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).

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.

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.

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.

PROSPERO (identifier, CRD42021242898).

我们进行了系统回顾和荟萃分析，以评估各种抗糖尿病药物与患有 2019 年冠状病毒病 (COVID-19) 的 2 型糖尿病 (T2DM) 患者死亡率的相关性。

我们在医学数据库（PubMed、Web of Science、Embase 和 Cochrane 图书馆）中对自成立之日起至 2021 年 2 月 2 日期间关于患有 COVID-19 的 T2DM 患者的死亡率结果进行了全面的文献检索。汇总 OR 和 95% CI 数据用于评估抗糖尿病药物与死亡率之间的关系。

荟萃分析中纳入了 18 项涉及 17,338 名患者的研究。二甲双胍（合并 OR，0.69；磷=0.001) 和磺酰脲类（合并 OR，0.80；磷=0.016）与患有 COVID-19 的 T2DM 患者较低的死亡风险相关。然而，患有 COVID-19 并接受胰岛素治疗的 T2DM 患者死亡率更高（合并 OR，2.20；磷=0.002）。死亡率没有显着差异（合并 OR，0.72；磷=0.057）DPP-4抑制剂使用者和非使用者之间的差异。

二甲双胍和磺酰脲类药物可能会降低患有 COVID-19 的 T2DM 患者的死亡风险。此外，胰岛素的使用可能会导致更高的死亡率，而 DPP-4 抑制剂的使用则不然。抗糖尿病药物对患有 COVID-19 的 T2DM 患者的影响需要进一步探索。

PROSPERO（标识符，CRD42021242898）。