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0 0.5 1 1.5 2+ Mortality 33% Improvement Relative Risk c19early.org/mf Chen et al. Metformin for COVID-19 Prophylaxis Is prophylaxis with metformin beneficial for COVID-19? Retrospective 120 patients in China Lower mortality with metformin (not stat. sig., p=0.46) Chen et al., Diabetes Care, doi:10.2337/dc20-0660 Favors metformin Favors control

Clinical Characteristics and Outcomes of Patients With Diabetes and COVID-19 in Association With Glucose-Lowering Medication

Chen et al., Diabetes Care, doi:10.2337/dc20-0660
Chen et al., Clinical Characteristics and Outcomes of Patients With Diabetes and COVID-19 in Association With.., Diabetes Care, doi:10.2337/dc20-0660
Jul 2020   Source   PDF  
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Retrospective 120 COVID-19 diabetes patients, showing non-statistically significantly lower mortality with existing metformin treatment.
Although the 33% lower mortality is not statistically significant, it is consistent with the significant 32% lower mortality [27‑37%] from meta analysis of the 49 mortality results to date.
risk of death, 33.0% lower, RR 0.67, p = 0.46, treatment 4 of 43 (9.3%), control 15 of 77 (19.5%), NNT 9.8, adjusted per study, odds ratio converted to relative risk.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Chen et al., 31 Jul 2020, retrospective, China, peer-reviewed, 12 authors.
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Clinical Characteristics and Outcomes of Patients With Diabetes and COVID-19 in Association With Glucose-Lowering Medication
Yuchen Chen, Dong Yang, Biao Cheng, Jian Chen, Anlin Peng, Chen Yang, Chong Liu, Mingrui Xiong, Aiping Deng, Yu Zhang, Ling Zheng, Kun Huang
Diabetes Care, doi:10.2337/dc20-0660
Diabetes is one of the most distinct comorbidities of COVID-19. Here, we describe the clinical characteristics of and outcomes in patients with diabetes in whom COVID-19 was confirmed or clinically diagnosed (with typical features on lung imaging and symptoms) and their association with glucose-lowering or blood pressure-lowering medications. RESEARCH DESIGN AND METHODS In this retrospective study involving 904 patients with COVID-19 (136 with diabetes, mostly type 2 diabetes), clinical and laboratory characteristics were collected and compared between the group with diabetes and the group without diabetes, and between groups taking different medications. Logistic regression was used to explore risk factors associated with mortality or poor prognosis. RESULTS The proportion of comorbid diabetes is similar between cases of confirmed and of clinically diagnosed COVID-19. Risk factors for higher mortality of patients with diabetes and COVID-19 were older age (adjusted odds ratio [aOR] 1.09 [95% CI 1.04, 1.15] per year increase; P 5 0.001) and elevated C-reactive protein (aOR 1.12 [95% CI 1.00, 1.24]; P 5 0.043). Insulin usage (aOR 3.58 [95% CI 1.37, 9.35]; P 5 0.009) was associated with poor prognosis. Clinical outcomes of those who use an ACE inhibitor (ACEI) or angiotensin II type-I receptor blocker (ARB) were comparable with those of patients who do not use ACEI/ARB among COVID-19 patients with diabetes and hypertension. CONCLUSIONS C-reactive protein may help to identify patients with diabetes who are at greater risk of dying during hospitalization. Older patients with diabetes were prone to death related to COVID-19. Attention needs to be paid to patients with diabetes and COVID-19 who use insulin. ACEI/ARB use showed no significant impact on patients with diabetes and hypertension who have COVID-19.
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