Metformin for covid-19: systematic review and meta-analysis of randomised controlled trials
Abstract
Abstract Objective To summarise the effects of metformin on covid-19 to inform a World Health Organization (WHO) clinical practice guideline. Design Systematic review and meta-analysis. Data sources As part of a living systematic review and network meta-analysis of drug treatments for covid-19 (covid-19 LNMA), a search was performed of the WHO covid-19 database, six Chinese databases, and the Epistemonikos Foundation's Living Overview of the Evidence covid-19 Repository (covid-19 L-OVE). Eligibility criteria for selecting studies Randomised controlled trials that compared metformin with placebo in patients with acute covid-19 infection. Data synthesis Frequentist pairwise meta-analyses were performed using the restricted maximum likelihood random effects model. The effects of interventions on selected outcomes were summarised using risk ratios, risk difference, and mean difference when appropriate, along with their corresponding 95% confidence intervals (CIs). To estimate absolute effects, the control arm event rate was used as the baseline risk. The risk of bias of the included studies was assessed using a modification of the Cochrane risk of bias 2.0 tool and the certainty of evidence using the GRADE (grading of recommendations assessment, development and evaluation) approach, with the minimally important difference in effect as the threshold. Results Three randomised controlled trials of 1869 patients were included; one study provided long term follow-up on long covid.…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 1,869 participants or records.
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