibTeX

References

  1. Alexaki VI, Henneicke H (2021). The role of glucocorticoids in the management of COVID-19. Hormone and Metabolic Research 53, 9–15. doi: 10.1055/a-1300-2550.
  2. Bramante CT, Ingraham NE, Murray TA, et al (2021). Metformin and risk of mortality in patients hospitalised with COVID-19: a retrospective cohort analysis. The Lancet Healthy Longevity 2, e34–41. doi: 10.1016/S2666-7568(20)30033-7.
  3. Burhan E, Susanto AD, Isbaniah F, et al (2022). Pedoman tatalaksana COVID-19 edisi 4, 4th edn. Jakarta. Available at: https://www.slideshare.net/ CIkumparan/buku-tatalaksana-covid19-5-op-edisi-4-jan-2022.
  4. Bwire GM (2020). Coronavirus: Why men are more Vulnerable to Covid-19 than women? SN Comprehensive Clinical Medicine 2, 874–876. doi: 10.1007/s42399-020-00341-w.
  5. Carfora V, Spiniello G, Ricciolino R, et al (2021). Anticoagulant treatment in COVID-19: a narrative review. Journal of Thrombosis and Thrombolysis 51, 642–648. doi: 10.1007/s11239-020-02242-0.
  6. Centers for Disease Control and Prevention (2023). About COVID-10. CDC. Available at: https://www.cdc.gov/coronavirus/2019-ncov/your -health/about-covid-19.html#:~:text=COVID-19 most often causes,some people become severely ill.
  7. El Chakhtoura NG, Bonomo RA, Jump RLP (2017). Influence of aging and environment on presentation of infection in older adults. Infectious Disease Clinics of North America 31, 593–608. doi: 10.1016/j.idc.2017.07.017.
  8. Chen Y, Lv X, Lin S, et al (2022). The association between antidiabetic agents and clinical outcomes of COVID-19 patients with diabetes: A bayesian network meta-analysis. Frontiers in Endocrinology (Lausanne). doi: 10.3389/fendo.2022.895458.
  9. Cheng X, Liu Y-M, Li H, et al (2020). Metformin is associated with higher incidence of acidosis, but not mortality, in individuals with COVID-19 and pre-existing type 2 diabetes. Cell Metabolism 32, 537-547.e3. doi: 10.1016/j.cmet.2020.08.013.
  10. Giorgino F, Bhana S, Czupryniak L, et al (2021). Management of patients with diabetes and obesity in the COVID-19 era: Experiences and learnings from South and East Europe, the Middle East, and Africa. Diabetes Research and Clinical Practice 172, 108617. doi: 10.1016/j.diabres.2020.108617.
  11. Groff A, Kavanaugh M, Ramgobin D, et al (2021). Gastrointestinal manifestations of COVID-19: A review of what we know. Ochsner Journal 21, 177–180. doi: 10.31486/toj.20.0086.
  12. Harbuwono DS, Handayani DOTL, Wahyuningsih ES, et al (2022). Impact of diabetes mellitus on COVID-19 clinical symptoms and mortality: Jakarta’s COVID-19 epidemiological registry. Primary Care Diabetes 16, 65–68. doi: 10.1016/j.pcd.2021.11.002.
  13. Holly JMP, Biernacka K, Maskell N, et al (2020). Obesity, diabetes and COVID-19: An infectious disease spreading from the east collides with the consequences of an unhealthy western lifestyle. Frontiers in Endocrinology (Lausanne). doi: 10.33 89/fendo.2020.582870.
  14. Inzucchi SE (2023). Management of diabetes mellitus in hospitalized patients. UpToDate. Available at: https://www.uptodate.com/contents /management-of-diabetes-mellitus-in-hospitalized -patients#H9.
  15. Jiang N, Chen Z, Liu L, et al (2021). Association of metformin with mortality or ARDS in patients with COVID-19 and type 2 diabetes: A retrospective cohort study. Diabetes Research and Clinical Practice 173, 108619. doi: 10.1016/j.diabr es.2020.108619.
  16. John TM, Jacob CN, Kontoyiannis DP (2021). When uncontrolled diabetes mellitus and severe COVID-19 converge: The perfect storm for mucormycosis. Journal of Fungi 7, 298. doi: 10.3390/jof7040298.
  17. Kamyshnyi O, Matskevych V, Lenchuk T, et al (2021). Metformin to decrease COVID-19 severity and mortality: Molecular mechanisms and therapeutic potential. Biomedicine & Pharmacotherapy 144, 112230. doi: 10.1016/j. biopha.2021.112230.
