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0 0.5 1 1.5 2+ Hospitalization 10% Improvement Relative Risk Boye et al. Metformin for COVID-19 Prophylaxis Is prophylaxis with metformin beneficial for COVID-19? Retrospective 9,531 patients in the USA Lower hospitalization with metformin (p=0.0000028) Boye et al., Diabetes Therapy, doi:10.1007/s13300-021-01110-1 Favors metformin Favors control

Risk Factors Associated with COVID-19 Hospitalization and Mortality: A Large Claims-Based Analysis Among People with Type 2 Diabetes Mellitus in the United States

Boye et al., Diabetes Therapy, doi:10.1007/s13300-021-01110-1
Boye et al., Risk Factors Associated with COVID-19 Hospitalization and Mortality: A Large Claims-Based Analysis Among.., Diabetes Therapy, doi:10.1007/s13300-021-01110-1
Jul 2021   Source   PDF  
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Retrospective 9531 COVID+ diabetes patients in the USA, showing lower risk of hospitalization with existing biguanides treatment (defined as mainly metformin in the abstract and entirely metformin in the text).
risk of hospitalization, 10.0% lower, RR 0.90, p < 0.001, treatment 2,067 of 4,250 (48.6%), control 3,196 of 5,281 (60.5%), NNT 8.4, odds ratio converted to relative risk.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Boye et al., 18 Jul 2021, retrospective, USA, peer-reviewed, 14 authors.
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Risk Factors Associated with COVID-19 Hospitalization and Mortality: A Large Claims-Based Analysis Among People with Type 2 Diabetes Mellitus in the United States
Kristina S Boye, Elif Tokar Erdemir, Nathan Zimmerman, Abraham Reddy, Brian D Benneyworth, Matan C Dabora, Emily R Hankosky, M Angelyn Bethel, Callahan Clark, Cody J Lensing, Scott Sailer, Ramira San Juan, Robert J Heine, Lida Etemad
Diabetes Therapy, doi:10.1007/s13300-021-01110-1
Introduction: Diabetes has been identified as a high-risk comorbidity for COVID-19 hospitalization. We evaluated additional risk factors for COVID-19 hospitalization and in-hospital mortality in a nationwide US database. Methods: This retrospective study utilized the UnitedHealth Group Clinical Discovery Database (January 1, 2019-July 15, 2020) containing de-identified nationwide administrative claims, SARS-CoV-2 laboratory test results, and COVID-19 inpatient admissions data. Logistic regression was used to understand risk factors for hospitalization and in-hospital mortality among people with type 2 diabetes (T2D) and in the overall population. Robustness of associations was further confirmed by subgroup and sensitivity analyses in the T2D population. Results: A total of 36,364 people were identified who were either SARS-CoV-2 ? or hospitalized for COVID-19. T2D was associated with increased COVID-19-related hospitalization and mortality. Factors associated with increased hospitalization risk were largely consistent in the overall population and the T2D subgroup, including age, male sex, and these top five comorbidities: dementia, metastatic tumor, congestive heart failure, paraplegia, and metabolic disease. Biguanides (mainly metformin) were consistently associated with lower odds of hospitalization, whereas sulfonylureas and insulins were associated with greater odds of hospitalization among people with T2D. Conclusion: In this nationwide US analysis, T2D was identified as an independent risk factor for COVID-19 complications. Many factors conferred similar risk of hospitalization across both populations; however, particular diabetes medications may be markers for differential risk. The insights on comorbidities and medications may inform population health initiatives, including prevention efforts for high-risk patient populations such as those with T2D.
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