Taking metformin after a positive test can reduce the risk of Long-COVID by 40%
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The Lancet: Taking metformin after a positive test can reduce the risk of Long-COVID by 40%。
Newly published research in The Lancet Infectious Diseases found that taking metformin, a common drug commonly used to control blood sugar in patients with type 2 diabetes, within three days of testing positive for SARS-CoV-2 6.3% of participants receiving the drug) reported being diagnosed with Long-COVID within 10 months, compared with 10.4% of those receiving placebo during the same period.
A U.S. study of 1,126 overweight and obese people found that 6.3 percent of participants who took metformin, a common drug used to control blood sugar in people with type 2 diabetes, within three days of testing positive for SARS-CoV-2 % reported being diagnosed with Long-COVID within 10 months, compared with 10.4% of participants receiving placebo during the same period.
This is the first published randomized controlled trial showing that taking the drug during the acute phase of COVID-19 may reduce the risk of Long-COVID.
The authors caution that the trial did not examine the effects of metformin on those who had already been diagnosed with Long-COVID, so no conclusions could be drawn about whether metformin could be used as a treatment for Long-COVID. They recommend further trials of metformin in people with low body mass index and previous SARS-CoV-2 infection.
A new study published in The Lancet Infectious Diseases finds that taking metformin, a safe and affordable diabetes drug, for two weeks after testing positive for SARS-CoV-2 People who took the placebo were 40% less likely to be diagnosed with Long-COVID over the next 10 months than those who took the placebo.
The long-term symptoms that some people develop after being infected with SARS-CoV-2 are called Long-COVID. This is an emerging chronic disease that potentially affects millions of people worldwide. Currently, there is nothing proven to treat or prevent Long-COVID other than reducing the risk of infection in the first place.
This is the first phase 3 randomized controlled trial of a treatment in community-based patients showing that taking the drug after testing positive for SARS-CoV-2 can reduce the risk of Long-COVID.
Long-COVID is a major public health emergency with the potential to have long-lasting impacts on physical and mental health and the economy, especially for socioeconomically marginalized groups. We urgently need to find potential ways to treat and prevent this disease.
This study shows that metformin, a safe, low-cost, and widely available drug, significantly reduces the risk of being diagnosed with Long-COVID if taken at the time of first infection with SARS-CoV-2. This trial does not say whether metformin is effective for people who already have Long-COVID,” said the study’s lead author, Dr Carolyn Bramante of the University of Minnesota School of Medicine. [1]
Participants in this trial were non-hospitalized patients at high risk for severe COVID-19 (overweight or obese), aged 30 years or older, who had tested positive for SARS-CoV-2 within the past three days, but had no prior known SARS-CoV -2 History of infection.
The study was open for patient recruitment from December 2020 to January 2022, during which time metformin or the same placebo tablet was given to 1126 patients who tested positive for SARS-CoV-2. Follow-up data were collected by self-reported questionnaires every 30 days for 10 months.
In this trial, metformin prevented more than 40% of Long-COVID cases, and 6.3% (35/564) of participants taking metformin reported being diagnosed with Long-COVID within 10 months of follow-up, compared with those taking placebo. This proportion was 10.4% (58/562) of participants.
These findings corroborate previously published results from the trial showing that metformin prevented more than 40% of emergency department visits, hospitalizations and deaths from COVID-19 compared with placebo within two weeks of starting treatment. [2]
The rest of the trial looked at ivermectin and fluvoxamine, and found neither drug could protect against Long-COVID.
“Previous studies have found that metformin can prevent laboratory replication of the SARS-CoV-2 virus [3,4], which is consistent with our predictions from mathematical models of viral replication, so this may be the reason for the observation of COVID-19 in this trial. Severe and Long-COVID diagnoses have declined,” said study co-author David Odde, a biomedical engineer at the University of Minnesota.
The authors acknowledge some limitations of the study, such as the trial did not include people with a body mass index (BMI) below 25 and those under the age of 30, so it is unclear whether the findings generalize to these groups.
They also caution that little is known about the best tools for assessing the presence of Long-COVID in clinical trial participants when Long-COVID assessments are included in trials, but they argue that using a Long-COVID diagnosis at a healthcare facility, along with long-term follow-up, will resolve the issue. Some issues with the changing nature of disease definitions.
Dr Jeremy Faust of Harvard Medical School, USA, who was not involved in the study, wrote in a related commentary that “if confirmed, Bramante and colleagues’ findings are far-reaching and potentially landmark […] This is the first high-quality evidence from a randomized controlled trial that the incidence of Long-COVID can be reduced by a medical intervention, metformin, an inexpensive treatment that clinicians have extensive experience with.”
References:
NOTES TO EDITORS
This study was funded by Parsemus Foundation, Rainwater Charitable Foundation, Fast Grants, and the UnitedHealth Group Foundation. See the Article for a full list of author affiliations.
[1] Quote direct from author and cannot be found in the text of the Article.
[2] Bramante CT, Huling JD, Tignanelli CJ, et al. Randomized Trial of Metformin, Ivermectin, and Fluvoxamine for COVID-19. The New England journal of medicine 2022; 387(7): 599-610.
[3] Parthasarathy H, Tandel D, Siddiqui AH, Harshan KH. Metformin suppresses SARS-CoV-2 in cell culture. Virus Res. 2022 Nov 20;323:199010 .
[4] Schaller et al., JCI Insight, 2021 and Gordon et al., Nature, 2020
Taking metformin after a positive test can reduce the risk of Long-COVID by 40%
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