Neither Metformin nor Ursodeoxycholic Acid Effectively Treats Postacute Sequelae of COVID-19

Lim et al., Annals of Internal Medicine, doi:10.7326/ANNALS-25-04883, Mar 2026
RCT 396 patients with existing long COVID, showing no significant benefit with metformin or UDCA.
Study covers metformin and ursodeoxycholic acid.
Lim et al., 3 Mar 2026, Double Blind Randomized Controlled Trial, placebo-controlled, peer-reviewed, 12 authors.
DOI record: { "DOI": "10.7326/annals-25-04883", "ISSN": [ "0003-4819", "1539-3704" ], "URL": "http://dx.doi.org/10.7326/ANNALS-25-04883", "alternative-id": [ "10.7326/ANNALS-25-04883" ], "article-number": "ANNALS-25-04883", "author": [ { "ORCID": "https://orcid.org/0000-0002-5647-3718", "affiliation": [ { "name": "Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea (S.Y.L., E.C., J.-S.K., C.Y.J., H.M.J., S.K.)" } ], "authenticated-orcid": false, "family": "Lim", "given": "So Yun", "sequence": "first" }, { "ORCID": "https://orcid.org/0009-0001-0124-5048", "affiliation": [ { "name": "Department of Infectious Diseases, Hallym University Kangnam Sacred Heart Hospital, Seoul, Republic of Korea (J.L., Y.S., J.J.P., S.H.N., H.P.)" } ], "authenticated-orcid": false, "family": "Lee", "given": "Jacob", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea (S.Y.L., E.C., J.-S.K., C.Y.J., H.M.J., S.K.)" } ], "family": "Chang", "given": "Euijin", "sequence": "additional" }, { "ORCID": "https://orcid.org/0000-0001-6945-6100", "affiliation": [ { "name": "Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea (S.Y.L., E.C., J.-S.K., C.Y.J., H.M.J., S.K.)" } ], "authenticated-orcid": false, "family": "Kwon", "given": "Ji-Soo", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea (S.Y.L., E.C., J.-S.K., C.Y.J., H.M.J., S.K.)" } ], "family": "Jang", "given": "Choi Young", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Infectious Diseases, Hallym University Kangnam Sacred Heart Hospital, Seoul, Republic of Korea (J.L., Y.S., J.J.P., S.H.N., H.P.)" } ], "family": "Seo", "given": "Yubin", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Infectious Diseases, Hallym University Kangnam Sacred Heart Hospital, Seoul, Republic of Korea (J.L., Y.S., J.J.P., S.H.N., H.P.)" } ], "family": "Park", "given": "Jin Ju", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Infectious Diseases, Hallym University Kangnam Sacred Heart Hospital, Seoul, Republic of Korea (J.L., Y.S., J.J.P., S.H.N., H.P.)" } ], "family": "Na", "given": "Sun Hee", "sequence": "additional" }, { "ORCID": "https://orcid.org/0000-0001-8249-4152", "affiliation": [ { "name": "Department of Infectious Diseases, Hallym University Kangnam Sacred Heart Hospital, Seoul, Republic of Korea (J.L., Y.S., J.J.P., S.H.N., H.P.)" } ], "authenticated-orcid": false, "family": "Park", "given": "Hyejin", "sequence": "additional" }, { "ORCID": "https://orcid.org/0009-0003-0132-5261", "affiliation": [ { "name": "Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea (S.Y.L., E.C., J.-S.K., C.Y.J., H.M.J., S.K.)" } ], "authenticated-orcid": false, "family": "Jang", "given": "Hyeon Mu", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea (S.-C.Y.)." } ], "family": "Yun", "given": "Sung-Cheol", "sequence": "additional" }, { "ORCID": "https://orcid.org/0000-0002-6596-8253", "affiliation": [ { "name": "Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea (S.Y.L., E.C., J.