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0 0.5 1 1.5 2+ Hospitalization 23% Improvement Relative Risk Case 12% Metformin  Dimnjaković et al.  Prophylaxis Is prophylaxis with metformin beneficial for COVID-19? Retrospective 7,539 patients in Croatia Lower hospitalization (p=0.0041) and fewer cases (p=0.04) Dimnjaković et al., PLOS ONE, March 2024 Favors metformin Favors control

Association of anti-diabetic drugs and covid-19 outcomes in patients with diabetes mellitus type 2 and chronic kidney disease: Nationwide registry analysis

Dimnjaković et al., PLOS ONE, doi:10.1371/journal.pone.0301056
Mar 2024  
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Metformin for COVID-19
3rd treatment shown to reduce risk in July 2020
*, now known with p < 0.00000000001 from 87 studies.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
4,000+ studies for 60+ treatments.
Retrospective 7,539 patients with diabetes mellitus type 2 and chronic kidney disease in Croatia showing lower risk of SARS-CoV-2 infection with SGLT-2 inhibitors, metformin, and repaglinide use, and lower risk of COVID-19 hospitalization with SGLT-2 inhibitors and metformin use.
risk of hospitalization, 23.1% lower, OR 0.77, p = 0.004, treatment 2,843, control 4,475, adjusted per study, multivariable, RR approximated with OR.
risk of case, 12.5% lower, OR 0.88, p = 0.04, treatment 2,843, control 4,475, adjusted per study, multivariable, RR approximated with OR.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Dimnjaković et al., 27 Mar 2024, retrospective, Croatia, peer-reviewed, 7 authors. Contact:
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Association of anti-diabetic drugs and covid-19 outcomes in patients with diabetes mellitus type 2 and chronic kidney disease: Nationwide registry analysis
Jelena Dimnjaković, Tamara Buble, Pero Ivanko, Tamara Poljičanin, Sandra Karanović Štambuk, Hana Brborović, Ognjen Brborović
PLOS ONE, doi:10.1371/journal.pone.0301056
Introduction Patients with diabetes mellitus type 2 and chronic kidney disease (T2DM-CKD) have a 5 times higher risk of developing severe SARS-CoV-2 infection than those without these 2 diseases. The goal of this study is to provide information on T2DM-CKD and COVID-19 outcomes, with an emphasis on the association with anti-diabetic medications. Methodology Study is designed as a retrospective cohort analysis covering the years 2020 and 2021. Data from the National Diabetes Registry (CroDiab) were linked to hospital data, primary healthcare data, Causes of Death Registry data, the SARS-CoV-2 vaccination database, and the SARS-CoV-2 test results database. Study outcomes were cumulative incidence of SARS-CoV-2 positivity, COVID-19 hospitalizations, and COVID-19 deaths. For outcome predictors, logistic regression models were developed. Results Of 231 796 patients with diabetes mellitus type 2 in the database, 7 539 were T2DM-CKD (3.25%). The 2-year cumulative incidences of all three studies' outcomes were higher in T2DM-CKD than in diabetes patients without CKD (positivity 18.1% vs. 14.4%; hospitalization 9.7% vs. 4.2%; death 3.3% vs. 1.1%, all p<0.001). For COVID-19 hospitalization, protective factors were SGLT-2 inhibitors use (OR 0.430; 95%CI 0.257-0.719) and metformin use (OR 0.769; 95% CI 0.643-0.920), risk factors were insulin use (1.411;) and sulfonylureas use (OR 1.226;. For SARS-CoV-2 positivity
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