Conv. Plasma
Nigella Sativa

All metformin studies
Meta analysis
study COVID-19 treatment researchMetforminMetformin (more..)
Melatonin Meta
Metformin Meta
Azvudine Meta
Bromhexine Meta Molnupiravir Meta
Budesonide Meta
Colchicine Meta
Conv. Plasma Meta Nigella Sativa Meta
Curcumin Meta Nitazoxanide Meta
Famotidine Meta Paxlovid Meta
Favipiravir Meta Quercetin Meta
Fluvoxamine Meta Remdesivir Meta
Hydroxychlor.. Meta Thermotherapy Meta
Ivermectin Meta

All Studies   Meta Analysis    Recent:   

Is metformin use associated with low mortality in patients with type 2 diabetes mellitus hospitalized for COVID-19? a multivariable and propensity score-adjusted meta-analysis

Feb 2023  
  Source   PDF   All Studies   Meta AnalysisMeta
Metformin for COVID-19
3rd treatment shown to reduce risk in July 2020
*, now known with p < 0.00000000001 from 88 studies.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
4,000+ studies for 60+ treatments.
Meta analysis of 22 metformin studies, showing significantly lower mortality with metformin use prior to hospitalization.
13 meta analyses show significant improvements with metformin for mortality Hariyanto, Kan, Kow, Li, Lukito, Ma, Oscanoa, Parveen, Petrelli, Poly, Schlesinger, Yang, hospitalization Li, progression Yang, and severity Petrelli, Schlesinger.
Currently there are 88 metformin for COVID-19 studies, showing 34% lower mortality [29‑38%], 31% lower ventilation [13‑45%], 16% lower ICU admission [6‑25%], 18% lower hospitalization [11‑24%], and 5% fewer cases [-4‑13%].
Ma et al., 23 Feb 2023, peer-reviewed, 2 authors. Contact:
This PaperMetforminAll
Is metformin use associated with low mortality in patients with type 2 diabetes mellitus hospitalized for COVID-19? a multivariable and propensity score-adjusted meta-analysis
Zhiyuan Ma, Mahesh Krishnamurthy
PLOS ONE, doi:10.1371/journal.pone.0282210
Background Coronavirus disease 2019 (COVID-19) is a new pandemic that the entire world is facing since December of 2019. Increasing evidence has shown that metformin is linked to favorable outcomes in patients with COVID-19. The aim of this study was to address whether outpatient or inpatient metformin therapy for type 2 diabetes mellitus is associated with low inhospital mortality in patients hospitalized for COVID-19. Methods We searched studies published in PubMed, Embase, Google Scholar and Cochrane Library up to November 1, 2022. Raw event data extracted from individual study were pooled using the Mantel-Haenszel approach. Odds ratio (OR) or hazard ratio (HR) adjusted for covariates that potentially confound the association using multivariable regression or propensity score matching was pooled by the inverse-variance method. Random effect models were applied for meta-analysis due to variance among studies. Results Twenty-two retrospective observational studies were selected. The pooled unadjusted OR for outpatient metformin therapy and in-hospital mortality was 0.48 (95% CI, 0.37-0.62) and the pooled OR adjusted with multivariable regression or propensity score matching was 0.71 (95% CI, 0.50-0.99). The pooled unadjusted OR for inpatient metformin therapy and in-hospital mortality was 0.18 (95% CI, 0.10-0.31), whereas the pooled adjusted HR was 1.10 (95% CI, 0.38-3.15).
