Metformin: A Potential Shield Against Long COVID

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Use of metformin, a diabetes medication, significantly reduces the risk of developing long COVID as per a new study at the University of Minnesota, published in The Lancet Infectious Diseases ().

The study, called COVID-OUT, investigated if early outpatient COVID-19 treatment with metformin, ivermectin, or fluvoxamine could prevent long COVID. Long COVID is a chronic illness that can affect up to 10% of people who have had COVID-19.

Curbing the Impact of Long COVID

"The results of this study are important because long COVID can have a significant impact on people's lives," said Carolyn Bramante, MD, principal investigator and an assistant professor at the U of M Medical School.

‘Recent study reveals that the administration of metformin, a commonly prescribed diabetes drug, effectively prevents the onset of long COVID. #Diabetes, #metformin, #long COVID ’

"Metformin is an inexpensive, safe, and widely available drug, and its use as a preventive measure could have significant public health implications."

This was a large, placebo-controlled randomized clinical trial that enrolled volunteers across the United States. The study found:

• Those who received metformin was more than 40% less likely to develop long COVID than those who received an identical-looking placebo.


• For participants who started metformin less than four days after their COVID symptoms started, metformin decreased the risk of long COVID by 63%.


• The effect was consistent across different demographic populations of volunteers who participated and across multiple viral variants, including the Omicron variant.


• Ivermectin and fluvoxamine did not prevent long COVID.

Promise of Metformin

The study included more than 1,200 participants who were randomly chosen to receive either metformin or placebo, and an additional subset received ivermectin, fluvoxamine, or their placebos.

Participants were between 30 and 85 years old and qualified as overweight or obese. Over 1,100 of the participants reported their symptoms for up to 10 months after their initial COVID-19 diagnosis.

"This long-term outcome from a randomized trial is high-quality evidence that metformin prevents harm from the SARS-CoV-2 virus," said Dr. Bramante, who is also an internist and pediatrician with M Health Fairview.

Metformin's Role in Preventing Long COVID

"While half of our trial had been vaccinated, none had been previously infected with the COVID-19 virus. Further research could show whether it is also effective in those with previous infection or in adults with lower body mass index."

Metformin's ability to stop the virus was predicted by a simulator developed by U of M Medical School and College of Science and Engineering Biomedical Engineering faculty.

The model has been highly accurate to date, successfully predicting, among others, the failure of hydroxychloroquine and the success of remdesivir before the results of clinical trials testing these therapies were announced.

Reference:

1. Outpatient treatment of COVID-19 and incidence of post-COVID-19 condition over 10 months (COVID-OUT): a multicentre, randomised, quadruple-blind, parallel-group, phase 3 trial - (https:www.thelancet.com/journals/laninf/article/PIIS1473-3099(23)00299-2/fulltext)

Source: Eurekalert