Therapeutic prevention of COVID-19 in elderly: a case–control study
Retrospective 179 patients in France exposed to COVID-19 showing, without statistical significance, a higher risk of cases, and a lower risk of mortality among cases with existing metformin treatment.
risk of death, 78.6% lower, RR 0.21, p = 0.06, treatment 1 of 14 (7.1%), control 25 of 75 (33.3%), NNT 3.8, COVID+.
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risk of case, 43.7% higher, RR 1.44, p = 0.12, treatment 11 of 16 (68.8%), control 78 of 163 (47.9%).
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Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
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Blanc et al., 17 Jul 2021, retrospective, France, peer-reviewed, 22 authors.
Abstract: GeroScience (2021) 43:2333–2343
https://doi.org/10.1007/s11357-021-00397-z
ORIGINAL ARTICLE
Therapeutic prevention of COVID‑19 in elderly:
a case–control study
Frederic Blanc · Cedric Waechter · Thomas Vogel · Benoit Schorr · Catherine Demuynck ·
Catherine Martin Hunyadi · Maxence Meyer · Denata Mutelica · Nadjiba Bougaa · Samira Fafi‑Kremer ·
Lidia Calabrese · Elise Schmitt · Delphine Imperiale · Catherine Jehl · Alexandre Boussuge ·
Carmen Suna · François Weill · Alexia Matzinger · Candice Muller · Patrick Karcher ·
Georges Kaltenbach · Erik Sauleau
Received: 1 May 2020 / Accepted: 31 May 2021 / Published online: 17 July 2021
© American Aging Association 2021
Abstract COVID-19 is a particularly aggressive
disease for the elderly as 86% of deaths related to
COVID-19 occur in people over 65 years of age.
Despite the urgent need for a preventive treatment,
there are currently no serious leads, other than the
vaccination. The aim of this retrospective casecontrol study is to find a pharmacological preventive treatment of COVID-19 in elderly patients.
One-hundred-seventy-nine patients had been in
contact with other COVID-19 patients at home or
in hospital, of whom 89 had tested RT-PCR-positive (COVID-pos) for the virus and 90 had tested
RT-PCR-negative (COVID-neg). Treatments within
F. Blanc (*) · E. Sauleau
ICube Laboratory, UMR 7357 and CNRS, University
of Strasbourg, Strasbourg, France
e-mail: f.blanc@unistra.fr
C. Waechter · T. Vogel · B. Schorr · C. Demuynck ·
C. M. Hunyadi · M. Meyer · D. Mutelica · N. Bougaa ·
L. Calabrese · E. Schmitt · D. Imperiale · C. Jehl ·
A. Boussuge · C. Suna · F. Weill · A. Matzinger ·
C. Muller · P. Karcher · G. Kaltenbach
Pôle de Gériatrie, La Robertsau Geriatric Hospital,
University Hospital of Strasbourg, Strasbourg, France
S. Fafi‑Kremer
Virology Department, University Hospital of Strasbourg,
Strasbourg, France
15 days prior to RT-PCR (including antihypertensive drugs, antipsychotics, antibiotics, nonsteroidal
anti-inflammatory drugs, proton pump inhibitors
(PPIs), oral antidiabetics (OADs), corticosteroids,
immunosuppressants), comorbidities, symptoms,
laboratory values, and clinical outcome were all
collected. COVID-pos patients more frequently
had a history of diabetes (P = .016) and alcoholism
(P = .023), a lower leukocyte count (P = .014) and
a higher mortality rate — 29.2% versus 14.4% —
(P = .014) when compared to COVID-neg patients.
Patients on PPIs were 2.3 times less likely (odds
ratio [OR] = 0.4381, 95% confidence interval [CI]
[0.2331, 0.8175], P = .0053) to develop COVID19 infection, compared to those not on PPIs. No
other treatment decreased or increased this risk.
COVID-pos patients on antipsychotics (P = .0013)
and OADs (P = .0153), particularly metformin
(P = .0237), were less likely to die. Thus, patients
on treatment with PPI were less likely to develop
COVID-19 infection, and those on antipsychotics or
metformin had a lower risk of mortality. However,
prospective studies, including clinical trials, are
needed to confirm or not these findings.
Keywords COVID-19 · Prevention · Elderly ·
Geriatrics · Proton pump inhibitors · Antipsychotics ·
Metformin
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