Metformin in COVID-19: Is There a Role Beyond Glycemic Control?

IF 2.1 Q3 ENDOCRINOLOGY & METABOLISM International Journal of Endocrinology and Metabolism Pub Date : 2023-04-01 DOI:10.5812/ijem-132965

Lakshmi Nagendra, Saptarshi Bhattacharya, Sanjay Kalra, Nitin Kapoor

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Abstract

Context: The coronavirus disease 2019 (COVID-19) pandemic is still a cause of worldwide health concern. Diabetes and its associated comorbidities are risk factors for mortality and morbidity in COVID-19. Selecting the right antidiabetic drug to achieve optimal glycemic control might mitigate some of the negative impacts of diabetes. Metformin continues to be the most widely administered antidiabetic agent. There is evidence of its beneficial outcome in COVID-19 independent of its glucose-lowering effect.

Evidence acquisition: A thorough literature search was conducted in PubMed, Google Scholar, Scopus, and Web of Science to identify studies investigating metformin in COVID-19.

Results: Several overlapping mechanisms have been proposed to explain its antiviral properties. It could bring about conformational changes in the angiotensin-converting enzyme-2 receptor and decrease viral entry. The effects on the mammalian target of the rapamycin pathway and cellular pH have been proposed to reduce viral protein synthesis and replication. The immunomodulatory effects of metformin might counter the detrimental effects of hyperinflammation associated with COVID-19.

Conclusions: These findings call for broader metformin usage to manage hyperglycemia in COVID-19.

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二甲双胍在COVID-19中的作用:除了控制血糖之外还有其他作用吗?

背景:2019冠状病毒病(COVID-19)大流行仍然是全球健康关注的一个原因。糖尿病及其相关合并症是COVID-19患者死亡和发病的危险因素。选择正确的降糖药来达到最佳的血糖控制可能会减轻糖尿病的一些负面影响。二甲双胍仍然是最广泛使用的降糖药。有证据表明其在COVID-19中的有益结果独立于其降血糖作用。证据获取:在PubMed、Google Scholar、Scopus和Web of Science中进行了全面的文献检索，以确定调查二甲双胍在COVID-19中的作用的研究。结果:提出了几种重叠机制来解释其抗病毒特性。它可以引起血管紧张素转换酶-2受体的构象改变，减少病毒的进入。雷帕霉素途径对哺乳动物靶点和细胞pH的影响已被提出，以减少病毒蛋白的合成和复制。二甲双胍的免疫调节作用可能会抵消与COVID-19相关的过度炎症的有害影响。结论:这些发现呼吁更广泛地使用二甲双胍来控制COVID-19患者的高血糖。

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来源期刊

International Journal of Endocrinology and Metabolism ENDOCRINOLOGY & METABOLISM-

CiteScore

3.10

自引率

4.80%

发文量

期刊介绍： The aim of the International Journal of Endocrinology and Metabolism (IJEM) is to increase knowledge, stimulate research in the field of endocrinology, and promote better management of patients with endocrinological disorders. To achieve this goal, the journal publishes original research papers on human, animal and cell culture studies relevant to endocrinology.