-S.K., C.Y.J., H.M.J., S.K.)" } ], "authenticated-orcid": false, "family": "Kim", "given": "Sung-Han", "sequence": "additional" } ], "container-title": "Annals of Internal Medicine", "container-title-short": "Ann Intern Med", "content-domain": { "crossmark-restriction": false, "domain": [] }, "created": { "date-parts": [ [ 2026, 3, 2 ] ], "date-time": "2026-03-02T22:00:35Z", "timestamp": 1772488835000 }, "deposited": { "date-parts": [ [ 2026, 3, 2 ] ], "date-time": "2026-03-02T22:01:11Z", "timestamp": 1772488871000 }, "indexed": { "date-parts": [ [ 2026, 3, 2 ] ], "date-time": "2026-03-02T22:53:43Z", "timestamp": 1772492023353, "version": "3.50.1" }, "is-referenced-by-count": 0, "issued": { "date-parts": [ [ 2026, 3, 3 ] ] }, "language": "en", "license": [ { "URL": "https://www.acpjournals.org/journal/aim/text-and-data-mining", "content-version": "tdm", "delay-in-days": 0, "start": { "date-parts": [ [ 2026, 3, 3 ] ], "date-time": "2026-03-03T00:00:00Z", "timestamp": 1772496000000 } } ], "link": [ { "URL": "https://www.acpjournals.org/doi/pdf/10.7326/ANNALS-25-04883", "content-type": "application/pdf", "content-version": "vor", "intended-application": "text-mining" }, { "URL": "https://www.acpjournals.org/doi/full-xml/10.7326/ANNALS-25-04883", "content-type": "application/xml", "content-version": "vor", "intended-application": "text-mining" } ], "member": "4285", "original-title": [], "prefix": "10.7326", "published": { "date-parts": [ [ 2026, 3, 3 ] ] }, "published-online": { "date-parts": [ [ 2026, 3, 3 ] ] }, "publisher": "American College of Physicians", "reference": [ { "DOI": "10.1016/S0140-6736(24)01136-X", "doi-asserted-by": "publisher", "key": "r1-ANNALS2504883" }, { "DOI": "10.1056/NEJMsb2408466", "doi-asserted-by": "publisher", "key": "r2-ANNALS2504883" }, { "DOI": "10.1001/jama.2023.8823", "doi-asserted-by": "publisher", "key": "r3-ANNALS2504883" }, { "DOI": "10.1038/s41586-022-04702-4", "doi-asserted-by": "publisher", "key": "r4-ANNALS2504883" }, { "DOI": "10.1016/j.cell.2023.07.019", "doi-asserted-by": "publisher", "key": "r5-ANNALS2504883" }, { "DOI": "10.3389/fimmu.2020.02056", "doi-asserted-by": "publisher", "key": "r6-ANNALS2504883" }, { "DOI": "10.1056/NEJMoa2201662", "doi-asserted-by": "publisher", "key": "r7-ANNALS2504883" }, { "DOI": "10.1016/S1473-3099(23)00299-2", "doi-asserted-by": "publisher", "key": "r8-ANNALS2504883" }, { "DOI": "10.1038/s41586-022-05594-0", "doi-asserted-by": "publisher", "key": "r9-ANNALS2504883" }, { "DOI": "10.1111/joim.13630", "doi-asserted-by": "publisher", "key": "r10-ANNALS2504883" }, { "DOI": "10.1371/journal.pone.0180673", "doi-asserted-by": "publisher", "key": "r11-ANNALS2504883" }, { "DOI": "10.1152/ajpgi.00406.2015", "doi-asserted-by": "publisher", "key": "r12-ANNALS2504883" }, { "DOI": "10.1097/HC9.0000000000000068", "doi-asserted-by": "publisher", "key": "r13-ANNALS2504883" }, { "DOI": "10.1001/jamainternmed.2024.2007", "doi-asserted-by": "publisher", "key": "r14-ANNALS2504883" }, { "DOI": "10.1016/S1473-3099(25)00073-8", "doi-asserted-by": "publisher", "key": "r15-ANNALS2504883" }, { "DOI": "10.1016/j.lana.2024.100688", "doi-asserted-by": "publisher", "key": "r16-ANNALS2504883" }, { "DOI": "10.3346/jkms.2026.41.e54", "doi-asserted-by": "publisher", "key": "r17-ANNALS2504883" }, { "DOI": "10.1007/s11606-025-10042-6", "doi-asserted-by": "publisher", "key": "r18-ANNALS2504883" }, { "DOI": "10.3346/jkms.2024.39.e237", "doi-asserted-by": "publisher", "key": "r19-ANNALS2504883" }, { "DOI": "10.3904/kjim.2024.217", "doi-asserted-by": "publisher", "key": "r20-ANNALS2504883" }, { "DOI": "10.1016/j.eclinm.2021.101019", "doi-asserted-by": "publisher", "key": "r21-ANNALS2504883" } ], "reference-count": 21, "references-count": 21, "relation": {}, "resource": { "primary": { "URL": "https://www.acpjournals.org/doi/10.7326/ANNALS-25-04883" } }, "score": 1, "short-title": [], "source": "Crossref", "subject": [], "subtitle": [ "A Randomized Clinical Trial" ], "title": "Neither Metformin nor Ursodeoxycholic Acid Effectively Treats Postacute Sequelae of COVID-19", "type": "journal-article" }
Late treatment
is less effective
Please send us corrections, updates, or comments. c19early involves the extraction of 200,000+ datapoints from thousands of papers. Community updates help ensure high accuracy. Treatments and other interventions are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. IMA and WCH provide treatment protocols.
  or use drag and drop   
Submit