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The Clinical Characteristics and Outcomes of Patients with Moderate-to-Severe Coronavirus Disease 2019 Infection and Diabetes in Daegu, South Korea

Kim et al., Diabetes & Metabolism Journal, doi:10.4093/dmj.2020.0146
Aug 2020  
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Mortality 64% Improvement Relative Risk Progression 52% Metformin for COVID-19  Kim et al.  Prophylaxis Is prophylaxis with metformin beneficial for COVID-19? Retrospective 235 patients in South Korea Lower mortality (p=0.1) and progression (p=0.13), not sig. c19early.org Kim et al., Diabetes & Metabolism J., Aug 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 92 studies.
No treatment is 100% effective. Protocols combine treatments. * >10% efficacy, ≥3 studies.
4,400+ studies for 79 treatments. c19early.org
Retrospective 235 hospitalized diabetes patients in South Korea, showing lower mortality and lower progression to severe disease with metformin.
risk of death, 64.0% lower, OR 0.36, p = 0.10, treatment 113, control 122, adjusted per study, multivariable, RR approximated with OR.
risk of progression, 52.0% lower, OR 0.48, p = 0.13, treatment 113, control 122, adjusted per study, multivariable, RR approximated with OR.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Kim et al., 12 Aug 2020, retrospective, South Korea, peer-reviewed, 32 authors.
This PaperMetforminAll
The Clinical Characteristics and Outcomes of Patients with Moderate-to-Severe Coronavirus Disease 2019 Infection and Diabetes in Daegu, South Korea
Mi Kyung Kim, Jae-Han Jeon, Sung-Woo Kim, Jun Sung Moon, Nan Hee Cho, Eugene Han, Ji Hong You, Ji Yeon Lee, Miri Hyun, Jae Seok Park, Yong Shik Kwon, Yeon-Kyung Choi, Ki Tae Kwon, Shin Yup Lee, Eon Ju Jeon, Jin-Woo Kim, Hyo-Lim Hong, Hyun Hee Kwon, Chi Young Jung, Yin Young Lee, Eunyeoung Ha, Seung Min Chung, Jian Hur, June Hong Ahn, Na-Young Kim, Shin-Woo Kim, Hyun Ha Chang, Yong Hoon Lee, Jaehee Lee, Keun-Gyu Park, Hyun Ah Kim, Ji-Hyun Lee
Diabetes & Metabolism Journal, doi:10.4093/dmj.2020.0146
Background: Coronavirus disease 2019 (COVID-19) is a global pandemic that had affected more than eight million people worldwide by June 2020. Given the importance of the presence of diabetes mellitus (DM) for host immunity, we retrospectively evaluated the clinical characteristics and outcomes of moderate-to-severe COVID-19 in patients with diabetes. Methods: We conducted a multi-center observational study of 1,082 adult inpatients (aged ≥18 years) who were admitted to one of five university hospitals in Daegu because of the severity of their COVID-19-related disease. The demographic, laboratory, and radiologic findings, and the mortality, prevalence of severe disease, and duration of quarantine were compared between patients with and without DM. In addition, 1:1 propensity score (PS)-matching was conducted with the DM group. Results: Compared with the non-DM group (n=847), patients with DM (n=235) were older, exhibited higher mortality, and required more intensive care. Even after PS-matching, patients with DM exhibited more severe disease, and DM remained a prognostic factor for higher mortality (hazard ratio, 2.40; 95% confidence interval, 1.38 to 4.15). Subgroup analysis revealed that the presence of DM was associated with higher mortality, especially in older people (≥70 years old). Prior use of a dipeptidyl peptidase-4 inhibitor or a renin-angiotensin system inhibitor did not affect mortality or the clinical severity of the disease. Conclusion: DM is a significant risk factor for COVID-19 severity and mortality. Our findings imply that COVID-19 patients with DM, especially if elderly, require special attention and prompt intensive care.
SUPPLEMENTARY MATERIALS Supplementary materials related to this article can be found online at https://doi.org/10.4093/dmj.2020.0146. CONFLICTS OF INTEREST No potential conflict of interest relevant to this article was reported. AUTHOR CONTRIBUTIONS
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'2020-10-21T09:52:13Z', 'timestamp': 1603273933000}, 'score': 1, 'subtitle': [], 'short-title': [], 'issued': {'date-parts': [[2020]]}, 'references-count': 29, 'journal-issue': {'issue': '4', 'published-print': {'date-parts': [[2020]]}}, 'URL': 'http://dx.doi.org/10.4093/dmj.2020.0146', 'relation': {}, 'ISSN': ['2233-6079', '2233-6087'], 'issn-type': [{'value': '2233-6079', 'type': 'print'}, {'value': '2233-6087', 'type': 'electronic'}], 'subject': ['Endocrinology, Diabetes and Metabolism'], 'published': {'date-parts': [[2020]]}, 'assertion': [ { 'value': '2020-06-26', 'name': 'received', 'label': 'Received', 'group': {'name': 'publication_history', 'label': 'Publication History'}}, { 'value': '2020-07-02', 'name': 'accepted', 'label': 'Accepted', 'group': {'name': 'publication_history', 'label': 'Publication History'}}, { 'value': '2020-08-12', 'name': 'published_online', 'label': 'Published online', 'group': {'name': 'publication_history', 'label': 'Publication History'}}, { 'value': 'Copyright © 2020 Korean Diabetes Association', 'name': 'copyright', 'label': 'Copyright', 'group': {'name': 'Copyright_and_licensing', 'label': 'Copyright and Licensing'}}, { 'value': 'This is an Open Access article distributed under the terms of the Creative ' 'Commons Attribution Non-Commercial License ' '(http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted ' 'non-commercial use, distribution, and reproduction in any medium, provided the ' 'original work is properly cited.', 'name': 'license', 'label': 'License', 'explanation': {'URL': 'http://creativecommons.org/licenses/by-nc/4.0/'}, 'group': {'name': 'Copyright_and_licensing', 'label': 'Copyright and Licensing'}}]}
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