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The Effect of Antihyperglycemic Medications on COVID-19: A Meta-analysis and Systematic Review from Observational Studies

Song et al., Therapeutic Innovation & Regulatory Science, doi:10.1007/s43441-024-00633-6
Apr 2024  
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Mortality 34% Improvement Relative Risk Severe case 35% Hospitalization 23% Metformin for COVID-19  Song et al.  META ANALYSIS c19early.org 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 98 studies.
No treatment is 100% effective. Protocols combine treatments.
5,100+ studies for 110 treatments. c19early.org
Meta analysis of 56 studies showing lower mortality and hospitalization with metformin, GLP-1 receptor agonists, and SGLT-2 inhibitors in COVID-19 patients with type 2 diabetes, while insulin was associated with increased risks.
22 meta analyses show significant improvements with metformin for mortality1-21, hospitalization7,13, progression1, and severity8,9,13.
Currently there are 98 metformin for COVID-19 studies, showing 35% lower mortality [31‑39%], 33% lower ventilation [17‑46%], 17% lower ICU admission [6‑26%], 18% lower hospitalization [11‑23%], and 5% fewer cases [-4‑13%].
risk of death, 34.0% lower, OR 0.66, p < 0.001, RR approximated with OR.
risk of severe case, 35.0% lower, OR 0.65, p = 0.002, RR approximated with OR.
risk of hospitalization, 23.0% lower, OR 0.77, p = 0.02, RR approximated with OR.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Song et al., 29 Apr 2024, peer-reviewed, 5 authors.
This PaperMetforminAll
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Front Endocrinol (Lausanne). 2021;12:708494.', 'journal-title': 'Front Endocrinol (Lausanne)'}, { 'key': '633_CR92', 'doi-asserted-by': 'publisher', 'DOI': '10.2217/fvl-2022-0112', 'author': 'S Nag', 'year': '2023', 'unstructured': 'Nag S, Mandal S, Mukherjee O, Mukherjee S, Kundu R. DPP-4 Inhibitors as ' 'a savior for COVID-19 patients with diabetes. Future Virol. 2023. ' 'https://doi.org/10.2217/fvl-2022-0112.', 'journal-title': 'Future Virol.'}, { 'issue': '5', 'key': '633_CR93', 'doi-asserted-by': 'publisher', 'first-page': '829', 'DOI': '10.1016/j.dsx.2020.06.015', 'volume': '14', 'author': 'JM Jagat', 'year': '2020', 'unstructured': 'Jagat JM, Kalyan KG, Subir R. Use of pioglitazone in people with type 2 ' 'diabetes mellitus with coronavirus disease 2019 (COVID-19): boon or ' 'bane? Diabetes Metab Syndr. 2020;14(5):829–31.', 'journal-title': 'Diabetes Metab Syndr.'}, { 'issue': '3', 'key': '633_CR94', 'doi-asserted-by': 'publisher', 'first-page': '1287', 'DOI': '10.1042/BST20200505', 'volume': '48', 'author': 'Spencer J Williams', 'year': '2020', 'unstructured': 'Williams Spencer J, Goddard-Borger Ethan D. α-glucosidase inhibitors as ' 'host-directed antiviral agents with potential for the treatment of ' 'COVID-19. Biochem Soc Trans. 2020;48(3):1287–95.', 'journal-title': 'Biochem Soc Trans'}], 'container-title': 'Therapeutic Innovation &amp; Regulatory Science', 'original-title': [], 'language': 'en', 'link': [ { 'URL': 'https://link.springer.com/content/pdf/10.1007/s43441-024-00633-6.pdf', 'content-type': 'application/pdf', 'content-version': 'vor', 'intended-application': 'text-mining'}, { 'URL': 'https://link.springer.com/article/10.1007/s43441-024-00633-6/fulltext.html', 'content-type': 'text/html', 'content-version': 'vor', 'intended-application': 'text-mining'}, { 'URL': 'https://link.springer.com/content/pdf/10.1007/s43441-024-00633-6.pdf', 'content-type': 'application/pdf', 'content-version': 'vor', 'intended-application': 'similarity-checking'}], 'deposited': { 'date-parts': [[2024, 4, 29]], 'date-time': '2024-04-29T14:19:03Z', 'timestamp': 1714400343000}, 'score': 1, 'resource': {'primary': {'URL': 'https://link.springer.com/10.1007/s43441-024-00633-6'}}, 'subtitle': [], 'short-title': [], 'issued': {'date-parts': [[2024, 4, 29]]}, 'references-count': 94, 'alternative-id': ['633'], 'URL': 'http://dx.doi.org/10.1007/s43441-024-00633-6', 'relation': {}, 'ISSN': ['2168-4790', '2168-4804'], 'subject': [], 'container-title-short': 'Ther Innov Regul Sci', 'published': {'date-parts': [[2024, 4, 29]]}, 'assertion': [ { 'value': '6 September 2023', 'order': 1, 'name': 'received', 'label': 'Received', 'group': {'name': 'ArticleHistory', 'label': 'Article History'}}, { 'value': '9 February 2024', 'order': 2, 'name': 'accepted', 'label': 'Accepted', 'group': {'name': 'ArticleHistory', 'label': 'Article History'}}, { 'value': '29 April 2024', 'order': 3, 'name': 'first_online', 'label': 'First Online', 'group': {'name': 'ArticleHistory', 'label': 'Article History'}}, {'order': 1, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Declarations'}}, { 'value': 'The authors declare no competing interests.', 'order': 2, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Competing Interests'}}, { 'value': 'Not applicable.', 'order': 3, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Ethical Approval'}}]}
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