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0 0.5 1 1.5 2+ Progression -225% Improvement Relative Risk Metformin for COVID-19  Gao et al.  Prophylaxis Is prophylaxis with metformin beneficial for COVID-19? Retrospective 110 patients in China (January - March 2020) Higher progression with metformin (p=0.045) Gao et al., Clinical and Translational.., Oct 2020 Favors metformin Favors control

Risk of Metformin in Patients With Type 2 Diabetes With COVID-19: A Preliminary Retrospective Report

Gao et al., Clinical and Translational Science, doi:10.1111/cts.12897
Oct 2020  
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Retrospective 110 hospitalized COVID-19 patients with diabetes in China, showing increased risk of severity with metformin.
risk of progression, 225.0% higher, RR 3.25, p = 0.045, treatment 16 of 56 (28.6%), control 4 of 54 (7.4%), odds ratio converted to relative risk, progression to life threatening complications.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Gao et al., 19 Oct 2020, retrospective, China, peer-reviewed, 7 authors, study period 31 January, 2020 - 20 March, 2020.
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Risk of Metformin in Patients With Type 2 Diabetes With COVID‐19: A Preliminary Retrospective Report
Yongchao Gao, Tao Liu, Weijun Zhong, Rong Liu, Honghao Zhou, Weihua Huang, Wei Zhang
Clinical and Translational Science, doi:10.1111/cts.12897
The current outbreak of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has spread across the world. No specific antiviral agents have been adequately evidenced for the treatment of coronavirus disease 2019 (COVID-19). Although metformin has been recommended as a host-directed therapy for COVID-19, there are some opposite views. The effects of metformin on the disease severity of patients with COVID-19 with diabetes during hospitalization remains unclear. This study aimed to determine the effect of metformin on disease severity. We enrolled 110 hospitalized patients with COVID-19 with diabetes prescribed either metformin or non-metformin hypoglycemic treatment for a case-control study. The primary outcome was the occurrence of life-threatening complications. There were no differences between the two groups in age, sex, comorbidities, and clinical severity at admission. Blood glucose and lactate dehydrogenase levels of the metformin group were higher than those of the non-metformin group at admission. Other laboratory parameters at admission and treatments after admission were not different between the two groups. Strikingly, the percentage of patients who experienced life-threatening complications was significantly higher in the metformin group (28.6% (16/56) vs. 7.4% (4/54), P = 0.004). Antidiabetic therapy with metformin was associated with a higher risk of disease progression in patients with COVID-19 with diabetes during hospitalization (adjusted odds ratio = 3.964, 95% confidence interval 1.034-15.194, P = 0.045). This retrospective analysis suggested a potential safety signal for metformin, the use of which was associated with a higher risk of severe COVID-19. We propose that metformin withdrawal in patients with COVID-19 be considered to prevent disease progression. The current outbreak of coronavirus disease 2019 (COVID-19) by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread quickly through human-to-human transmission, 1 and has been declared as "Public Health Emergency of International Concern" by the World Health Organization (WHO). As both SARS-CoV 2 and Middle East respiratory syndrome coronavirus (MERS-CoV), 3 the SARS-CoV-2 outbreak has caused a large number of human deaths
Conflict of Interest. All other authors declared no competing interests for this work.
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