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Efficacy of physiological seawater nasal irrigation for the treatment of children with SARS-CoV-2 Omicron BA.2 variant infection: a randomized controlled trial

Lin et al., World Journal of Pediatrics, doi:10.1007/s12519-023-00749-z, Sep 2023
https://c19early.org/lin8.html
Viral clearance 25% Improvement Relative Risk Viral clearance b 21% NaCl  Lin et al.  EARLY TREATMENT  RCT Is early treatment with NaCl beneficial for COVID-19? RCT 403 patients in China Improved viral clearance with NaCl (not stat. sig., p=0.11) c19early.org Lin et al., World J. Pediatrics, September 2023 FavorsNaCl Favorscontrol 0 0.5 1 1.5 2+
NaCl for COVID-19
43rd treatment shown to reduce risk in July 2022, now with p = 0.02 from 8 studies.
Lower risk for viral clearance.
No treatment is 100% effective. Protocols combine treatments.
6,000+ studies for 175 treatments. c19early.org
RCT 403 children in China with mild/asymptomatic COVID-19, showing significantly faster viral clearance with physiological seawater nasal irrigation.
Standard of Care (SOC) for COVID-19 in the study country, China, is poor with low average efficacy for approved treatments1.
risk of no viral clearance, 24.8% lower, HR 0.75, p = 0.11, treatment 204, control 199, inverted to make HR<1 favor treatment, viral clearance, day 5.
risk of no viral clearance, 21.3% lower, HR 0.79, p = 0.02, treatment 204, control 199, inverted to make HR<1 favor treatment, shorter viral shedding duration, day 5.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Lin et al., 10 Sep 2023, Randomized Controlled Trial, China, peer-reviewed, 10 authors.
The Association Between Metformin Use and Outcomes of Hospitalized COVID-19 Patients
Chen-Yi Lin, Hsin-Pei Chung, Yen-Hsiang Tang, Chun-Yen Chen, Chao-Hsien Chen, Wen-Kuei Chang, Kuan-Chih Kuo, Yen-Ting Chen, Jou-Chun Wu, Chang-Yi Lin, Dr Chieh-Jen Wang
Background: Metformin is a widely prescribed medication for type 2 diabetes; however, therapeutic effects beyond glucose control have been reported. Recent studies have suggested its potential in alleviating symptoms of post-COVID-19 condition (long COVID), and possibly shortening the duration of the disease. We conducted this study to investigate whether metformin use could improve the outcomes of hospitalized COVID-19 patients. Methods: We included patients diagnosed with COVID-19 infection at MacKay Memorial Hospital from May to June 2021. We categorized the patients into metformin and nonmetformin use groups, regardless of their diabetes mellitus status. Results: A total of 285 patients were included. After propensity score matching, 82 patients were enrolled for analysis, including 41 patients in each group. Cox proportional hazards analysis showed that mortality was not related to metformin use (adjusted hazard ra io a con ence in er al p=0.76) or duration of metformin use (aHR: 0.91, 95% CI: 0.74-1.13, p=0.40). However, patients with a longer duration of metformin use had a higher risk of receiving invasive mechanical ventilation support (aHR: 1.08, 95% CI: 1.03-1.13, p=0.003). Conclusion: Our findings showed that mortality was not significantly associated with metformin use or its duration. However, patients with a longer duration of metformin use appeared to have a higher risk of requiring invasive mechanical ventilation support. Consequently, the duration of metformin use may be linked to the progression of COVID-19. Further studies are warranted to clarify the relevance of metformin use in the treatment of
