Association of clinical characteristics, antidiabetic and cardiovascular agents with diabetes mellitus and COVID-19: a 7-month follow-up cohort study

Pazoki et al., Journal of Diabetes & Metabolic Disorders, doi:10.1007/s40200-021-00901-4, Nov 2021
Mortality -13% improvement lower risk ← → higher risk Severe case -24% Metformin for COVID-19  Pazoki et al.  PROPHYLAXIS Is prophylaxis with metformin beneficial for COVID-19? Retrospective 393 patients in Iran (February - October 2020) Higher severe cases with metformin (not stat. sig., p=0.58) c19early.org Pazoki et al., J. Diabetes & Metab.., Nov 2021 0 0.5 1 1.5 2+ RR
Metformin for COVID-19
3rd treatment shown to reduce risk in July 2020, now with p < 0.00000000001 from 110 studies.
No treatment is 100% effective. Protocols combine treatments.
6,400+ studies for 210+ treatments. c19early.org
Retrospective 393 hospitalized diabetic COVID-19 patients showing no significant difference in mortality with metformin and insulin use.
risk of death, 13.0% higher, HR 1.13, p = 0.57, treatment 177, control 216, model 2.
risk of severe case, 24.0% higher, HR 1.24, p = 0.57, treatment 177, control 216, model 2.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Pazoki et al., 8 Nov 2021, retrospective, Iran, peer-reviewed, mean age 59.2, 17 authors, study period 20 February, 2020 - 29 October, 2020. Contact: heydarianpeimaneh@gmail.com.
$0 $500 $1,000+ Efficacy vs. cost for COVID-19 treatment protocols c19early.org February 2026 Iran United Kingdom USA Russia Sudan Angola Colombia Kenya Mozambique Pakistan Peru Philippines Argentina Vietnam Spain Brazil Italy France Japan China Uzbekistan Nepal Ethiopia Mexico South Korea Ghana Germany Bangladesh Saudi Arabia Algeria Morocco Yemen Poland India DR Congo Madagascar Thailand Uganda Venezuela Nigeria Egypt Bolivia Taiwan Zambia Fiji Bosnia-Herzegovina Ukraine Côte d'Ivoire Bulgaria Greece Slovakia Singapore Iceland New Zealand Mongolia Czechia Israel Trinidad and Tobago Hong Kong Belarus North Macedonia Qatar Panama Serbia CAR Iran favored high-profit treatments.The average efficacy of treatments was moderate.High-cost protocols reduce early treatment, andforgo complementary/synergistic benefits. More effective More expensive 75% 50% 25% ≤0%
$0 $500 $1,000+ Efficacy vs. cost for COVID-19treatment protocols worldwide c19early.org February 2026 Iran United Kingdom USA Russia Sudan Angola Colombia Kenya Mozambique Pakistan Peru Philippines Argentina Vietnam Spain Brazil Italy France Japan China Uzbekistan Nepal Ethiopia Mexico South Korea Ghana Germany Bangladesh Saudi Arabia Algeria Morocco Yemen Poland India DR Congo Madagascar Thailand Uganda Venezuela Nigeria Egypt Bolivia Taiwan Zambia Fiji Bosnia-Herzegovina Côte d'Ivoire Bulgaria Greece Slovakia Iceland Mongolia Czechia Israel Trinidad and Tobago Hong Kong Belarus North Macedonia Qatar Panama Serbia Syria Iran favored high-profit treatments.The average efficacy was moderate.High-cost protocols reduce early treatment,and forgo complementary/synergistic benefits. More effective More expensive 75% 50% 25% ≤0%
Association of clinical characteristics, antidiabetic and cardiovascular agents with diabetes mellitus and COVID-19: a 7-month follow-up cohort study
Marzieh Pazoki, Fatemeh Chichagi, Azar Hadadi, Samira Kafan, Mahnaz Montazeri, Sina Kazemian, Arya Aminorroaya, Mehdi Ebrahimi, Haleh Ashraf, Mojgan Mirabdolhagh Hazaveh, Mohammad Reza Khajavi, Reza Shariat Moharari, Seyed Hamidreza Sharifnia, Shahrokh Karbalai Saleh, Hormat Rahimzadeh, Neda Goodarzi, Peimaneh Heydarian
Journal of Diabetes & Metabolic Disorders, doi:10.1007/s40200-021-00901-4
Background The prognostic factors of long-term outcomes in hospitalized patients with diabetes mellitus and COVID-19 are lacking. Methods In this retrospective cohort study, we evaluated patients aged ≥ 18-years-old with the COVID-19 diagnosis who were hospitalized between Feb 20 and Oct 29, 2020, in the Sina Hospital, Tehran, Iran. 1323 patients with COVID-19 entered in the final analysis, of whom 393 (29.7%) patients had diabetes. We followed up patients for incurring in-hospital death, severe COVID-19, in-hospital complications, and 7-month all-cause mortality. By doing univariate analysis, variables with unadjusted P-value < 0.1 in univariate analyses were regarded as the confounders to include in the logistic regression models. We made adjustments for possible clinical (model 1) and both clinical and laboratory (model 2) confounders. Results After multivariable regression, it was revealed that preadmission use of sulfonylureas was associated with a borderline increased risk of severity in both models [model 1, OR (95% CI):1.83 (0.91-3.71), P-value: 0.092; model 2, 2.05 (0.87-4.79), P-value: 0.099] and major adverse events (MAE: each of the severe COVID-19, multi-organ damage, or inhospital mortality) in model 1 [OR (95% CI): 1.86 (0.90-3.87), P-value: 0.094]. Preadmission use of ACEIs/ARBs was associated with borderline increased risk of MAE in the only model 1 [OR (95% CI):1.83 (0.96-3.48), P-value: 0.066]. Conclusions Preadmission use of sulfonylureas and ACEIs/ARBs were associated with borderline increased risk of inhospital adverse outcomes.
Supplementary Information The online version contains supplementary material available at https:// doi. org/ 10. 1007/ s40200-021-00901-4 . Author contributions MP: concept and design, drafting of the manuscript, revision of the manuscript. FC: data Interpretation, statistical analysis, drafting of the manuscript, revision of the manuscript. A.Hadadi: concept and design, data acquisition, supervision. SK: concept and design, data acquisition, supervision. MM: concept and design, data acquisition, supervision. SK: concept and design, data interpretation, statistical analysis, drafting of the manuscript, revision of the manuscript. AA: data interpretation, statistical analysis, drafting of the manuscript, revision of the manuscript. ME: concept and design, data acquisition, supervision. HA: concept and design, data interpretation, statistical analysis, drafting of the manuscript, supervision. MMH: concept and design, data acquisition, supervision. MRK: concept and design, data acquisition, supervision. RSM: concept and design, data acquisition, supervision. SHS: concept and design, data acquisition, supervision. SKS: concept and design, data acquisition, supervision. HR: concept and design, data acquisition, supervision. NG: concept and design, data acquisition. PH: data Interpretation, statistical analysis, drafting of the manuscript, revision of the manuscript. Declarations Conflict of interest All authors declare that they have no competing interests. Ethical approval..
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Please send us corrections, updates, or comments. c19early involves the extraction of 200,000+ datapoints from thousands of papers. Community updates help ensure high accuracy. Treatments and other interventions are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. IMA and WCH provide treatment protocols.
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