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0 0.5 1 1.5 2+ Mortality 37% Improvement Relative Risk Metformin for COVID-19  Sourij et al.  Prophylaxis Is prophylaxis with metformin beneficial for COVID-19? Retrospective 247 patients in Austria Lower mortality with metformin (not stat. sig., p=0.13) Sourij et al., Diabetes, Obesity and M.., Dec 2020 Favors metformin Favors control

COVID‐19 fatality prediction in people with diabetes and prediabetes using a simple score upon hospital admission

Sourij et al., Diabetes, Obesity and Metabolism, doi:10.1111/dom.14256
Dec 2020  
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Retrospective 247 hospitalized COVID-19 diabetes patients, showing lower mortality with metformin use in unadjusted results.
Although the 37% lower mortality is not statistically significant, it is consistent with the significant 32% lower mortality [28‑37%] from meta analysis of the 55 mortality results to date.
risk of death, 37.3% lower, RR 0.63, p = 0.13, treatment 14 of 77 (18.2%), control 44 of 161 (27.3%), NNT 11, odds ratio converted to relative risk.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Sourij et al., 4 Dec 2020, retrospective, Austria, peer-reviewed, mean age 71.1, 24 authors.
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COVID‐19 fatality prediction in people with diabetes and prediabetes using a simple score upon hospital admission
MD Harald Sourij, Faisal Aziz, MD Alexander Bräuer, MD Christian Ciardi, MD Martin Clodi, MD Peter Fasching, MD Mario Karolyi, Alexandra Kautzky‐willer, MD Carmen Klammer, MD Oliver Malle, Abderrahim Oulhaj, MD Erich Pawelka, MD Slobodan Peric, MD Claudia Ress, MD Caren Sourij, MD Lars Stechemesser, MD Harald Stingl, MD Thomas Stulnig, Norbert Tripolt, MD Michael Wagner, Peter Wolf, MD Andreas Zitterl, MD Susanne Kaser
Diabetes, Obesity and Metabolism, doi:10.1111/dom.14256
Aim: To assess predictors of in-hospital mortality in people with prediabetes and diabetes hospitalized for COVID-19 infection and to develop a risk score for identifying those at the greatest risk of a fatal outcome. Materials and Methods: A combined prospective and retrospective, multicentre, cohort study was conducted at 10 sites in Austria in 247 people with diabetes or newly diagnosed prediabetes who were hospitalized with COVID-19. The primary outcome was in-hospital mortality and the predictor variables upon admission included clinical data, co-morbidities of diabetes or laboratory data. Logistic regression analyses were performed to identify significant predictors and to develop a risk score for in-hospital mortality. Results: The mean age of people hospitalized (n = 238) for COVID-19 was 71.1 ± 12.9 years, 63.6% were males, 75.6% had type 2 diabetes, 4.6% had type 1 diabetes and 19.8% had prediabetes. The mean duration of hospital stay was 18 ± 16 days, 23.9% required ventilation therapy and 24.4% died in the hospital. The mortality rate in people with diabetes was numerically higher (26.7%) compared with those with prediabetes (14.9%) but without statistical significance (P = .128). A score including age, arterial occlusive disease, C-reactive protein, estimated glomerular filtration rate and aspartate aminotransferase levels at admission predicted in-hospital mortality with a Cstatistic of 0.889 (95% CI: 0.837-0.941) and calibration of 1.000 (P = .909). Conclusions: The in-hospital mortality for COVID-19 was high in people with diabetes but not significantly different to the risk in people with prediabetes. A risk score
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