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0 0.5 1 1.5 2+ Death/intubation 62% Improvement Relative Risk Progression, severe respir.. 81% Progression, ARDS 80% Metformin for COVID-19  Guo et al.  Prophylaxis Is prophylaxis with metformin beneficial for COVID-19? Retrospective 571 patients in China (February - April 2020) Lower death/intubation (p=0.032) and progression (p=0.0029) Guo et al., Diabetes, Metabolic Syndro.., Aug 2023 Favors metformin Favors control

Effects of Metformin on COVID-19 Patients with Type 2 Diabetes: A Retrospective Study

Guo et al., Diabetes, Metabolic Syndrome and Obesity, doi:10.2147/DMSO.S417925
Aug 2023  
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Metformin for COVID-19
3rd treatment shown to reduce risk in July 2020
*, now known with p < 0.00000000001 from 89 studies.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
4,100+ studies for 60+ treatments.
Retrospective 571 type 2 diabetes patients with COVID-19 in China, showing lower combined mortality/mechanical ventilation with metformin.
risk of death/intubation, 62.4% lower, HR 0.38, p = 0.03, treatment 241, control 330, adjusted per study, multivariable, Cox proportional hazards.
risk of progression, 81.1% lower, HR 0.19, p = 0.003, treatment 241, control 330, adjusted per study, severe respiratory failure, multivariable, Cox proportional hazards.
risk of progression, 80.1% lower, HR 0.20, p = 0.05, treatment 241, control 330, adjusted per study, ARDS, multivariable, Cox proportional hazards.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Guo et al., 24 Aug 2023, retrospective, China, peer-reviewed, median age 65.0, 8 authors, study period 4 February, 2020 - 11 April, 2020. Contact:
This PaperMetforminAll
Effects of Metformin on COVID-19 Patients with Type 2 Diabetes: A Retrospective Study
Ziyu Guo, Yanxiang Gao, Enmin Xie, Zixiang Ye, Yike Li, Xuecheng Zhao, Nan Shen, Jingang Zheng
Diabetes, Metabolic Syndrome and Obesity, doi:10.2147/dmso.s417925
The pandemic of coronavirus disease 2019 (COVID-19) has highlighted the intricate relationship between underlying conditions and death. We designed this study to determine whether metformin therapy for type 2 diabetes mellitus (T2D) is associated with low in-hospital mortality in patients hospitalized for COVID-19. Materials and Methods: This was a retrospective study including patients with COVID-19 and T2D in Wuhan, from February 4th to April 11th, 2020. Patients were divided into two groups according to metformin exposure. The hazard ratio (HR) of COVID-19-related mortality and invasive mechanical ventilation was estimated using Cox regression. Results: There were 571 T2D patients among the 4330 confirmed COVID-19 patients. Of those patients, 241 received metformin therapy. The in-hospital mortality and invasive mechanical ventilation of metformin group was lower than non-metformin group. In the multivariate model, metformin use was linked to a decreased in-hospital mortality and invasive mechanical ventilation when compared with that of the control group (HR: 0.376 [95% CI 0.154-0.922]; P = 0.033). Conclusion: Our study indicated that metformin therapy was associated with decreased death risk in COVID-19 patients with T2D.
Abbreviations T2D, type 2 diabetes mellitus; COVID-19, coronavirus disease 2019; HR, hazard ratio; SARA-COV-2, severe acute respiratory syndrome coronavirus 2; ACE2, angiotensin-converting enzyme 2; AMPK, 5'-AMP-activated protein kinase; DPP4, dipeptidyl peptidase-4; CK-MB, creatine kinase-myocardial band; ALT, alanine aminotransferase; LDH, lactic DovePress Diabetes, Metabolic Syndrome and Obesity 2023:16 Disclosure The authors declare that they have no known competing commercial or financial relationships that could have appeared to influence the work reported in this paper.
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