3/ This trial had 6 groups of patients because 3 meds (metformin/fluvoxamine/ivermectin) were randomized vs. placebo.
The other drugs showed no benefit toward Long COVID reduction.
Metformin also looked good for Acute COVID.
4/ In COVID-OUT, Metformin showed a similar effect on the acute early primary outcome w a 42% reduction (OR=0.58, 95% CI 0.35 to 0.94) in prevention of ED visits, hospitalizations, or death due to Covid and hospitalizations or death (OR 0.47, 95% CI 0.20 to 1.11) through Day 14.
5/ Definition: Long Covid @ 10 months was a pre-specified outcome in COVID-OUT.
LongCOVID Dx made by medical providers who rendered each diagnosis. And patients consented to medical record review for confirmation of these diagnoses. (so not just self-report as in many studies)
8/fin
📌 This prevention study doesn’t mean metformin will help TREAT #LongCOVID. That is a completely separate issue
📌 These are solid data about prevention that must be replicated
📌 People are desperate but they should NOT start taking metformin until we know more
🔹S protein viral sequences that are immutable, immunogenic & accessible to neutralizing Abs
🔹SARS viral membrane, envelope or nucleocapsid proteins & structurally hidden epitopes
🔹Vaccines based on T-cell receptor constructs
✔️75% Protection >1 Year
✔️Not just help w death & hospitalizations
✔️Protect vs symptomatic disease
✔️Less viral transmission
✔️Fewer adverse events like myocarditis
📍as a #LongCovid patient you admitted on embarking to Turkey for pheresis that
📍this Tx was an UN-established long shot
📍but your life w this syndrome had devolved
📍as a scientist you now found yourself willing
📍while others conduct trials
2/ I see your choices in seeking therapy for #LongCOVID as brave & honest w cautious expectations cognitively & physically.
Most importantly, you’re demonstrating hope & a desire never to give up.
Knowing you, @pamelarbishop, and calling you friend is a gift beyond measure.
3/ For anyone who chides a highly intelligent person for pursuing alternative approaches to solving health problems #medicine scoffs at, seek empathy & read these truth-telling books 📚
QUESTION:
Is it OK for doctors to make unilateral decisions to limit life-sustaining therapy (eg, remove a ventilators) without patient/family discussion?
2/ Variable Approach to Limiting Life Sustaining Treatment for ICU Patients
N=12,850 patients in ETHICUS-2
% “NO DISCUSSION” at EOL was 2% in North America vs 37% in Latin America