Among people infected with COVID-19, about 1 in 4 report experiencing symptoms of Long COVID, such as fatigue, brain fog, chronic cough, and chest pain, for more than three months after infection. In this context, evidence has emerged suggesting that the widely used diabetes drug Metformin can significantly lower the risk of developing Long COVID.
A research team from the University of Minnesota conducted a comprehensive review of four studies, including two randomized controlled clinical trials involving adults who were administered Metformin before and after COVID-19 infection, and two analyses of electronic medical records, to evaluate the impact of Metformin on the prevention of Long COVID. The findings were published on January 29 in the official journal of the Infectious Diseases Society of America, 《Clinical Infectious Diseases》.
The combined results of the four studies indicated that when Metformin was taken for 14 days within a few days after COVID-19 infection, Long COVID was prevented in approximately 1 in 50 patients. This trend was consistently observed across clinical trials and real-world data analyses, including both low-risk and high-risk adult populations.
The researchers explained that Metformin may inhibit the intracellular replication of the coronavirus or modulate the immune response through anti-inflammatory effects. In fact, some studies observed a reduction in viral load compared to placebo, as well as an inhibition of viral load rebound. However, the exact mechanisms of action are not yet clearly defined, and further research is needed.
Metformin has been used for over 60 years, and there is substantial clinical evidence regarding its safety. The researchers noted that the use of Metformin during the acute phase of COVID-19 was safe, with no reports of hypoglycemia or serious side effects. However, they emphasized that it is still unclear whether the same preventive effects occur in children and adolescents, or whether it can treat already existing Long COVID.
Metformin is estimated to be taken by about 200 million people worldwide as a treatment for type 2 diabetes. Recently, its associations with cancer, obesity, aging, cardiovascular, and neurological diseases have also been studied, but much of this research remains observational or in early clinical stages.
The researchers stated that Metformin may be used alone or in combination with other treatments during the acute phase of COVID-19, and additional clinical trials are needed to identify the optimal timing and target populations for real-world clinical application.
[Frequently Asked Questions]
Q1. Should Metformin be taken before getting COVID-19?
A. The study observed a trend of reduced risk of Long COVID when Metformin was started within a few days after COVID-19 infection and taken for 14 days. The preventive effect before infection was not the focus of this study.
Q2. Is there a treatment effect if Long COVID has already developed?
A. This analysis focused on 'preventive effects', and whether it can treat already developed Long COVID has not yet been confirmed in both adults and children.
Q3. Can children also prevent Long COVID with Metformin?
A. Current evidence is limited to studies conducted on adults. It has not yet been determined whether the same preventive effects exist in children and adolescents.
