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0 0.5 1 1.5 2+ Mortality -10% Improvement Relative Risk Metformin  Pérez-Belmonte et al.  Prophylaxis Is prophylaxis with metformin beneficial for COVID-19? PSM retrospective 498 patients in Spain No significant difference in mortality c19early.org Pérez-Belmonte et al., BMC Medicine, Nov 2020 Favors metformin Favors control

Mortality and other adverse outcomes in patients with type 2 diabetes mellitus admitted for COVID-19 in association with glucose-lowering drugs: a nationwide cohort study

Pérez-Belmonte et al., BMC Medicine, doi:10.1186/s12916-020-01832-2
Nov 2020  
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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.
3,900+ studies for 60+ treatments. c19early.org
Retrospective 2,666 type 2 diabetes COVID-19 patients in Spain, showing higher mortality with existing metformin use (not statistically significant).
risk of death, 10.4% higher, RR 1.10, p = 0.48, treatment 79 of 249 (31.7%), control 79 of 249 (31.7%), adjusted per study, odds ratio converted to relative risk, mixed effect logistic regression, propensity score matching.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Pérez-Belmonte et al., 16 Nov 2020, retrospective, propensity score matching, Spain, peer-reviewed, 26 authors.
This PaperMetforminAll
Mortality and other adverse outcomes in patients with type 2 diabetes mellitus admitted for COVID-19 in association with glucose-lowering drugs: a nationwide cohort study
Luis M Pérez-Belmonte, José David Torres-Peña, María D López-Carmona, M Mar. Ayala-Gutiérrez, Francisco Fuentes-Jiménez, Lucía Jorge Huerta, Jaime Alonso Muñoz, Manuel Rubio-Rivas, Manel Madrazo, Marcos Guzmán Garcia, Beatriz Vicente Montes, Joaquim Fernández Sola, Javier Ena, Ruth Gonzalez Ferrer, Carmen Mella Pérez, Carlos Jorge Ripper, Jose Javier Napal Lecumberri, Iris El Attar Acedo, Susana Plaza Canteli, Sara Fuente Cosío, Francisco Amorós Martínez, Begoña Cortés Rodríguez, Pablo Pérez-Martínez, José Manuel Ramos-Rincón, Ricardo Gómez-Huelgas
BMC Medicine, doi:10.1186/s12916-020-01832-2
Background: Limited evidence exists on the role of glucose-lowering drugs in patients with COVID-19. Our main objective was to examine the association between in-hospital death and each routine at-home glucose-lowering drug both individually and in combination with metformin in patients with type 2 diabetes mellitus admitted for COVID-19. We also evaluated their association with the composite outcome of the need for ICU admission, invasive and non-invasive mechanical ventilation, or in-hospital death as well as on the development of in-hospital complications and a long-time hospital stay.
Supplementary Information Supplementary information accompanies this paper at https://doi.org/10. 1186/s12916-020-01832-2. Additional file 1: Table S1 . Pre-and post-propensity score matching of baseline sociodemographic and clinical characteristics of patients with type 2 diabetes mellitus admitted for coronavirus disease 2019 treated with metformin versus other glucose-lowering drugs. Additional file 2: Table S2 . Pre-and post-propensity score matching of baseline sociodemographic and clinical characteristics of patients with type 2 diabetes mellitus admitted for coronavirus disease 2019 treated with dipeptidyl peptidase-4 inhibitors versus other glucose-lowering drugs. Additional file 3: Table S3 . Pre-and post-propensity score matching of baseline sociodemographic and clinical characteristics of patients with type 2 diabetes mellitus admitted for coronavirus disease 2019 treated with insulin versus other glucose-lowering drugs. Additional file 4: Table S4 . Pre-and post-propensity score matching of baseline sociodemographic and clinical characteristics of patients with type 2 diabetes mellitus admitted for coronavirus disease 2019 treated with metformin plus dipeptidyl peptidase-4 inhibitors versus other glucose-lowering drugs. Additional file 5: Table S5 . Pre-and post-propensity score matching of baseline sociodemographic and clinical characteristics of patients with type 2 diabetes mellitus admitted for coronavirus disease 2019 treated with metformin plus..
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