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Risk factors for severe disease in patients admitted with COVID-19 to a hospital in London, England: a retrospective cohort study

Goodall et al., Epidemiology and Infection, doi:10.1017/S0950268820002472
Oct 2020  
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Mortality 3% Improvement Relative Risk Metformin for COVID-19  Goodall et al.  Prophylaxis Is prophylaxis with metformin beneficial for COVID-19? Retrospective 981 patients in the United Kingdom (Mar - Apr 2020) No significant difference in mortality c19early.org Goodall et al., Epidemiology and Infec.., Oct 2020 Favorsmetformin Favorscontrol 0 0.5 1 1.5 2+
Metformin for COVID-19
3rd treatment shown to reduce risk in July 2020, now with p < 0.00000000001 from 98 studies.
No treatment is 100% effective. Protocols combine treatments.
5,100+ studies for 110 treatments. c19early.org
Retrospective 981 hospitalized patients in the UK, showing no significant difference with metformin use.
risk of death, 3.0% lower, HR 0.97, p = 0.81, treatment 74 of 210 (35.2%), control 280 of 771 (36.3%), NNT 93.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Goodall et al., 13 Oct 2020, retrospective, United Kingdom, peer-reviewed, 7 authors, study period 12 March, 2020 - 15 April, 2020.
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Risk factors for severe disease in patients admitted with COVID-19 to a hospital in London, England: a retrospective cohort study
J W Goodall, T A N Reed, M Ardissino, P Bassett, A M Whittington, D L Cohen, N Vaid
Epidemiology and Infection, doi:10.1017/s0950268820002472
COVID-19 has caused a major global pandemic and necessitated unprecedented public health restrictions in almost every country. Understanding risk factors for severe disease in hospitalised patients is critical as the pandemic progresses. This observational cohort study aimed to characterise the independent associations between the clinical outcomes of hospitalised patients and their demographics, comorbidities, blood tests and bedside observations. All patients admitted to Northwick Park Hospital, London, UK between 12 March and 15 April 2020 with COVID-19 were retrospectively identified. The primary outcome was death. Associations were explored using Cox proportional hazards modelling. The study included 981 patients. The mortality rate was 36.0%. Age (adjusted hazard ratio (aHR) 1.53), respiratory disease (aHR 1.37), immunosuppression (aHR 2.23), respiratory rate (aHR 1.28), hypoxia (aHR 1.36), Glasgow Coma Scale <15 (aHR 1.92), urea (aHR 2.67), alkaline phosphatase (aHR 2.53), C-reactive protein (aHR 1.15), lactate (aHR 2.67), platelet count (aHR 0.77) and infiltrates on chest radiograph (aHR 1.89) were all associated with mortality. These important data will aid clinical risk stratification and provide direction for further research.
Author contributions. NV, DLC and TANR designed the study. MA, JWG and TANR collected the data with assistance from those acknowledged below. PB and JWG conducted the data analysis. JWG wrote the first draft of the article and conducted the literature search. TANR, MA, PB, AMW, DLC and NV all reviewed and approved the final report. Conflict of interest. All authors declare no conflict of interest.
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