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All Studies   Meta Analysis    Recent:   
0 0.5 1 1.5 2+ Mortality 28% Improvement Relative Risk Discharge 15% Metformin for COVID-19  CORONADO  Prophylaxis Is prophylaxis with metformin beneficial for COVID-19? Retrospective 2,794 patients in France (March - April 2020) Lower mortality (p=0.026) and higher discharge (p=0.019) c19early.org Wargny et al., Diabetologia, February 2021 Favors metformin Favors control

Predictors of hospital discharge and mortality in patients with diabetes and COVID-19: updated results from the nationwide CORONADO study

Wargny et al., Diabetologia, doi:10.1007/s00125-020-05351-w, CORONADO, NCT04324736
Feb 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 88 studies.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
4,100+ studies for 60+ treatments. c19early.org
Retrospective 2,796 hospitalized diabetes patients with COVID-19 in France, showing lower mortality with metformin use.
risk of death, 28.3% lower, RR 0.72, p = 0.03, treatment 247 of 1,553 (15.9%), control 330 of 1,241 (26.6%), NNT 9.4, adjusted per study, odds ratio converted to relative risk, multivariable, day 28.
risk of no hospital discharge, 14.8% lower, RR 0.85, p = 0.02, treatment 690 of 1,553 (44.4%), control 702 of 1,241 (56.6%), NNT 8.2, adjusted per study, inverted to make RR<1 favor treatment, odds ratio converted to relative risk, multivariable, day 28.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Wargny et al., 17 Feb 2021, retrospective, France, peer-reviewed, 43 authors, study period 10 March, 2020 - 10 April, 2020, trial NCT04324736 (history) (CORONADO).
This PaperMetforminAll
Predictors of hospital discharge and mortality in patients with diabetes and COVID-19: updated results from the nationwide CORONADO study
Matthieu Wargny, Louis Potier, Pierre Gourdy, Matthieu Pichelin, Coralie Amadou, Pierre-Yves Benhamou, Jean-Baptiste Bonnet, Lyse Bordier, Olivier Bourron, Claude Chaumeil, Nicolas Chevalier, Patrice Darmon, Blandine Delenne, Delphine Demarsy, Marie Dumas, Olivier Dupuy, Anna Flaus-Furmaniuk, Jean-François Gautier, Anne-Marie Guedj, Nathalie Jeandidier, Etienne Larger, Jean-Philippe Le Berre, Myriam Lungo, Nathanaëlle Montanier, Philippe Moulin, Françoise Plat, Vincent Rigalleau, René Robert, Dominique Seret-Bégué, Pierre Sérusclat, Sarra Smati, Jean-François Thébaut, Blandine Tramunt, Camille Vatier, Fritz-Line Velayoudom, Bruno Vergès, Patrice Winiszewski, Audrey Zabulon, Pierre-Antoine Gourraud, Ronan Roussel, Bertrand Cariou, Samy Hadjadj
Diabetologia, doi:10.1007/s00125-020-05351-w
Aims/hypothesis This is an update of the results from the previous report of the CORONADO (Coronavirus SARS-CoV-2 and Diabetes Outcomes) study, which aims to describe the outcomes and prognostic factors in patients with diabetes hospitalised for coronavirus disease-2019 (COVID-19). Methods The CORONADO initiative is a French nationwide multicentre study of patients with diabetes hospitalised for COVID-19 with a 28-day follow-up. The patients were screened after hospital admission from 10 March to 10 April 2020. We mainly focused on hospital discharge and death within 28 days. Results We included 2796 participants: 63.7% men, mean age 69.7 ± 13.2 years, median BMI (25th-75th percentile) 28.4 (25.0-32.4) kg/m 2 . Microvascular and macrovascular diabetic complications were found in 44.2% and 38.6% of participants, respectively. Within 28 days, 1404 (50.2%; 95% CI 48.3%, 52.1%) were discharged from hospital with a median duration of hospital stay of 9 (5-14) days, while 577 participants died (20.6%; 95% CI 19.2%, 22.2%). In multivariable models, younger age, routine metformin therapy and longer symptom duration on admission were positively associated with discharge. History of microvascular complications, anticoagulant routine therapy, dyspnoea on admission, and higher aspartate aminotransferase, white cell count and C-reactive protein levels were associated with a reduced chance of discharge. Factors associated with death within 28 days mirrored those associated with discharge, and also included routine treatment by insulin and statin as deleterious factors. Conclusions/interpretation In patients with diabetes hospitalised for COVID-19, we established prognostic factors for hospital discharge and death that could help clinicians in this pandemic period. Trial registration Clinicaltrials.gov identifier: NCT04324736
Supplementary Information The online version contains peer-reviewed but unedited supplementary material available at https://doi.org/10.1007/ s00125-020-05351-w. Authors' relationships and activities BC reports grants and personal fees from Amgen, AstraZeneca, Akcea, Genfit, Gilead, Eli Lilly, Novo Nordisk, and MSD, and grants and personal fees from Sanofi and Regeneron. PD reports personal fees from Novo Nordisk, Sanofi, Eli Lilly, MSD, Novartis, Abbott, AstraZeneca, Boehringer Ingelheim and Mundipharma. J-FG reports personal fees and non-financial support from Eli Lilly, Novo Nordisk and AstraZeneca, personal fees from Bristol-Myers Squibb, Gilead and Bayer; all disclosures above unrelated to this presentation. PG reports personal fees from Abbott, Amgen, AstraZeneca, Boehringer Ingelheim, Eli Lilly, MSD, Mundipharma, Sanofi and Servier, and grants and personal fees from Novo Nordisk. SH reports personal fees and nonfinancial support from AstraZeneca, grants and personal fees from Bayer, personal fees from Boehringer Ingelheim, grants from Dinno Santé, personal fees from Eli Lilly, non-financial support from LVL, personal fees and non-financial support from MSD, personal fees from Novartis, grants from Pierre Fabre Santé, personal fees and non-financial support from Sanofi, personal fees and non-financial support from Servier, and personal fees from Valbiotis. MP reports personal fees and non-financial support from Novo Nordisk, and non-financial support from Sanofi and..
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