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0 0.5 1 1.5 2+ Mortality 32% Improvement Relative Risk HCQ for COVID-19  Luo et al.  LATE TREATMENT Is late treatment with HCQ beneficial for COVID-19? Retrospective 283 patients in China No significant difference in mortality Luo et al., The American J. Tropical M.., May 2020 Favors HCQ Favors control

Metformin Treatment Was Associated with Decreased Mortality in COVID-19 Patients with Diabetes in a Retrospective Analysis

Luo et al., The American Journal of Tropical Medicine and Hygiene, doi:10.4269/ajtmh.20-0375
May 2020  
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HCQ for COVID-19
1st treatment shown to reduce risk in March 2020
*, now known with p < 0.00000000001 from 421 studies, recognized in 42 countries.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
3,800+ studies for 60+ treatments.
Retrospective 283 COVID-19+ diabetes patients in China, showing non-statistically significant lower mortality with HCQ/CQ treatment.
Although the 32% lower mortality is not statistically significant, it is consistent with the significant 24% lower mortality [20‑29%] from meta analysis of the 249 mortality results to date.
Study covers HCQ and metformin.
risk of death, 32.4% lower, OR 0.68, p = 0.72, treatment 19, control 264, inverted to make OR<1 favor treatment, multivariate, RR approximated with OR.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Luo et al., 21 May 2020, retrospective, China, peer-reviewed, 9 authors.
This PaperHCQAll
Metformin Treatment Was Associated with Decreased Mortality in COVID-19 Patients with Diabetes in a Retrospective Analysis
Pan Luo, Lin Qiu, Yi Liu, Xiu-Lan Liu, Jian-Ling Zheng, Hui-Ying Xue, Wen-Hua Liu, Dong Liu, Juan Li
The American Journal of Tropical Medicine and Hygiene, doi:10.4269/ajtmh.20-0375
Metformin was proposed to be a candidate for host-directed therapy for COVID-19. However, its efficacy remains to be validated. In this study, we compared the outcome of metformin users and nonusers in hospitalized COVID-19 patients with diabetes. Hospitalized diabetic patients with confirmed COVID-19 in the Tongji Hospital of Wuhan, China, from January 27, 2020 to March 24, 2020, were grouped into metformin and no-metformin groups according to the diabetic medications used. The demographics, characteristics, laboratory parameters, treatments, and clinical outcome in these patients were retrospectively assessed. A total of 283 patients (104 in the metformin and 179 in the no-metformin group) were included in this study. There were no significant differences between the two groups in gender, age, underlying diseases, clinical severity, and oxygen-support category at admission. The fasting blood glucose level of the metformin group was higher than that of the no-metformin group at admission and was under effective control in both groups after admission. Other laboratory parameters at admission and treatments after admission were not different between the two groups. The length of hospital stay did not differ between the two groups (21.0 days for metformin versus 19.5 days for no metformin, P = 0.74). However, in-hospital mortality was significantly lower in the metformin group (3/104 (2.9%) versus 22/179 (12.3%), P = 0.01). Antidiabetic treatment with metformin was associated with decreased mortality compared with diabetics not receiving metformin. This retrospective analysis suggests that metformin may offer benefits in patients with COVID-19 and that further study is indicated.
Ahmed, Raqib, Guethmundsson, Bergman, Agerberth et al., Host-directed therapy as a novel treatment strategy to overcome tuberculosis: targeting immune modulation, Antibiotics
Ba, Xu, Yin, Yang, Wang et al., Metformin inhibits pro-inflammatory responses via targeting nuclear factor-kappaB in HaCaT cells, Cell Biochem Funct
Burgos-Moron, Relationship between oxidative stress, ER stress, and inflammation in type 2 diabetes: the battle continues, J Clin Med
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Shi, Wang, Shao, Huang, Gan et al., COVID-19 infection: the perspectives on immune responses, Cell Death Differ
Vilela, Peixoto, Teixeira, Baptista, Caixeta et al., The role of metformin in controlling oxidative stress in muscle of diabetic rats, Oxid Med Cell Longev
Yew, Chang, Chan, Zhang, Metformin as a host-directed therapeutic in tuberculosis: is there a promise?, Tuberculosis
Zhang, Wang, Ni, Di, Ma et al., COVID-19: melatonin as a potential adjuvant treatment, Life Sci
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Late treatment
is less effective
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