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0 0.5 1 1.5 2+ Mortality 37% Improvement Relative Risk ICU admission -39% ARDS -3% Metformin  Akinosoglou et al.  Prophylaxis Is prophylaxis with metformin beneficial for COVID-19? Prospective study of 354 patients in Greece (Feb - Jun 2021) Lower mortality (p=0.12) and higher ICU admission (p=0.26), not sig. c19early.org Akinosoglou et al., Microorganisms, May 2023 Favors metformin Favors control

COVID-19 Outcomes and Diabetes Mellitus: A Comprehensive Multicenter Prospective Cohort Study

Akinosoglou et al., Microorganisms, doi:10.3390/microorganisms11061416
May 2023  
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Metformin for COVID-19
3rd treatment shown to reduce risk in July 2020
 
*, now known with p < 0.00000000001 from 89 studies.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
4,100+ studies for 60+ treatments. c19early.org
Prospective multicenter study of 354 hospitalized type 2 diabetes patients with COVID-19 in Greece showing increased risk with DPP4 inhibitor use as part of chronic diabetes treatment. There was no significant difference with metformin use in unadjusted results. Results do not account for differences in the risk of hospitalization.
Although the 37% lower mortality is not statistically significant, it is consistent with the significant 34% lower mortality [29‑39%] from meta analysis of the 64 mortality results to date.
This study is excluded in the after exclusion results of meta analysis: unadjusted results with no group details.
risk of death, 36.8% lower, OR 0.63, p = 0.12, treatment 147, control 207, RR approximated with OR.
risk of ICU admission, 38.7% higher, OR 1.39, p = 0.26, treatment 147, control 207, RR approximated with OR.
risk of ARDS, 2.7% higher, OR 1.03, p = 0.92, treatment 147, control 207, RR approximated with OR.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Akinosoglou et al., 27 May 2023, prospective, Greece, peer-reviewed, median age 70.0, 23 authors, study period February 2021 - June 2021. Contact: ntentolouris@yahoo.gr (corresponding author), akin@upatras.gr, georg.schinas@gmail.com, vasilina.dim@gmail.com, evabletsa@gmail.com, panouharis@gmail.com, leolanaras@gmail.com, chmichailidis@gmail.com, katsikastheodoros@gmail.com, fotiosbarkas@gmail.com, vaglimp@yahoo.com, vkotsis@auth.gr, kostento1@yahoo.com, peggigrigo@yahoo.gr, atetoka@yahoo.gr, dimitris.bassoulis@gmail.com, z_alexiou@yahoo.gr, mdaganou@hotmail.com, medp2011815@med.uoc.gr, akoutsou@med.uoa.gr, pefan1@otenet.gr, ioannisbaraboutis@yahoo.gr, eleni_agelonidou@yahoo.com.
This PaperMetforminAll
COVID-19 Outcomes and Diabetes Mellitus: A Comprehensive Multicenter Prospective Cohort Study
Karolina Akinosoglou, Georgios Schinas, Evanthia Bletsa, Magdaline Bristianou, Leonidas Lanaras, Charalambos Michailides, Theodoros Katsikas, Fotios Barkas, Evangelos Liberopoulos, Vasileios Kotsis, Konstantinos Tentolouris, Pinelopi Grigoropoulou, Archontoula Frangou, Dimitrios Basoulis, Zoi Alexiou, Mary Daganou, Clementine Bostantzoglou, Vasiliki Dimakopoulou, Antonia Koutsoukou, Angelos Pefanis, Ioannis G Baraboutis, Eleni Agelonidou, Nikolaos Tentolouris
Microorganisms, doi:10.3390/microorganisms11061416
The link between type 2 diabetes (T2D) and the severe outcomes of COVID-19 has raised concerns about the optimal management of patients with T2D. This study aimed to investigate the clinical characteristics and outcomes of T2D patients hospitalized with COVID-19 and explore the potential associations between chronic T2D treatments and adverse outcomes. This was a multicenter prospective cohort study of T2D patients hospitalized with COVID-19 in Greece during the third wave of the pandemic (February-June 2021). Among the 354 T2D patients included in this study, 63 (18.6%) died during hospitalization, and 16.4% required ICU admission. The use of DPP4 inhibitors for the chronic management of T2D was associated with an increased risk of in-hospital death (adjusted odds ratio (adj. OR) 2.639, 95% confidence interval (CI) 1.148-6.068, p = 0.022), ICU admission (adj. OR = 2.524, 95% CI: 1.217-5.232, p = 0.013), and progression to ARDS (adj. OR = 2.507, 95% CI: 1.278-4.916, p = 0.007). Furthermore, the use of DPP4 inhibitors was significantly associated with an increased risk of thromboembolic events (adjusted OR of 2.249, 95% CI: 1.073-4.713, p = 0.032) during hospitalization. These findings highlight the importance of considering the potential impact of chronic T2D treatment regiments on COVID-19 and the need for further studies to elucidate the underlying mechanisms.
Author Contributions: Conceptualization, N.T.; formal analysis, K.A. and G.S.; data curation, K.A., G.S., E.B., M.B., L.L., C.M., T.K., F.B., E.L., V.K., K.T., P.G., A.F., D.B., Z.A., M.D., C.B., V.D., A.K., A.P., I.G.B. and E.A.; writing-original draft preparation, K.A. and G.S., writing-review and editing, K.A. and N.T.; visualization, K.A. and G.S.; supervision, N.T. All authors have read and agreed to the published version of the manuscript.
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OR) 2.639, 95% confidence ' 'interval (CI) 1.148–6.068, p = 0.022), ICU admission (adj. OR = 2.524, 95% CI: 1.217–5.232, p ' '= 0.013), and progression to ARDS (adj. OR = 2.507, 95% CI: 1.278–4.916, p = 0.007). ' 'Furthermore, the use of DPP4 inhibitors was significantly associated with an increased risk ' 'of thromboembolic events (adjusted OR of 2.249, 95% CI: 1.073–4.713, p = 0.032) during ' 'hospitalization. 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Please send us corrections, updates, or comments. c19early involves the extraction of 100,000+ datapoints from thousands of papers. Community updates help ensure high accuracy. Treatments and other interventions are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. FLCCC and WCH provide treatment protocols.
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