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DOI record: { "DOI": "10.1007/s12519-023-00749-z", "ISSN": [ "1708-8569", "1867-0687" ], "URL": "http://dx.doi.org/10.1007/s12519-023-00749-z", "alternative-id": [ "749" ], "assertion": [ { "group": { "label": "Article History", "name": "ArticleHistory" }, "label": "Received", "name": "received", "order": 1, "value": "3 January 2023" }, { "group": { "label": "Article History", "name": "ArticleHistory" }, "label": "Accepted", "name": "accepted", "order": 2, "value": "14 July 2023" }, { "group": { "label": "Article History", "name": "ArticleHistory" }, "label": "First Online", "name": "first_online", "order": 3, "value": "10 September 2023" }, { "group": { "label": "Declarations", "name": "EthicsHeading" }, "name": "Ethics", "order": 1 }, { "group": { "label": "Conflict of interest", "name": "EthicsHeading" }, "name": "Ethics", "order": 2, "value": "No financial or non-financial benefits have been received or will be received from any party related directly or indirectly to the subject of this article." }, { "group": { "label": "Ethical approval", "name": "EthicsHeading" }, "name": "Ethics", "order": 3, "value": "The study was approved by the ethics committee of the Shanghai Children's Medical Center and conducted according to the Declaration of Helsinki guidelines (SCMCIRB-K2022036-1)." } ], "author": [ { "affiliation": [], "family": "Lin", "given": "Ji-Lei", "sequence": "first" }, { "affiliation": [], "family": "Zhang", "given": "Fen", "sequence": "additional" }, { "affiliation": [], "family": "Li", "given": "Yan-Bo", "sequence": "additional" }, { "affiliation": [], "family": "Yuan", "given": "Shu-Hua", "sequence": "additional" }, { "affiliation": [], "family": "Wu", "given": "Jin-Hong", "sequence": "additional" }, { "affiliation": [], "family": "Zhang", "given": "Jing", "sequence": "additional" }, { "affiliation": [], "family": "Zhang", "given": "Lei", "sequence": "additional" }, { "affiliation": [], "family": "He", "given": "Yi", "sequence": "additional" }, { "affiliation": [], "family": "Chen", "given": "Jie", "sequence": "additional" }, { "ORCID": "http://orcid.org/0000-0003-0944-2692", "affiliation": [], "authenticated-orcid": false, "family": "Yin", "given": "Yong", "sequence": "additional" } ], "container-title": "World Journal of Pediatrics", "container-title-short": "World J Pediatr", "content-domain": { "crossmark-restriction": false, "domain": [ "link.springer.com" ] }, "created": { "date-parts": [ [ 2023, 9, 10 ] ], "date-time": "2023-09-10T18:01:48Z", "timestamp": 1694368908000 }, "deposited": { "date-parts": [ [ 2023, 9, 10 ] ], "date-time": "2023-09-10T18:03:00Z", "timestamp": 1694368980000 }, "funder": [ { "award": [ "PW2021E-06" ], "name": "Health and Family Planning Research Project of Pudong New Area Health Committee" } ], "indexed": { "date-parts": [ [ 2023, 9, 11 ] ], "date-time": "2023-09-11T21:27:42Z", "timestamp": 1694467662266 }, "is-referenced-by-count": 0, "issued": { "date-parts": [ [ 2023, 9, 10 ] ] }, "language": "en", "license": [ { "URL": "https://www.springernature.com/gp/researchers/text-and-data-mining", "content-version": "tdm", "delay-in-days": 0, "start": { "date-parts": [ [ 2023, 9, 10 ] ], "date-time": "2023-09-10T00:00:00Z", "timestamp": 1694304000000 } }, { "URL": "https://www.springernature.com/gp/researchers/text-and-data-mining", "content-version": "vor", "delay-in-days": 0, "start": { "date-parts": [ [ 2023, 9, 10 ] ], "date-time": "2023-09-10T00:00:00Z", "timestamp": 1694304000000 } } ], "link": [ { "URL": "https://link.springer.com/content/pdf/10.1007/s12519-023-00749-z.pdf", "content-type": "application/pdf", "content-version": "vor", "intended-application": "text-mining" }, { "URL": "https://link.springer.com/article/10.1007/s12519-023-00749-z/fulltext.html", "content-type": "text/html", "content-version": "vor", "intended-application": "text-mining" }, { "URL": "https://link.springer.com/content/pdf/10.1007/s12519-023-00749-z.pdf", "content-type": "application/pdf", "content-version": "vor", "intended-application": "similarity-checking" } ], "member": "297", "original-title": [], "prefix": "10.1007", "published": { "date-parts": [ [ 2023, 9, 10 ] ] }, "published-online": { "date-parts": [ [ 2023, 9, 10 ] ] }, "publisher": "Springer Science and Business Media LLC", "reference": [ { "DOI": "10.1016/j.jinf.2022.08.034", "doi-asserted-by": "crossref", "key": "749_CR1", "unstructured": "Yin Y, Lin J, Yuan S, Tong S, Chen E, Zheng J, et al. 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