  18. Kan C, Zhang Y, Han F, et al. (2021). Mortality risk of antidiabetic agents for type 2 diabetes with COVID-19: A systematic review and meta-analysis. Frontiers in Endocrinology (Lausanne). doi: 10.3389/fendo.2021.708494.
  19. Kristanti W, Yulia R, Herawati F (2022). Analysis of antibiotic use in COVID-19 patients at a hospital in Sidoarjo. Jurnal Farmasi dan Ilmu Kefarmasian Indonesia 9, 200–208. doi: 10.20473/jfiki.v9i22022.200-208.
  20. Kshanti IA, Aji G, Epriliawati M, et al (2020). Clinical presentation and outcome of COVID-19 infection in Type 2 Diabetes Mellitus: a preliminary data from a tertiary hospital in Jakarta during the early days of the pandemic. Bali Medical Journal 9, 787–793. doi: 10.15562/bmj .v9i3.1969.
  21. Lally MA, Tsoukas P, Halladay CW, et al (2021). Metformin is associated with decreased 30-day mortality among nursing home residents infected with SARS-CoV2. Journal of the American Medical Directors Association 22, 193–198. doi: 10.1016/j.jamda.2020.10.031.
  22. Li J, Wei Q, McCowen KC, et al (2022). Inpatient use of metformin and acarbose is associated with reduced mortality of COVID‐19 patients with type 2 diabetes mellitus. Endocrinology, Diabetes & Metabolism. doi: 10.1002/edm2.301.
  23. Luo P, Qiu L, Liu Y, et al (2020). Metformin treatment was associated with decreased mortality in COVID-19 patients with diabetes in a retrospective analysis. The American Journal of Tropical Medicine and Hygiene 103, 69–72. doi: 10.4269/ajtmh.20-0375.
  24. Mirani M, Favacchio G, Carrone F, et al (2020). Impact of comorbidities and glycemia at admission and dipeptidyl peptidase 4 inhibitors in patients with Type 2 Diabetes With COVID-19: A case series from an Academic Hospital in Lombardy, Italy. Diabetes Care 43, 3042–3049. doi: 10.2337/dc20-1340.
  25. Nguyen NN, Ho DS, Nguyen HS, et al (2022). Preadmission use of antidiabetic medications and mortality among patients with COVID-19 having type 2 diabetes: A meta-analysis. Metabolism 131, 155196. doi: 10.1016/j.metabol.2022.155196.
  26. Ouchi D, Vilaplana-Carnerero C, de Dios V, et al (2022). Antidiabetic treatment and COVID-19 Outcomes: A population-based cohort study in primary health care in Catalonia during the first wave of the pandemic. Primary Care Diabetes 16, 753–759. doi: 10.1016/j.pcd.2022.10.001.
  27. Satgas COVID-19 (2022). Peta sebaran Covid-19. Available at: https://covid19.go.id/peta-sebaran.
  28. Sutriyawan A (2021). Metodologi penelitian kedokteran dan kesehatan (dilengkapi tuntunan membuat proposal penelitian). Refika Aditama, Bandung.
  29. Wang L, Amin AK, Khanna P, et al (2021). An observational cohort study of bacterial co-infection and implications for empirical antibiotic therapy in patients presenting with COVID-19 to hospitals in North West London. Journal of Antimicrobial Chemotherapy 76, 796–803. doi: 10.1093/jac/dkaa475.
  30. Woolcott OO, Castilla-Bancayán JP (2021). The effect of age on the association between diabetes and mortality in adult patients with COVID-19 in Mexico. Scientific Reports 11, 8386. doi: 10.1038/s41598-021-88014-z.
  31. Yang W, Sun X, Zhang J, et al (2021). The effect of metformin on mortality and severity in COVID-19 patients with diabetes mellitus. Diabetes Research and Clinical Practice 178, 108977. doi: 10.1016/j. diabres.2021.108977.
  32. Yitao Z, Mu C, Ling Z, et al (2021). Predictors of clinical deterioration in non-severe patients with COVID-19: a retrospective cohort study. Current Medical Research and Opinion 37, 385–391. doi: 10.1080/03007995.2021.1876005.
  33. Zhang J, Kong W, Xia P, et al (2020). Impaired fasting glucose and diabetes are related to higher risks of complications and mortality among patients with Coronavirus Disease 2019. Frontiers in Endocrinology (Lausanne). doi: 10.3389/fendo.2020.00525.

Most read articles by the same author(s)