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0 0.5 1 1.5 2+ Mortality 50% Improvement Relative Risk Metformin for COVID-19  Mamari et al.  Prophylaxis Is prophylaxis with metformin beneficial for COVID-19? Retrospective 109 patients in Syria Study compares with sulfonylureas, results vs. placebo may differ Lower mortality with metformin (p=0.015) Mamari et al., Research J. Pharmacy an.., Nov 2023 Favors metformin Favors sulfonylureas

The effect of Chronic treatments of Type 2-diabetes mellitus on COVID-19 Morbidity and Symptoms Severity

Mamari et al., Research Journal of Pharmacy and Technology, doi:10.52711/0974-360X.2023.00831
Nov 2023  
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Metformin for COVID-19
3rd treatment shown to reduce risk in July 2020
*, now known with p < 0.00000000001 from 84 studies.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
3,800+ studies for 60+ treatments.
Retrospective 109 hospitalized COVID-19 patients in Syria, 68 with diabetes, showing significantly lower mortality with metformin vs. sulfonylureas, and significantly higher mortality with discontinuation of metformin.
risk of death, 50.0% lower, RR 0.50, p = 0.01, treatment 11 of 34 (32.4%), control 22 of 34 (64.7%), NNT 3.1.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Mamari et al., 30 Nov 2023, retrospective, Syria, peer-reviewed, 2 authors, this trial compares with another treatment - results may be better when compared to placebo.
This PaperMetforminAll
The effect of Chronic treatments of Type 2diabetes mellitus on COVID-19 Morbidity and Symptoms Severity
Rozalia Mamari, Key=rama Ibrahim, Ibrahim Rama, Syria Latakia
Coronavirus disease 2019 (COVID-19) is a highly contagious viral disease that causes the severe acute respiratory syndrome (SARS), and has had a disastrous impact on demographics around the world. Studies have classified type 2-diabetes mellitus (T2DM) as a risk factor for increasing mortality and se-verity of disease symptoms. However, the effect of different T2DMchronic medications on disease progression is still unclear. The aim of this study was to determine the effect of glycemic control on COVID-19-related mortality and symptom severity, as well as the impact of commonly used T2DM therapeutic approaches on disease outcomes. This study included 109 COVID-19 patients with (68 patients) or without (41 patients) type 2-diabetes mellitus. Diabetic patients were further classified according to: 1) their glycemic control [HbA1c levels ˂6.5% (Well-controlled) and ≥ 6.5% (Less-controlled)], or 2) their pre-hospital anti-hyperglycemic med-ication [metformin (50%) or sulfonylureas (50%)]. Our results showed that diabetes is associated with a significantly higher risk of death in COVID-19 pa-tients. We also found that metformin treatment reduces plasma C-reactive protein levels and mortality Compared with sulfonylureas, and continuing with metformin during the hospital stay had a better prog-nostic for survival. We also, demonstrated that taking sulfonylurea is associated with an increase in COVID-19 mortality as compared to metformin by increasing cardiovascular events.
CONFLICT OF INTEREST: The authors have no conflicts of interest regarding this investigation.
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