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0 0.5 1 1.5 2+ Severe case 33% Improvement Relative Risk Metformin  Milosavljevic et al.  Prophylaxis Is prophylaxis with metformin beneficial for COVID-19? Retrospective 733 patients in the USA (March - December 2020) Lower severe cases with metformin (p=0.025) Milosavljevic et al., J. Community Hos.., Nov 2022 Favors metformin Favors control

Evaluation of Glycemic Control and Predictors of Severe Illness and Death in Patients With Diabetes Hospitalized With COVID-19

Milosavljevic et al., Journal of Community Hospital Internal Medicine Perspectives, doi:10.55729/2000-9666.1127
Nov 2022  
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Metformin for COVID-19
3rd treatment shown to reduce risk in July 2020
*, now known with p < 0.00000000001 from 89 studies.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
4,100+ studies for 60+ treatments.
Retrospective 733 hospitalized COVID-19 patients with diabetes in the USA, showing lower risk of severity with metformin use.
risk of severe case, 33.0% lower, OR 0.67, p = 0.03, treatment 377, control 356, RR approximated with OR.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Milosavljevic et al., 9 Nov 2022, retrospective, USA, peer-reviewed, mean age 67.4, 7 authors, study period 1 March, 2020 - 31 December, 2020. Contact:
This PaperMetforminAll
Evaluation of Glycemic Control and Predictors of Severe Illness and Death in Patients With Diabetes Hospitalized With COVID-19
Jovan Milosavljevic, Navya Reddy Perkit, Sakshi Jhawar, Melbin Thomas, Justin Ling, Samuel Amankwah, Asha Mary Thomas
Journal of Community Hospital Internal Medicine Perspectives, doi:10.55729/2000-9666.1127
Objectives: To identify risk factors for severe disease and death among patients with diabetes and coronavirus disease 2019 (COVID-19) infection. Methods: This retrospective cohort study conducted at three hospitals included 733 consecutive patients with DM admitted with confirmed COVID-19 (March 1 -December 31, 2020). Multivariable logistic regression was performed to identify predictors of severe disease and death. Results: The mean age was 67.4 ± 14.3 years, 46.9% were males and 61.5% were African American. Among all patients, 116 (15.8%) died in the hospital. A total of 317 (43.2%) patients developed severe disease, 183 (25%) were admitted to an ICU and 118 (16.1%) required invasive mechanical ventilation. Increasing BMI (OR, 1.13; 95% CI, 1.02e1.25), history of chronic lung disease (OR, 1.49; 95% CI, 1.05e2.10) and increasing time since the last HbA1c test (OR, 1.25; 95% CI, 1.05e1.49) were the preadmission factors associated with increased odds of severe disease. Preadmission use of metformin (OR, 0.67; 95% CI, 0.47e0.95) or GLP-1 agonists (OR, 0.49; 95% CI, 0.27e0.87) was associated with decreased odds of severe disease. Increasing age (OR, 1.21; 95% CI, 1.09e1.34), co-existing chronic kidney disease greater than stage 3 (OR, 3.38; 95% CI, 1.67e6.84), ICU admission (OR, 2.93; 95% CI, 1.28e6.69) and use of invasive mechanical ventilation (OR, 8.67, 95% CI, 3.88e19.39) were independently associated with greater odds of in-hospital death. Conclusion: Several clinical characteristics were identified to be predictive of severe disease and in-hospital death among patients with underlying diabetes hospitalized with COVID-19.
Author contributions J.M.: data collection, data analysis, writing e original draft; N.P.: data collection, writing e original draft; M.T., S.J., J.L. and S.A.: data collection, writing e review & editing; A.T.: conceptualization, supervision, writing -review & editing. All authors read and approved the final manuscript. Conflict of interest The authors declare that they have no competing or conflicts of interests.
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