ABSTRACT
BACKGROUND AND AIMS: During the current Coronavirus Disease 2019 (COVID-19) pandemic, patients with diabetes face disproportionately more. This study was performed to clarify anti-inflammatory effects of anti-diabetic agents on COVID-19 in patients with diabetes. METHODS AND RESULTS: Relevant literature was searched on 15 databases up to November 14, 2020 and was updated on April 13, 2021. The pooled ORs along with 95% CIs were calculated to evaluate combined effects. 31 studies with 66,914 patients were included in qualitative and quantitative synthesis. Meta-analysis showed that metformin was associated with a statistically significant lower mortality (pooled OR = 0.62, 95% CI, 0.50-0.76, p = 0.000) and poor composite outcomes (pooled OR = 0.83, 95% CI, 0.71-0.97, p = 0.022) in diabetic patients with COVID-19. Significance of slight lower mortality remained in sulfonylurea/glinides (pooled OR = 0.93, 95% CI, 0.89-0.98, p = 0.004), but of poor composite outcomes was not (pooled OR = 1.48, 95% CI, 0.61-3.60, p = 0.384). Dipeptidyl peptidase-4 inhibitors (DPP-4 inhibitors) were associated with statistically non-significant lower mortality (pooled OR = 0.95, 95% CI, 0.72-1.26, p = 0.739) or poor composite outcomes (pooled OR = 1.27, 95% CI, 0.91-1.77, p = 0.162) of COVID-19 in diabetic patients. CONCLUSION: Metformin might be beneficial in decreasing mortality and poor composite outcomes in diabetic patients infected with SARS-CoV-2. DPP-4 inhibitors, sulfonylurea/glinides, SGLT-2 inhibitors, and GLP-1RA would not seem to be adverse. There was insufficient evidence to conclude effects of other anti-diabetic agents. Limited by retrospective characteristics, with relative weak capability to verify causality, more prospective studies, especially RCTs are needed. REGISTRATION NUMBER: PROSPERO-CRD42020221951.
Subject(s)
COVID-19 Drug Treatment , Diabetes Mellitus, Type 2 , Dipeptidyl-Peptidase IV Inhibitors , Diabetes Mellitus, Type 2/complications , Dipeptidyl-Peptidase IV Inhibitors/pharmacology , Humans , Hypoglycemic Agents/pharmacology , Hypoglycemic Agents/therapeutic use , Prospective Studies , Retrospective Studies , SARS-CoV-2ABSTRACT
BACKGROUND: Famotidine was reported to potentially provide benefits to Coronavirus Disease 2019 (COVID-19) patients. However, it remains controversial whether it is effective in treating COVID-19. AIMS: This study aimed to explore whether famotidine use is associated with reduced risk of the severity, death, and intubation for COVID-19 patients. METHODS: This study was registered on International Prospective Register of Systematic Reviews (PROSPERO) (ID: CRD42020213536). A comprehensive search was performed to identify relevant studies up to October 2020. I-squared statistic and Q-test were utilized to assess the heterogeneity. Pooled risk ratios (RR) and 95% confidence intervals (CI) were calculated through the random effects or fixed effects model according to the heterogeneity. Subgroup analyses, sensitivity analysis, and publication bias assessment were also conducted. RESULTS: Five studies including 36,635 subjects were included. We found that famotidine use was associated with a statistically non-significant reduced risk of progression to severe disease, death, and intubation for Coronavirus Disease 2019 (COVID-19) patients (pooled RR was 0.82, 95% CI = 0.52-1.30, P = 0.40). CONCLUSION: Famotidine has no significant protective effect in reducing the risk of developing serious illness, death, and intubation for COVID-19 patients. More original studies are needed to further clarify whether it is associated with reduced risk of the severity, death, and intubation for COVID-19 patients.
Subject(s)
COVID-19 Drug Treatment , COVID-19/pathology , Famotidine/therapeutic use , Intubation, Intratracheal , SARS-CoV-2 , COVID-19/mortality , Histamine H2 Antagonists/therapeutic use , HumansABSTRACT
BACKGROUND: Based on the status of the COVID-19 global pandemic, there is an urgent need to systematically evaluate the effectiveness of wearing masks to protect public health from COVID-19 infection. METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement was consulted to report this systematic review. We conducted a systematic review and meta-analysis to evaluate the effectiveness of using face masks to prevent the spread of SARS-CoV-2. Relevant articles were retrieved from PubMed, Web of Science, ScienceDirect, Cochrane Library, and Chinese National Knowledge Infrastructure, VIP (Chinese) database. There were no language restrictions. This study was registered with PROSPERO under the number CRD42020211862. RESULTS: A total of 6 studies were included, involving 4 countries, after a total of 5,178 eligible articles were searched in databases and references. In general, wearing a mask was associated with a significantly reduced risk of COVID-19 infection (ORâ¯=â¯0.38, 95% CI: 0.21-0.69, I2â¯=â¯54.1%). For the healthcare workers group, masks were shown to have a reduced risk of infection by nearly 70%. Sensitivity analysis showed that the results were robust. CONCLUSIONS: The results of this systematic review and meta-analysis support the conclusion that wearing a mask could reduce the risk of COVID-19 infection. Robust randomized trials are needed in the future to better provide evidence for these interventions.