The Efficacy and Potential Mechanisms of Metformin in the Treatment of COVID-19 in the Diabetics: A Systematic Review

Diabetes mellitus (DM) is one of the most common comorbidities among patients with coronavirus disease 2019 (COVID-19) which may exacerbate complications of this new viral infection. Metformin is an anti-hyperglycemic agent with host-directed immune-modulatory effects, which relieve exaggerated infl...

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Vydáno v:Frontiers in endocrinology (Lausanne) Ročník 12; s. 645194
Hlavní autoři: Zangiabadian, Moein, Nejadghaderi, Seyed Aria, Zahmatkesh, Mohammad Mahdi, Hajikhani, Bahareh, Mirsaeidi, Mehdi, Nasiri, Mohammad Javad
Médium: Journal Article
Jazyk:angličtina
Vydáno: Switzerland Frontiers Media S.A 19.03.2021
Témata:
2019-nCoV
COVID-19
COVID-19 - complications
COVID-19 - drug therapy
Diabetes Complications - drug therapy
diabetes mellitus
Diabetes Mellitus - drug therapy
Endocrinology
Humans
Hypoglycemic Agents - therapeutic use
metformin
Metformin - therapeutic use
SARS-CoV-2
systematic review
COVID-19
metformin
SARS-CoV-2
diabetes mellitus
2019-nCoV
systematic review
ISSN:1664-2392, 1664-2392
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Shrnutí:Diabetes mellitus (DM) is one of the most common comorbidities among patients with coronavirus disease 2019 (COVID-19) which may exacerbate complications of this new viral infection. Metformin is an anti-hyperglycemic agent with host-directed immune-modulatory effects, which relieve exaggerated inflammation and reduce lung tissue damage. The current systematic review aimed to summarize the available evidence on the potential mechanism of action and the efficacy of metformin in COVID-19 patients with DM. A systematic search was carried out in PubMed/Medline, EMBASE, the Cochrane Controlled Register of Trials (CENTRAL), and Web of Science up to July 30, 2020. The following keywords were used: "COVID-19", "SARS-CoV-2", "2019-nCoV", "metformin", and "antidiabetic drug". Fourteen studies were included in our systematic review. Three of them were observational with 6,659 participants. Decreasing insulin resistance, reduction of some inflammatory cytokines like IL-6 and TNF-α, modulation of angiotensin-converting enzyme 2 (ACE2) receptor, and improving neutrophil to lymphocyte ratio are some of the potential mechanisms of metformin in COVID-19 patients with DM. Nine out of fourteen articles revealed the positive effect of metformin on the prognosis of COVID-19 in diabetic or even non-diabetic patients. Moreover, different studies have shown that metformin is more effective in women than men. The use of metformin may lead to improve the clinical outcomes of patients with mild to moderate SARS-CoV-2, especially in diabetic women. Further observational studies should be conducted to clarify the effects of metformin as a part of the treatment strategy of COVID-19.
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Edited by: Reza Beigverdi, Tehran University of Medical Sciences, Iran
This article was submitted to Clinical Diabetes, a section of the journal Frontiers in Endocrinology
Reviewed by: Mukunthan Murthi, John H. Stroger, Jr. Hospital of Cook County, United States; Kayo Henrique Fernandes E. Magalhaes Santos, Jackson Memorial Hospital, United States
ISSN:1664-2392
1664-2392
DOI:10.3389/fendo.2021.645194