Is Metformin Use Associated With a Decreased Mortality for COVID-19 Diabetic Patients? A Meta-Analysis
Notice bibliographique
Résumé
Abstract Introduction: Coronavirus disease 2019 (COVID-19) has been spreading globally for more than half a year. Previous studies remain controversial regarding whether metformin is associated with reduced risk for COVID-19 diabetic patients. Thus, this meta-analysis is performed. Method: A comprehensive literature search on PubMed and Web of Science was conducted to identify all relevant studies published prior to October 2020 according to the established inclusion criteria. This meta-analysis was reported in conformity to the Preferred Reporting Project declared by the Systematic Review and Meta-Analysis (PRISMA). The quality assessment was performed by the Newcastle-Ottawa Scale (NOS). The pooled odds ratio (OR) and 95% confidence intervals (CI) were calculated to estimate the association between metformin use and mortality for COVID-19 patients. A random-effect or fixed-effect model was used based on heterogeneity significance. Subgroup analysis was performed based on in-hospital-use or home-use, and different sample sizes. Sensitivity analysis and publication bias detection were also performed. All statistical analyses were performed using RevMan software (version 5.3; Cochrane library) and STATA 12.0 statistical software (Stata Corp., College Station, TX), and all P values were two-tailed, the test level was 0.05. Result: 97 articles were obtained from the database search, and 5 articles obtained from other sources. 8 articles involving 11,169 participants were included. Most studies were considered moderate quality. A statistically significant association between metformin use and decreased mortality of COVID-19 patients was found (OR 0.53, 95%CI: 0.34, 0.83, P=0.005, I2=77%). In the subgroup analyses, home-use of metformin was also associated with a reduced risk of mortality (OR 0.54, 95%CI: 0.35, 0.84, P=0.006, I2=66%), and one study reporting in-hospital use did not find reduced mortality among COVID-19 patients taking metformin (OR 1.65, 95%CI: 0.71, 3.86, P=0.247). For sample size >1,000, no statistically significant reduced risk of mortality (OR 0.84, 95%CI: 0.57, 1.26, P=0.41, I2=73%) was found, however, for sample ≤1,000, a statistically significant reduced risk of mortality (OR 0.29, 95%CI: 0.19, 0.44 P<0.00001, I2=0%) was found. Sensitivity analysis by change fixed-effect models to random-effect models and by omitting each study at a time confirmed the relative stability of the result. Begg’s test (z=0.37, P=0.711) and Egger’s test (t=-1.98, P=0.096) did not detect a significant risk of publication bias. Conclusion: The current meta-analysis demonstrates that metformin use is associated with decreased mortality for COVID-19 diabetic patients. However, only one study investigating the in-hospital use of metformin. More high-quality original studies are needed to further explore the association between metformin use and mortality risk of COVID-19.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,010 | 0,021 |
| Méta-épidémiologie (sens strict) | 0,003 | 0,002 |
| Méta-épidémiologie (sens large) | 0,017 | 0,064 |
| Bibliométrie | 0,005 | 0,005 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,004 | 0,001 |
| Science ouverte | 0,002 | 0,001 |
| Intégrité de la recherche | 0,002 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,004 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».