Effect of Antidiabetic Therapy on Clinical Outcomes of COVID-19 Patients With Type 2 Diabetes: A Systematic Review and Meta-Analysis

作者全名："Zhan, Kegang; Weng, Liuqi; Qi, Li; Wang, Luhan; Lin, Hao; Fang, Xiaoyu; Jia, Hong; Ma, Xiangyu"

作者地址："[Zhan, Kegang; Jia, Hong] Southwest Med Univ, Coll Publ Hlth, Luzhou 646000, Sichuan, Peoples R China; [Zhan, Kegang; Wang, Luhan; Fang, Xiaoyu; Ma, Xiangyu] Third Mil Med Univ, Army Med Univ, Coll Prevent Med, Dept Epidemiol, 30 Gaotanyan Zhenpe, Chongqing 400038, Peoples R China; [Weng, Liuqi] Chongqing Med Univ, Childrens Hosp, Natl Clin Res Ctr Child Hlth & Disorders,Key Lab, Chongqing Key Lab Pediat,Dept Orthoped,Minist Edu, Chongqing, Peoples R China; [Qi, Li] Chongqing Municipal Ctr Dis Control & Prevent, Dept Infect Dis Control & Prevent, Chongqing, Peoples R China; [Lin, Hao] Sichuan Univ, West China Sch Clin Med, Chengdu, Peoples R China"

通信作者："Jia, H (通讯作者)，Southwest Med Univ, Coll Publ Hlth, Luzhou 646000, Sichuan, Peoples R China.; Ma, XY (通讯作者)，Third Mil Med Univ, Army Med Univ, Coll Prevent Med, Dept Epidemiol, 30 Gaotanyan Zhenpe, Chongqing 400038, Peoples R China."

来源：ANNALS OF PHARMACOTHERAPY

ESI学科分类：PHARMACOLOGY & TOXICOLOGY

WOS号：WOS:000875911500001

JCR分区：Q3

影响因子：2.9

年份：2022

卷号：　

期号：　

开始页：　

结束页：　

文献类型：Review; Early Access

关键词：COVID-19; SARS-CoV-2; meta-analysis; diabetes; antidiabetic therapy

摘要："Background: No study has yet systematically evaluated the effect of antidiabetic therapy on clinical outcomes of COVID-19 patients with type 2 diabetes (T2D). Objective: We aimed to evaluate the effect of different antidiabetic therapy on clinical outcomes of COVID-19 patients with T2D. Methods: We comprehensively retrieved the published research which examined the effect of antidiabetic therapy on clinical outcomes of COVID-19 patients with T2D. The odds ratio (OR) and its 95% confidence interval (95% CI) for clinical outcomes were calculated using the random-effects model, and meta-regression was adopted to evaluate the potential sources of heterogeneity between studies. Results: A total of 54 studies were included in this study. We found that the use of metformin (OR = 0.66, 95% CI: 0.58-0.75), SGLT-2i (OR = 0.80, 95% CI: 0.73-0.88), and GLP-1ra (OR = 0.83, 95% CI: 0.70-0.98) were significantly associated with lower mortality risk in COVID-19 patients with T2D, while insulin use might unexpectedly increase the ICU admission rate (OR = 2.32, 95% CI: 1.34-4.01) and risk of death (OR = 1.52, 95% CI: 1.32-1.75). No statistically significant associations were identified for DPP-4i, SUs, AGIs, and TZDs. Conclusion and Relevance: We demonstrated that the usage of metformin, SGLT-2i, and GLP-1ra could significantly decrease mortality in COVID-19 patients with T2D. The heterogeneity across the studies, baseline characteristics of the included patients, shortage of dosage and the duration of antidiabetic drugs and autonomy of drug selection might limit the objectivity and accuracy of results. Further adequately powered and high-quality randomized controlled trials are warranted for conclusive findings."

基金机构：Outstanding Youth Science Foundation of Chongqing [cstc2020jcyj-jqX0014]; Chongqing Talents: Exceptional Young Talents Project [CQYC202005003]; Science Foundation for Outstanding Young People of the Army Medical University

基金资助正文："The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by Outstanding Youth Science Foundation of Chongqing (grant no. cstc2020jcyj-jqX0014), Chongqing Talents: Exceptional Young Talents Project (grant no. CQYC202005003), and the Science Foundation for Outstanding Young People of the Army Medical University (grant to Pro Xiangyu Ma)."