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0 0.5 1 1.5 2+ Mortality 30% Improvement Relative Risk Metformin for COVID-19  Ravindra et al.  Prophylaxis Is prophylaxis with metformin beneficial for COVID-19? Retrospective 366 patients in India Lower mortality with metformin (not stat. sig., p=0.42) Ravindra et al., medRxiv, May 2021 Favors metformin Favors control

Retrospective Assessment of Treatments of Hospitalized Covid-19 Patients

Ravindra et al., medRxiv, doi:10.1101/2021.04.20.21255792
May 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 87 studies.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
4,000+ studies for 60+ treatments.
Retrospective 1,035 hospitalized patients in India. Of 366 diabetic patients, there was lower mortality for the 53 that were on metformin.
Although the 30% lower mortality is not statistically significant, it is consistent with the significant 34% lower mortality [29‑38%] from meta analysis of the 62 mortality results to date.
This study is excluded in the after exclusion results of meta analysis: minimal details provided.
risk of death, 29.6% lower, RR 0.70, p = 0.42, treatment 5 of 53 (9.4%), control 57 of 313 (18.2%), adjusted per study, odds ratio converted to relative risk.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Ravindra et al., 5 May 2021, retrospective, India, peer-reviewed, 14 authors.
This PaperMetforminAll
Retrospective Assessment of Treatments of Hospitalized Covid-19 Patients
Ph.D Ghooi Ravindra, Ph. D Lele Chitra, Ph. D Motwani Madhur, Ph. D Dixit Santosh, Ph. D Premnath Venugopalan, M.D. Ph.D Salvi Sundeep, M.D Bhat Shreepad, Chaudhari Piyush, D’costa Pradeep, M.D Jahagirdar Ashwini, M.D Mane Abhay, M.D Padbidri Vikram, M.D Pande Chetan, M.D Shukla Urvi
Infection with SARS-Cov-2 virus, is associated with significant morbidity and mortality, in addition to the economic burden it has put on the country. While waiting for a vaccine that gives adequate protection, it is necessary to understand the course of the infection and identify drugs that could reduce its impact. The results of this multicenter study involving 1035 hospitalized patients in Pune, identified diabetes, hypertension and low lymphocyte counts as predictors of mortality. There is also an indication that multiple comorbidities add to risk of severe disease and mortality. Data from metformin treated diabetics raises the possibility of considering repurposing of this drug in a larger study. It is also noted that Hydroxychloroquine, dexamethasone, azithromycin and remdesivir were associated with lower overall mortality. Diabetes and hypertension put Covid infected patients at greater risk of death, coexistence of both diseases further augment the risk, and must be aggressively treated.
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