Abu-Jamous, Anisimovich, Baxter, Mackillop, Vizcaychipi et al., Associations of comorbidities and medications with COVID-19 outcome: A retrospective analysis of real-world evidence data, medRxiv, doi:10.1101/2020.08.20.20174169
Bramante, Buse, Tamaritz, Palacio, Cohen et al., Outpatient metformin use is associated with reduced severity of COVID-19 disease in adults with overweight or obesity, J Med Virol, doi:10.1002/jmv.26873
Bramante, Ingraham, Murray, Marmor, Hovertsen et al., Metformin and risk of mortality in patients hospitalised with COVID-19: a retrospective cohort analysis, Lancet Healthy Longev, doi:10.1016/S2666-7568%2820%2930033-7
Cameron, Morrison, Levin, Mohan, Forteath et al., Anti-Inflammatory Effects of Metformin Irrespective of Diabetes Status, Circ Res, doi:10.1161/CIRCRESAHA.116.308445
Cariou, Hadjadj, Wargny, Pichelin, Al-Salameh et al., Phenotypic characteristics and prognosis of inpatients with COVID-19 and diabetes: the CORONADO study, Diabetologia, doi:10.1007/s00125-020-05180-x
Chen, Yang, Cheng, Chen, Peng et al., Clinical Characteristics and Outcomes of Patients With Diabetes and COVID-19 in Association With Glucose-Lowering Medication, Diabetes Care, doi:10.2337/dc20-0660
Cheng, Liu, Li, Zhang, Lei et al., Metformin Is Associated with Higher Incidence of Acidosis, but Not Mortality, in Individuals with COVID-19 and Pre-existing Type 2 Diabetes, Cell Metab, doi:10.1016/j.cmet.2020.08.013
Crouse, Grimes, Li, Might, Ovalle et al., Metformin Use Is Associated With Reduced Mortality in a Diverse Population With COVID-19 and Diabetes, Front Endocrinol, doi:10.3389/fendo.2020.600439
Cummings, Baldwin, Abrams, Jacobson, Meyer et al., Epidemiology, clinical course, and outcomes of critically ill adults with COVID-19 in New York City: a prospective cohort study, Lancet, doi:10.1016/S0140-6736%2820%2931189-2
Dalan, Metformin, neutrophils and COVID-19 infection, Diabetes Res Clin Pract, doi:10.1016/j.diabres.2020.108230
Esam, A proposed mechanism for the possible therapeutic potential of Metformin in COVID-19, Diabetes Res Clin Pract, doi:10.1016/j.diabres.2020.108282
Garcia, Flumamine, a new synthetic analgesic and anti-flu drug, J Philipp Med Assoc
Ghany, Palacio, Dawkins, Chen, Mccarter et al., Metformin is associated with lower hospitalizations, mortality and severe coronavirus infection among elderly medicare minority patients in 8 states in USA, Diabetes Metab Syndr, doi:10.1016/j.dsx.2021.02.022
Grasselli, Zangrillo, Zanella, Antonelli, Cabrini et al., Baseline Characteristics and Outcomes of 1591 Patients Infected With SARS-CoV-2 Admitted to ICUs of the Lombardy Region, JAMA, doi:10.1001/jama.2020.5394
Guan, Liang, Zhao, Liang, Chen et al., Comorbidity and its impact on 1590 patients with COVID-19 in China: a nationwide analysis, Eur Respir J, doi:10.1183/13993003.00547%26%23x2013%3B2020
Guan, Ni, Hu, Liang, Ou et al., Clinical Characteristics of Coronavirus Disease 2019 in China, N Engl J Med, doi:10.1056/NEJMoa2002032
Huang, Lim, Pranata, Diabetes mellitus is associated with increased mortality and severity of disease in COVID-19 pneumonia-A systematic review, meta-analysis, and meta-regression, Diabetes Metab Syndr, doi:10.1016/j.dsx.2020.04.018
Jiang, Chen, Liu, Yin, Yang et al., Association of metformin with mortality or ARDS in patients with COVID-19 and type 2 diabetes: A retrospective cohort study, Diabetes Res Clin Pract, doi:10.1016/j.diabres.2020.108619
Lalau, Al-Salameh, Hadjadj, Goronflot, Wiernsperger et al., Metformin use is associated with a reduced risk of mortality in patients with diabetes hospitalised for COVID-19, Diabetes Metab, doi:10.1016/j.diabet.2020.101216
Li, Wei, Li, Mccowen, Xiong et al., Metformin Use in Diabetes Prior to Hospitalization: Effects on Mortality in Covid-19, Endocr Pract, doi:10.4158/EP-2020-0466
Li, Wei, Mccowen, Xiong, Liu et al., Inpatient use of metformin and acarbose is associated with reduced mortality of COVID-19 patients with type 2 diabetes mellitus, Endocrinol Diabetes Metab, doi:10.1002/edm2.301
Li, Yang, Yan, Sun, Zeng et al., Metformin in Patients With COVID-19: A Systematic Review and Meta-Analysis, Front Med, doi:10.3389/fmed.2021.704666
Lighter, Phillips, Hochman, Sterling, Johnson et al., Obesity in Patients Younger Than 60 Years Is a Risk Factor for COVID-19 Hospital Admission, Clin Infect Dis, doi:10.1093/cid/ciaa415
