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Association of renin-angiotensin-aldosterone system inhibitors with best COVID-19 outcomes in a diabetic population of the Veneto Region (north-east Italy): a lesson for endemic phase?

Piarulli et al., Nutrition, Metabolism and Cardiovascular Diseases, doi:10.1016/j.numecd.2023.06.016
Jun 2023  
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Death/ICU 53% Improvement Relative Risk Death/ICU, hosp. patients 15% Hospitalization 45% Metformin for COVID-19  Piarulli et al.  Prophylaxis Is prophylaxis with metformin beneficial for COVID-19? Retrospective 4,014 patients in Italy (February 2020 - February 2021) Lower hospitalization with metformin (p=0.00021) c19early.org Piarulli et al., Nutrition, Metabolism.., Jun 2023 Favorsmetformin Favorscontrol 0 0.5 1 1.5 2+
Metformin for COVID-19
3rd treatment shown to reduce risk in July 2020
 
*, now with p < 0.00000000001 from 92 studies.
No treatment is 100% effective. Protocols combine treatments. * >10% efficacy, ≥3 studies.
4,400+ studies for 79 treatments. c19early.org
Retrospective diabetic COVID-19 patients in Italy, showing lower risk of hospitalization with metformin use.
risk of death/ICU, 53.0% lower, OR 0.47, p = 0.08, treatment 1,444, control 1,009, adjusted per study, for all patients, combined odds of hospitalization and ICU/death for hospitalized patients, multivariable, RR approximated with OR.
risk of death/ICU, 15.0% lower, OR 0.85, p = 0.68, treatment 209, control 180, adjusted per study, among hospitalized patients, multivariable, RR approximated with OR.
risk of hospitalization, 45.0% lower, OR 0.55, p < 0.001, treatment 1,444, control 1,009, adjusted per study, multivariable, RR approximated with OR.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Piarulli et al., 24 Jun 2023, retrospective, Italy, peer-reviewed, 7 authors, study period February 2020 - February 2021. Contact: francesco.piarulli@unipd.it, eugenio.ragazzi@unipd.it, drmassimocarollo@gmail.com, luca.benacchio@aulss6.veneto.it, fabio.piovanello@aulss6.veneto.it, ivana.simoncello@libero.it, annunziata.lapolla@unipd.it.
This PaperMetforminAll
Association of renin-angiotensin-aldosterone system inhibitors with best COVID-19 outcomes in a diabetic population of the Veneto Region (north-east Italy): a lesson for endemic phase?
MD Francesco Piarulli, MD Eugenio Ragazzi, MD Massimo Carollo, MSc Luca Benacchio, Fabio Piovanello, MD Ivana Simoncello, MD Annunziata Lapolla
Nutrition, Metabolism and Cardiovascular Diseases, doi:10.1016/j.numecd.2023.06.016
This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
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