The length of hospital stay in COVID-19 patients using pre-hospital metformin at a Saudi tertiary hospital: a retrospective cohort study
et al., BMC Infectious Diseases, doi:10.1186/s12879-026-13170-4, Mar 2026
Metformin for COVID-19
3rd treatment shown to reduce risk in
July 2020, now with p < 0.00000000001 from 111 studies.
Lower risk for mortality, ventilation, ICU, hospitalization, progression, recovery, and viral clearance.
No treatment is 100% effective. Protocols
combine treatments.
6,500+ studies for
210+ treatments. c19early.org
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Retrospective 114 hospitalized COVID-19 patients with T2DM in Saudi Arabia, showing significantly shorter hospital stay with pre-hospital metformin use.
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risk of mechanical ventilation, 44.3% lower, RR 0.56, p = 0.24, treatment 10 of 82 (12.2%), control 7 of 32 (21.9%), NNT 10.
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risk of ICU admission, 8.9% lower, RR 0.91, p = 0.79, treatment 14 of 82 (17.1%), control 6 of 32 (18.8%), NNT 60.
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risk of ARDS, 35.0% lower, RR 0.65, p = 0.38, treatment 10 of 82 (12.2%), control 6 of 32 (18.8%), NNT 15.
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risk of no hospital discharge, 45.9% lower, HR 0.54, p = 0.01, treatment 82, control 32, inverted to make HR<1 favor treatment.
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time to discharge, 64.3% lower, relative time 0.36, p < 0.001, treatment 5.0 [4.0-6.0] n=82, control 14.0 [7.0-14.0] n=32.
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| Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates |
Felemban et al., 31 Mar 2026, retrospective, Saudi Arabia, peer-reviewed, 8 authors.
Contact: duaa.babaer@gmail.com.
Abstract: 2.
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The Length of Hospital Stay in COVID-19 Patients Using Pre-hospital Metformin at a Saudi Tertiary Hospital: A Retrospective Cohort Study
Authors and affiliations
Razaz Felemban 1,2 , Talha S Mayet 1,2 , Zeyad O Khaimi 1,2 , Yazeed H Aljabri 1,2 ,
Mohammed A Hadi 1,2 , Abdulrahman F Alsulami 1,2 , Alaa Althubaiti 1,2 , Duaa
Babaer 1,2
1.
College of Medicine, King Saud bin Abdulaziz University for Health
Sciences, Jeddah, Saudi Arabia.
King Abdullah International Medical Research Center, Jeddah, Saudi
Arabia.
Corresponding author
Duaa Babaer
Phone number: +966567034325
[Email: duaa.babaer@gmail.com](mailto:duaa.babaer@gmail.com)
ARTIC/E IN PRESS
Abstract Background
Type 2 diabetes mellitus (T2DM) is prevalent in Saudi Arabia and is associated with severe outcomes from Coronavirus Disease 2019 (COVID-19). Metformin, the most prescribed medication for T2DM, has shown potential antiviral and anti-inflammatory properties that may be relevant in patients with COVID-19. This study evaluated the association of pre-hospital metformin use with length of hospital stay and secondary outcomes among patients with COVID-19 and T2DM. Methods ARTIC/E IN PRESS
This retrospective cohort study was conducted at King Abdulaziz Medical City in Jeddah from 2020 to 2023 and included hospitalized adult patients with confirmed COVID-19 and pre-existing T2DM. Pre-hospital metformin use was defined as documented within 90 days before hospital admission. Clinical characteristics, treatments, and hospital outcomes were analyzed using electronic health record data.
Results
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Metformin use was associated with a significantly shorter hospital stay, with a median time to discharge of five days (95% CI: 4-6) compared with 14 days (95% CI: 7-44) in the non-metformin group. Metformin use was associated with a higher hazard of discharge than nonuse (HR = 1.85, 95% CI: 1.14-3.0; p = 0.012). No statistically significant differences were observed between the two groups for secondary outcomes, including mechanical ventilation, intensive care unit admission, and respiratory complications, defined as acute respiratory distress syndrome and severe respiratory failure.
Conclusion
Among hospitalized patients with type 2 diabetes and COVID-19, metformin use was associated with shorter hospital stays and a higher discharge rate. However, given the retrospective, single-center design, potential survivor bias, and residual confounding, these findings should be interpreted cautiously. Prospective multicenter studies using competingrisk approaches and incorporating mortality outcomes are recommended. Keywords: COVID-19, Type 2 diabetes mellitus, Metformin, Hospital stay ARTIC/E IN PRESS
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ARTICLE IN PRESS
ARTIC/E IN PRESS
Background
Coronavirus disease 2019 (COVID-19) is caused by the highly transmissible severe acute respiratory syndrome coronavirus 2 (SARS-CoV2). Although it primarily targets the respiratory system, it can also involve multiple extrapulmonary organs, including the renal and cardiovascular systems [1]. Consequently, the clinical manifestations and severity of COVID-19 are heterogeneous, reflecting the combined influence of viral factors and host-related risk profiles, with important implications for disease burden and outcomes at the..
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