Internal medicine

Cochrane Library

Disease

Coronavirus disease 2019 (COVID-19)

Infectious disease (medical specialty)

Diabetes mellitus

Biology

Meta-analysis

Endocrinology

Type 2 diabetes

Sulfonylurea

Insulin

MEDLINE

Metformin

Type 2 Diabetes Mellitus

Biochemistry

Medicine

Frontiers in Endocrinology

Aims We conducted a systematic review and meta-analysis to assess various antidiabetic agents’ association with mortality in patients with type 2 diabetes (T2DM) who have coronavirus disease 2019 (COVID-19). Methods We performed comprehensive literature retrieval from the date of inception until February 2, 2021, in medical databases (PubMed, Web of Science, Embase, and Cochrane Library), regarding mortality outcomes in patients with T2DM who have COVID-19. Pooled OR and 95% CI data were used to assess relationships between antidiabetic agents and mortality. Results Eighteen studies with 17,338 patients were included in the meta-analysis. Metformin (pooled OR, 0.69; P =0.001) and sulfonylurea (pooled OR, 0.80; P =0.016) were associated with lower mortality risk in patients with T2DM who had COVID-19. However, patients with T2DM who had COVID-19 and received insulin exhibited greater mortality (pooled OR, 2.20; P =0.002). Mortality did not significantly differ (pooled OR, 0.72; P =0.057) between DPP-4 inhibitor users and non-users. Conclusions Metformin and sulfonylurea could be associated with reduced mortality risk in patients with T2DM who have COVID-19. Furthermore, insulin use could be associated with greater mortality, while DPP-4 inhibitor use could not be. The effects of antidiabetic agents in patients with T2DM who have COVID-19 require further exploration. Systematic Review Registration PROSPERO (identifier, CRD42021242898).

Mortality Risk of Antidiabetic Agents for Type 2 Diabetes With COVID-19: A Systematic Review and Meta-Analysis