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0 0.5 1 1.5 2+ Mortality 47% Improvement Relative Risk Mortality (b) 24% Mortality (c) 85% Mortality (d) 76% c19early.org/mf Ong et al. Metformin for COVID-19 Prophylaxis Is prophylaxis with metformin beneficial for COVID-19? Retrospective 355 patients in Philippines (March - September 2020) Lower mortality with metformin (p=0.017) Ong et al., J. the ASEAN Federation of Endocrine.., doi:10.15605/jafes.036.02.20 Favors metformin Favors control
Association Between Metformin Use and Mortality Among Patients with Type 2 Diabetes Mellitus Hospitalized for COVID-19 Infection
Ong et al., Journal of the ASEAN Federation of Endocrine Societies, doi:10.15605/jafes.036.02.20
Ong et al., Association Between Metformin Use and Mortality Among Patients with Type 2 Diabetes Mellitus Hospitalized for.., Journal of the ASEAN Federation of Endocrine Societies, doi:10.15605/jafes.036.02.20
Oct 2021   Source   PDF  
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Retrospective 355 diabetic hospitalized COVID-19 patients in the Philippines, showing lower mortality with metformin use.
risk of death, 46.8% lower, RR 0.53, p = 0.02, treatment 33 of 186 (17.7%), control 57 of 169 (33.7%), NNT 6.3, adjusted per study, odds ratio converted to relative risk, combined pre-existing and in-hospital use.
risk of death, 23.9% lower, RR 0.76, p = 0.16, treatment 28 of 109 (25.7%), control 57 of 169 (33.7%), NNT 12, odds ratio converted to relative risk, pre-existing use, unadjusted.
risk of death, 85.2% lower, RR 0.15, p = 0.002, treatment 2 of 40 (5.0%), control 57 of 169 (33.7%), NNT 3.5, odds ratio converted to relative risk, in-hospital use, unadjusted.
risk of death, 76.0% lower, RR 0.24, p = 0.005, treatment 3 of 37 (8.1%), control 57 of 169 (33.7%), NNT 3.9, odds ratio converted to relative risk, mixed pre-existing/in-hospital use, unadjusted.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Ong et al., 30 Oct 2021, retrospective, Philippines, peer-reviewed, 6 authors, study period 1 March, 2020 - 30 September, 2020.
Contact: anj0321ong@gmail.com.
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Abstract: Original Article Journal of the ASEAN Federation of Endocrine Societies Association Between Metformin Use and Mortality among Patients with Type 2 Diabetes Mellitus Hospitalized for COVID-19 Infection Angeli Nicole Ong,1 Ceryl Cindy Tan,1 Maria Teresa Cañete,2 Bryan Albert Lim,3 Jeremyjones Robles1,4 Section of Endocrinology, Diabetes and Metabolism, Department of Internal Medicine, Chong Hua Hospital, Cebu City, Philippines 2 Section of Neurology, Department of Internal Medicine, Chong Hua Hospital, Cebu City, Philippines 3 Section of Infectious Diseases, Department of Internal Medicine, Chong Hua Hospital, Cebu City, Philippines 4 Department of Internal Medicine, Cebu Institute of Medicine – Cebu Velez General Hospital, Cebu City, Philippines 1 Abstract Introduction. Metformin has known mechanistic benefits on COVID-19 infection due to its anti-inflammatory effects and its action on the ACE2 receptor. However, some physicians are reluctant to use it in hypoxemic patients due to potential lactic acidosis. The primary purpose of the study was to determine whether metformin use is associated with survival. We also wanted to determine whether there is a difference in outcomes in subcategories of metformin use, whether at home, in-hospital, or mixed home/in-hospital use. Objectives. This study aimed to determine an association between metformin use and mortality among patients with type 2 diabetes mellitus hospitalized for COVID-19 infection. Methodology. This was a cross-sectional analysis of data acquired from the COVID-19 database of two tertiary hospitals in Cebu from March 1, 2020, to September 30, 2020. Hospitalized adult Filipino patients with type 2 diabetes mellitus who tested positive for COVID-19 via RT-PCR were included and categorized as either metformin users or metformin non-users. Results. We included 355 patients with type 2 diabetes mellitus in the study, 186 (52.4%) were metformin users. They were further categorized into home metformin users (n=109, 30.7%), in-hospital metformin users (n=40, 11.3%), and mixed home/in-hospital metformin users (n=37, 10.4%). Metformin use was associated with a lower risk for mortality compared to non-users (p=0.001; OR=0.424). In-hospital and mixed home/in-hospital metformin users were associated with lower mortality odds than non-users (p=0.002; OR=0.103 and p=0.005; OR 0.173, respectively). The lower risk for mortality was noted in metformin, regardless of dosage, from 500 mg to 2 g daily (p=0.002). Daily dose between ≥1000 mg to <2000 mg was associated with the greatest benefit on mortality (p≤0.001; OR=0.252). The survival distributions between metformin users and non-users were statistically different, showing inequality in survival (χ2=5.67, p=0.017). Conclusion. Metformin was associated with a lower risk for mortality in persons with type 2 diabetes mellitus hospitalized for COVID-19 disease compared to non-users. Use of metformin in-hospital, and mixed home/in-hospital metformin use, was also associated with decreased risk for mortality. The greatest benefit seen was in those taking a daily dose of ≥1000 mg to <2000 mg. Key words: metformin, diabetes mellitus, COVID-19, mortality
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