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0 0.5 1 1.5 2+ Mortality -26% Improvement Relative Risk Case 28% Metformin for COVID-19  Oh et al.  Prophylaxis Is prophylaxis with metformin beneficial for COVID-19? Retrospective 11,892 patients in the USA Fewer cases with metformin (p<0.000001) Oh et al., Acta Diabetologica, February 2021 Favors metformin Favors control

Metformin use and risk of COVID-19 among patients with type II diabetes mellitus: an NHIS-COVID-19 database cohort study

Oh et al., Acta Diabetologica, doi:10.1007/s00592-020-01666-7
Feb 2021  
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Metformin for COVID-19
3rd treatment shown to reduce risk in July 2020
*, now known with p < 0.00000000001 from 88 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 27,493 type II diabetes patients in the USA, 7,204 on metformin, showing significantly lower COVID-19 cases, but no significant difference in mortality.
risk of death, 26.0% higher, OR 1.26, p = 0.30, treatment 5,946, control 5,946, adjusted per study, multivariable, RR approximated with OR.
risk of case, 28.0% lower, RR 0.72, p < 0.001, treatment 390 of 5,946 (6.6%), control 541 of 5,946 (9.1%), NNT 39, adjusted per study, odds ratio converted to relative risk, propensity score matching.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Oh et al., 13 Feb 2021, retrospective, USA, peer-reviewed, 2 authors.
This PaperMetforminAll
Metformin use and risk of COVID-19 among patients with type II diabetes mellitus: an NHIS-COVID-19 database cohort study
Tak Kyu Oh, In-Ae Song
Acta Diabetologica, doi:10.1007/s00592-020-01666-7
Aims The relationship between metformin therapy and the risk of coronavirus disease has not been reported among patients with type 2 diabetes mellitus (DM). We aimed to investigate whether metformin therapy was associated with the incidence of COVID-19 among type 2 DM patients in South Korea. Methods The National Health Insurance Service-COVID-19 cohort database, comprising COVID-19 patients from 1 January 2020 to 4 June 2020, was used for this study. Among them, adult patients with type 2 DM were included in this study. Metformin users were defined as those who had been prescribed continuous oral metformin for over a period of ≥ 90 days, and the control group was defined as all other patients. Results Overall, 27,493 patients with type 2 DM (7204, metformin user group; 20,289, control group) were included. After propensity score matching, 11,892 patients (5946 patients in each group) were included in the final analysis. In the logistic regression analysis, the odds of metformin users developing COVID-19 was 30% lower than that of the control group [odds ratio (OR): 0.70, 95% confidence interval (CI): 0.61-0.80; P < 0.001]. However, in the multivariate model, metformin use was not associated with hospital mortality when compared with that of the control group (OR: 1.26, 95% CI: 0.81-1.95; P = 0.301). Conclusions Metformin therapy might have potential benefits for the prevention of COVID-19 among patients with type 2 DM in South Korea. However, it did not affect the hospital mortality of type 2 DM patients diagnosed with COVID-19. Keywords Antidiabetic drug • Cohort study • Metformin • Type 2 diabetes Managed by Massimo Federici .
Supplementary Information The online version contains supplementary material available at https :// 2-020-01666 -7. Author contributions TK Oh designed the study, analysed the data, interpreted the data, and drafted the manuscript; In-Ae Song contributed to the study conceptualization, acquisition of data, and reviewed the manuscript. All authors have given approved the final version of the manuscript. Data availability The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request. Compliance with ethical standards Conflicts of interest The authors declare that they have no conflicts of interest. Ethics approval The study protocol was approved by the Institutional Review Board of Seoul National University Bundang Hospital (X-2004-604-905) and the Health Insurance Review and Assessment Service (NHIS-2020-1-291). Informed consent The requirement of informed consent was waived because data analyses were performed retrospectively using anonymised data retrieved from the South Korean National Health Insurance Service database. Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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