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All Studies   Meta Analysis   Recent:  
0 0.5 1 1.5 2+ Mortality 45% Improvement Relative Risk Metformin for COVID-19  Mirani et al.  Prophylaxis Is prophylaxis with metformin beneficial for COVID-19? Retrospective 90 patients in Italy (February - April 2020) Lower mortality with metformin (not stat. sig., p=0.097) c19early.org Mirani et al., Diabetes Care, October 2020 Favors metformin Favors control

Impact of Comorbidities and Glycemia at Admission and Dipeptidyl Peptidase 4 Inhibitors in Patients With Type 2 Diabetes With COVID-19: A Case Series From an Academic Hospital in Lombardy, Italy

Mirani et al., Diabetes Care, doi:10.2337/dc20-1340
Oct 2020  
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Retrospective 90 hospitalized COVID-19 patients with diabetes in Italy, showing lower mortality with metformin use, without statistical significance.
risk of death, 45.0% lower, HR 0.55, p = 0.10, treatment 25 of 69 (36.2%), control 13 of 21 (61.9%), NNT 3.9, adjusted per study, Cox proportional hazards.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Mirani et al., 6 Oct 2020, retrospective, Italy, peer-reviewed, median age 66.0, 8 authors, study period 20 February, 2020 - 9 April, 2020.
Contact: mirani@humanitas.it.
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Impact of Comorbidities and Glycemia at Admission and Dipeptidyl Peptidase 4 Inhibitors in Patients With Type 2 Diabetes With COVID-19: A Case Series From an Academic Hospital in Lombardy, Italy
Marco Mirani, Giuseppe Favacchio, Flaminia Carrone, Nazarena Betella, Emilia Biamonte, Emanuela Morenghi, Gherardo Mazziotti, Andrea Gerardo Lania
doi:10.2337/figshare.12980015.
Diabetes may unfavorably influence the outcome of coronavirus disease 19 , but the determinants of this effect are still poorly understood. In this monocentric study, we aimed at evaluating the impact of type 2 diabetes, comorbidities, plasma glucose levels, and antidiabetes medications on the survival of COVID-19 patients. RESEARCH DESIGN AND METHODS This was a case series involving 387 COVID-19 patients admitted to a single center in the region of Lombardy, the epicenter of the severe acute respiratory syndrome coronavirus 2 pandemic in Italy, between 20 February and 9 April 2020. Medical history, pharmacological treatments, laboratory findings, and clinical outcomes of patients without diabetes and patients with type 2 diabetes were compared. Cox proportional hazards analysis was applied to investigate risk factors associated with mortality. RESULTS Our samples included 90 patients (23.3%) with type 2 diabetes, who displayed double the mortality rate of subjects without diabetes (42.3% vs. 21.7%, P < 0.001). In spite of this, after correction for age and sex, risk of mortality was significantly associated with a history of hypertension (adjusted hazard ratio [aHR] 1.84, 95% CI 1.15-2.95; P 5 0.011), coronary artery disease (aHR 1.56, 95% CI 1.04-2.35; P 5 0.031), chronic kidney disease (aHR 2.07, 95% CI 1.27-3.38; P 5 0.003), stroke (aHR 2.09, 95% CI 1.23-3.55; P 5 0.006), and cancer (aHR 1.57, 95% CI 1.08-2.42; P 5 0.04) but not with type 2 diabetes (P 5 0.170). In patients with diabetes, elevated plasma glucose (aHR 1.22, 95% CI 1.04-1.44, per mmol/L; P 5 0.015) and IL-6 levels at admission (aHR 2.47, 95% CI 1.28-4.78, per 1-SD increase; P 5 0.007) as well as treatment with insulin (aHR 3.05, 95% CI 1.57-5.95; P 5 0.001) and b-blockers (aHR 3.20, 95% CI 1.50-6.60; P 5 0.001) were independently associated with increased mortality, whereas the use of dipeptidyl peptidase 4 inhibitors was significantly and independently associated with a lower risk of mortality (aHR 0.13, 95% CI 0.02-0.92; P 5 0.042). CONCLUSIONS Plasma glucose levels at admission and antidiabetes drugs may influence the survival of COVID-19 patients affected by type 2 diabetes.
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