Luk, Yip, Zhang, Kong, Wong et al., Glucose-lowering drugs and outcome from COVID-19 among patients with type 2 diabetes mellitus: a population-wide analysis in Hong Kong, BMJ Open, doi:10.1136/bmjopen-2021-052310
Luo, Qiu, Liu, Liu, Zheng et al., Metformin Treatment Was Associated with Decreased Mortality in COVID-19 Patients with Diabetes in a Retrospective Analysis, Am J Trop Med Hyg, doi:10.4269/ajtmh.20-0375
Ma, Fan, Cheng, Does sleeve lobectomy concomitant with or without pulmonary artery reconstruction (double sleeve) have favorable results for non-small cell lung cancer compared with pneumonectomy? A meta-analysis, Eur J Cardiothorac Surg, doi:10.1016/j.ejcts.2007.03.018
Ma, Patel, Vemparala, Krishnamurthy, Metformin is associated with favorable outcomes in patients with COVID-19 and type 2 diabetes mellitus, Sci Rep, doi:10.1038/s41598-022-09639-2
Mirani, Favacchio, Carrone, Betella, Biamonte et al., Impact of Comorbidities and Glycemia at Admission and Dipeptidyl Peptidase 4 Inhibitors in Patients With Type 2 Diabetes With COVID-19: A Case Series From an Academic Hospital in Lombardy, Italy, Diabetes Care, doi:10.2337/dc20-1340
Oh, Song, Metformin use and risk of COVID-19 among patients with type II diabetes mellitus: an NHIS-COVID-19 database cohort study, Acta Diabetol, doi:10.1007/s00592-020-01666-7
Ojeda-Fernandez, Foresta, Macaluso, Colacioppo, Tettamanti et al., Metformin use is associated with a decrease in the risk of hospitalization and mortality in COVID-19 patients with diabetes: A population-based study in Lombardy, Diabetes Obes Metab, doi:10.1111/dom.14648
Ong, Tan, Canete, Lim, Robles, Association Between Metformin Use and Mortality among Patients with Type 2 Diabetes Mellitus Hospitalized for COVID-19 Infection, J ASEAN Fed Endocr Soc, doi:10.15605/jafes.036.02.20
Oscanoa, Amado, Vidal, Savarino, Romero-Ortuno, Metformin therapy, severity and mortality of SARS-CoV-2 infection: a meta-analysis, Clin Diabetol
Perez-Belmonte, Torres-Pena, Lopez-Carmona, Ayala-Gutierrez, Fuentes-Jimenez et al., Mortality and other adverse outcomes in patients with type 2 diabetes mellitus admitted for COVID-19 in association with glucose-lowering drugs: a nationwide cohort study, BMC Med, doi:10.1186/s12916-020-01832-2
Ramos-Rinco ´n, ´rez-Belmonte, ´nchez, Jansen-Chaparro, De-Sousa-Baena, type 2 diabetes mellitus hospitalized due to COVID-19. A nationwide observational study in Spain, doi:10.21203/
Roncon, Zuin, Rigatelli, Zuliani, Diabetic patients with COVID-19 infection are at higher risk of ICU admission and poor short-term outcome, J Clin Virol, doi:10.1016/j.jcv.2020.104354
Siddiqi, Mehra, COVID-19 illness in native and immunosuppressed states: A clinical-therapeutic staging proposal, J Heart Lung Transplant, doi:10.1016/j.healun.2020.03.012
Stang, Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses, Eur J Epidemiol, doi:10.1007/s10654-010-9491-z
Tamura, Said, De Freitas, Rubio, Outcome and death risk of diabetes patients with Covid-19 receiving pre-hospital and in-hospital metformin therapies, Diabetol Metab Syndr, doi:10.1186/s13098-021-00695-8
Thomas, Li, Pencina, Overlap Weighting: A Propensity Score Method That Mimics Attributes of a Randomized Clinical Trial, JAMA, doi:10.1001/jama.2020.7819
Ursini, Ciaffi, Landini, Meliconi, COVID-19 and diabetes: Is metformin a friend or foe? Diabetes, Res Clin Pract, doi:10.1016/j.diabres.2020.108167
Ursini, Russo, Pellino, Angelo, Chiaravalloti et al., Metformin and Autoimmunity: A "New Deal" of an Old Drug, Front Immunol, doi:10.3389/fimmu.2018.01236
Wiernsperger, Al-Salameh, Cariou, Lalau, Protection by metformin against severe Covid-19: An in-depth mechanistic analysis, Diabetes Metab, doi:10.1016/j.diabet.2022.101359
Wu, Mcgoogan, Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72314 Cases From the Chinese Center for Disease Control and Prevention, JAMA, doi:10.1001/jama.2020.2648
Yang, Sun, Zhang, Zhang, The effect of metformin on mortality and severity in COVID-19 patients with diabetes mellitus, Diabetes Res Clin Pract, doi:10.1016/j.diabres.2021.108977
Yang, Yu, Xu, Shu, Xia et al., Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lan, cet Respir Med, doi:10.1016/S2213-2600%2820%2930079-5
Zhou, Yu, Du, Fan, Liu et al., Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study, Lancet, doi:10.1016/S0140-6736%2820%2930566-3
Please send us corrections, updates, or comments. c19early involves the extraction of 100,000+ 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. FLCCC and WCH provide treatment protocols.
  or use drag and drop