BACKGROUND: The first cases of the coronavirus disease 2019 (COVID-19) were reported in Wuhan, China. No antiviral treatment options are currently available with proven clinical efficacy. However, preliminary findings from phase III trials suggest that remdesivir is an effective and safe treatment option for COVID-19 patients with both moderate and severe disease. OBJECTIVE: The aim of the present meta-analysis was to investigate whether remdesivir was effective for treating COVID-19 including reduced in-hospital adverse events, oxygen support, and mortality rates. METHODS: According to the PRISMA reporting guidelines, a review was conducted from January 1, 2020, until August 25, 2020, with MeSH terms including COVID-19, COVID, coronavirus, SARS-CoV-2, remdesivir, adenosine nucleoside triphosphate analog, and Veklury using MEDLINE, Scopus, and CINAHL Plus. A modified Delphi process was utilized to include the studies and ensure that the objectives were addressed. Using dichotomous data for select values, the unadjusted odds ratios (ORs) were calculated applying Mantel–Haenszel random-effects method in Review Manager 5.4. RESULTS: Randomized controlled trials pooled in 3013 participants with 46.3% ( n = 1395) in the remdesivir group and 53.7% ( n = 1618) in the placebo group. The placebo group had a higher risk of mortality as compared to the intervention group with significant OR (0.61) (95% confidence interval of 0.45–0.82; P = 0.001). There was minimal heterogeneity among the studies ( I 2 = 0%). CONCLUSIONS: Our findings suggest that remdesivir extends clinical benefits by reducing mortality, adverse events, and oxygen support in moderate to severely ill COVID-19 patients. Concerted efforts and further randomized placebo-controlled trials are warranted to examine the potency of antiviral drugs and immunopathological host responses contributing to the severity of COVID-19.

Background: The first cases of the coronavirus disease 2019 (COVID-19) were reported in Wuhan, China. No antiviral treatment options are currently available with proven clinical efficacy. However, preliminary findings from phase III trials suggest that remdesivir is an effective and safe treatment option for COVID-19 patients with severe disease. Objective: The aim of the present meta-analysis is to investigate whether remdesivir is effective for treating COVID-19 including reduced in-hospital adverse events, oxygen support, and mortality rates. Methods: Using PRISMA reporting guidelines, a review was conducted from January 1 2020 until 6 August 2020 with MeSH terms including COVID-19, coronavirus, SARS-CoV-2, COVID, remdesivir, adenosine nucleoside triphosphate analog, Veklury using Medline, Scopus, and CINAHL Plus. A modified Delphi process was used to include the studies and ensure that the objectives were addressed (Appendix A). Using dichotomous data for select values, the unadjusted odds ratios (ORs) were calculated applying Mantel Haenszel (M-H) random-effects method in Review Manager 5.4. Results: Randomized controlled trials pooled in 2,429 participants with 41.6% (n=1011) in the remdesivir group and 58.4% (n=1,418) in the placebo group. The placebo group had a higher risk of mortality as compared to the intervention group with significant odds ratio (OR=0.61) (95% confidence interval of 0.45-0.83; P=0.001). There was moderate heterogeneity among the studies. Conclusions: Our findings suggest that remdesivir extends clinical benefits by reducing mortality, adverse events and oxygen support in moderate to severely ill COVID-19 patients. Concerted efforts and further randomized placebo-controlled trials are warranted to examine the potency of anti-viral drugs and immune-pathological host responses contributing to severity of COVID-19.

In the early pandemic, it was brought to attention that individuals with Diabetes Mellitus (DM) are prone to a more severe form of Coronavirus Disease 2019 (COVID-19). With this in mind, healthcare professionals need to be vigilant about their patients’ medical history in these challenging times as this could change the course of treatment and follow-ups for someone with COVID-19 and DM. Moreover, this is of utmost importance as the coronavirus is deemed to thrive in the elevated blood glucose environment. Though there is little known about the best medications for glycemic control in COVID-19, however, there are multiple other factors that can be beneficial in exploring for management in DM patients who are infected with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and some of these factors are as follow adequate glycemic control, medication dosages adjustment, diet, physical guidelines, thromboembolism prophylaxis, and empirical treatments for the possible co-infections. We conducted a literature review of publicly available information to summarize knowledge about the correlation between Diabetes Mellitus and the COVID-19 infections. The main objective of this manuscript is to provide a brief overview of the potential pathophysiologic correlation of DM and COVID-19, optimal management and prevention.

Aimed to review newer therapeutic agents for the treatment of diabetes that are related to hormones responsible for glucose metabolism other than insulin. Data from several new therapeutic agents were reviewed to provide an overview of the efficacy and tolerability of these agents. With a greater understanding of the physiology of glucose homeostasis and the pathophysiology of diabetes, new therapeutic agents have been developed to address other hormonal deficiencies/defects that are seen in the disease. These new agents fall under the categories of incretin-related therapies, such as glucagon-like peptide-1 mimetics, glucagon-like peptide-1 analogs, dipeptidyl peptidase-4 inhibitors, and amylin analogs. A1c reductions with these agents range from 0.4% to 1.6% (depending on each agent), with added benefits such as weight neutrality/loss and low risk for hypoglycemia.

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