Metformin can reduce the risk of “Long COVID-19” by at least 42%

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Metformin can reduce the risk of “Long COVID-19” by at least 42%

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Metformin can reduce the risk of “Long COVID-19” by at least 42%.

“The Lancet” preprint: The world’s first four-blind randomized controlled phase 3 clinical study confirmed that taking metformin early in the infection of COVID-19 reduces the risk  of developing COVID-19 by at least 42% .

The day when metformin is used in the clinical treatment of the COVID-19 may be getting closer and closer to us.

Recently, Carolyn T. Bramante’s team at the University of Minnesota published a groundbreaking research result [1] in the preprint of the top medical journal The Lancet.

This multicenter, quadruple-blind, parallel randomized controlled trial in three phases confirmed that taking metformin in the early stage of COVID-19 infection could reduce the risk of overweight and obese people developing long COVID-19 (also known as “post-COVID-19 syndrome”) by 42% compared with the placebo group. If metformin is started within four days of symptom onset, the risk of long COVID-19 occurrence is reduced by 63%.

These data indicate that once this research paper passes peer review, metformin may be recommended for the treatment of COVID-19 and prevention of long COVID-19 occurrence.

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Although the whole country has now entered the influenza A epidemic season, we all know that the COVID-19 has not gone far.

It is the immunity produced by the pandemic last year that is protecting us. Judging from the law of the epidemic of COVID-19s at home and abroad, the COVID-19s come in waves, and there may be a wave of pandemics after a period of time.

After the round of the COVID-19 pandemic at the end of last year, I believe everyone must be very clear about what a COVID-19 is and what symptoms it has.

Some people may not have recovered from the impact of last year’s COVID-19.

Regarding Changxinguan, we wrote a long article last year, which introduced Changxinguan very comprehensively.

Interested friends can click this link to jump to that article .

Because of the high incidence of COVID-19s and their greater impact on work and life, many scientists and doctors are looking for ways to reduce the incidence of COVID-19s.

The COVID-OUT study (NCT04510194) is one of them.

This study recruited 1,323 people aged 30-85 (median age 45), 56% were women, 7% of whom were pregnant, overweight or obese (median BMI 29.8), symptom onset time <7 days of COVID-19 infection .

Among them, 1,125 patients uniformly participated in the long-term COVID-19 follow-up study, and completed at least one follow-up survey on the subsequent 180 days or longer.

Through random grouping, there were 564 people in the metformin group and 561 people in the placebo control group.

Metformin was taken for two weeks at a dose of 500 mg on the first day, 500 mg twice a day for the next 4 days, and 500 mg in the morning and 1,000 mg in the afternoon for the remainder of the day .

Research Process

The median number of days from symptom onset to initiation of medication was 5 days, with 47 percent starting medication 4 days or less after symptom onset.

Finally, 95% (1070/1125) completed at least 9 months of follow-up , or reported being diagnosed with COVID-19.

Lost to follow-up before day 270 was 5.1% (29/564) in the metformin group and 4.6% (26/561) in the placebo group.

During the entire study, the COVID-19 patients, investigators, nurses and outcome assessors were not aware of the grouping of patients, which is the so-called four-blind.

From the results of the study, the cumulative incidence of COVID-19 pneumonia in the metformin treatment group was 6.3%, while the cumulative incidence in the placebo control patients was 10.6% .

In other words, taking metformin can reduce the risk of developing a COVID-19 by 42% (HR=0.58, P=0.009).

If it is further subdivided, if you start taking metformin within <4 days after the onset of symptoms, the risk of developing a COVID-19 will be reduced by 63% (HR=0.37), and if you start taking metformin >4 days after the onset of symptoms, the risk of developing a COVID-19 will be reduced by 36% (HR= 0.64).

Effects of Metformin

Based on the above data, Bramante and his colleagues believe that two weeks of metformin treatment can reduce the risk of developing COVID-19 pneumonia by 42% for patients with COVID-19 infection treated in outpatient clinics, and the effect is even greater if it is started early in the symptoms. good.

However, this study also has certain limitations: First, the enrolled population is overweight or obese people aged 30-85, and those with normal BMI or those under the age of 30 are not included in the study; secondly, patients receiving emergency treatment or requiring hospitalization , are not included in the study .

Therefore, whether metformin has the same effect on these two groups still needs further research.

It should be emphasized that although this study was published in the preprint of “The Lancet”, it has not yet been peer-reviewed, so the results of this study cannot guide clinical treatment .

Looking forward to reviewing this study as soon as possible.

references:

[1].Bramante C, Buse JB, Liebovitz D, et al. Outpatient Treatment of COVID-19 and the Development of Long COVID Over 10 Months: A Multi-Center, Quadruple-Blind, Parallel Group Randomized Phase 3 Trial[J] .

Metformin can reduce the risk of “Long COVID-19” by at least 42%

(source:internet, reference only)

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