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Metformin for COVID-19
114 studies with >300,000 patients
Serious outcome risk
Metformin
Control
Significantly lower risk for mortality, ventilation, ICU, hospitalization, progression, recovery, and viral clearance.
76 studies from 70 independent teams in 24 countries show significant benefit.
COVID-19 Metformin studies · October 2026
Most studies analyze existing use with diabetic patients. Prophylaxis results typically include continuing use after infection and hospitalization, and greater benefit is seen for more serious outcomes. Recent:
Yigitturk
Reis
Rodríguez-Fernández
Butzin-Dozier.
Covid Analysis Metformin reduces COVID-19 risk: real-time meta-analysis of 114 studies (Version 105)
Significantly lower risk is seen for mortality, ventilation, ICU admission, hospitalization, progression, recovery, and viral clearance. 76 studies from 70 independent teams in 24 countries show significant benefit. Meta-analysis using th..
Oct 6
 Reis et al., Annals of Internal Medicine, doi:10.7326/ANNALS-26-02144 Effect of Fluvoxamine and Metformin for Fatigue in Patients With Long COVID
RCT 399 long COVID patients in Brazil showing reduced fatigue with fluvoxamine, and inconclusive results for metformin. This is a republication of a retracted paper [Reis]. Metformin was reduced from 750mg to 500mg bid in May 2024, and th..
Sep 11
 Rodríguez-Fernández et al., Scientific Reports, doi:10.1038/s41598-026-68017-4 Metformin use and decreased risk of severe COVID-19 outcomes in a real-world case-control study
31% lower hospitalization (p=0.03) and 7% fewer cases (p=0.46). Population-based case-control study of 81,348 adults in Spain, showing lower risk of hospitalization with prior metformin use. The analysis among patients with type 2 diabetes may be the most reliable. The primary analysis compares metfor..
Jul 9
 Butzin-Dozier et al., medRxiv, doi:10.64898/2026.07.06.26357398 Metformin and Severe Post-COVID-19 Outcomes Among Individuals with Diabetes Mellitus
39% lower mortality (p<0.0001) and 13% lower long COVID (p=0.0003). Retrospective 53,332 adults with type 2 diabetes mellitus and COVID-19 in the U.S. National Clinical Cohort Collaborative (N3C), showing lower 12-month all-cause mortality and probable long COVID with metformin vs. DPP4 inhibitor (DPP4i) ..
Jun 3
 Ngiam et al., Infectious Diseases and Therapy, doi:10.1007/s40121-026-01362-z Prior SGLT2 Inhibitor and Metformin Use and Risk of Long COVID in Type 2 Diabetes: A Nationwide Population-Based Cohort Study
20% lower long COVID (p=0.01). Retrospective 71,698 patients with type 2 diabetes in Singapore showing reduced risk of long COVID with prior metformin use and SGLT2 inhibitor use.
May 24
 Yigitturk et al., Immunopharmacology and Immunotoxicology, doi:10.1080/08923973.2026.2671721 Metformin and phenformin attenuate SARS–CoV-2 spike protein S1-induced endothelial inflammation involving AMPK/NF-κB signaling in HUVECs
In vitro study showing inhibition of SARS-CoV-2 spike protein S1-induced endothelial inflammation with metformin and phenformin in human umbilical vein endothelial cells. Metformin counteracted S1 exposure by increasing AMPK phosphorylati..
Mar 31
 Reis et al., Annals of Internal Medicine, doi:10.7326/ANNALS-25-03959 RETRACTED: The Effect of Fluvoxamine and Metformin for Fatigue in Patients With Long COVID
RCT 399 adults with long COVID fatigue in Brazil showing significant benefit with fluvoxamine but not metformin for reducing fatigue severity. Authors hypothesize that fluvoxamine's σ-1 receptor agonism and immunomodulatory properties may..
Mar 31
 Felemban et al., BMC Infectious Diseases, doi:10.1186/s12879-026-13170-4 The length of hospital stay in COVID-19 patients using pre-hospital metformin at a Saudi tertiary hospital: a retrospective cohort study
44% lower ventilation (p=0.24), 9% lower ICU admission (p=0.79), 35% lower ARDS (p=0.38), and 46% higher hospital discharge (p=0.01). Retrospective 114 hospitalized COVID-19 patients with T2DM in Saudi Arabia, showing significantly shorter hospital stay with pre-hospital metformin use.
Mar 3
 Lim et al., Annals of Internal Medicine, doi:10.7326/ANNALS-25-04883 Neither Metformin nor Ursodeoxycholic Acid Effectively Treats Postacute Sequelae of COVID-19
RCT 396 patients with existing long COVID, showing no significant benefit with metformin or UDCA.
Feb 12
 Morales-Vazquez et al., Life, doi:10.3390/life16020319 Arrhythmias as Part of Long COVID Syndrome in Hospitalized Patients That Survived a Severe COVID-19 Infection and the Potential Protective Role of Metformin in These Patients
Retrospective 53 hospitalized COVID-19 patients showing a 41% prevalence of cardiac arrhythmias during long COVID, with metformin use associated with reduced arrhythmia risk. Authors hypothesize metformin's protective effect occurs throug..
Dec 1
2025
 Ling et al., Authorea Inc., doi:10.22541/au.176460133.31712164/v1 Metformin for Long COVID: A Systematic Review and Meta-Analysis
Systematic review and meta-analysis of 26 studies showing lower mortality, hospitalization, and long COVID wiht metformin treatment.
Nov 26
2025
 Bramante et al., Authorea Inc., doi:10.22541/au.176418398.81170401/v1 Metformin at the time of Covid-19 infection and risk of Long Covid: A Target Trial Emulation Study
53% lower long COVID (p=0.02). Target trial emulation of 496 outpatients in the N3C nationwide EHR database, showing lower risk of long COVID or death with metformin prescribed within 6 days of documented SARS-CoV-2 infection. Low event count: the primary result depend..
Nov 17
2025
 Liu et al., Renal Failure, doi:10.1080/0886022X.2025.2584572 Associations of hypoglycemic medications, cordycepin and vaccination with clinical outcomes in diabetic kidney disease patients with COVID-19
64% lower progression (p=0.0006), 9% lower hospitalization (p=0.62), 15% improved recovery (p=0.28), and 1% worse results (p=0.83). Retrospective 642 diabetic kidney disease patients with COVID-19 in China showing lower risk of pneumonia with metformin use, and lower risk of hospitalization with SGLT2 inhibitors and cordycepin use.
Nov 7
2025
 Lee et al., PLOS One, doi:10.1371/journal.pone.0336015 SARS-CoV-2 spike protein causes synaptic dysfunction and p-tau and α-synuclein aggregation leading cognitive impairment: The protective role of metformin
Animal study showing that the SARS-CoV-2 spike protein causes cognitive impairment in rats, with metformin providing protective effects.
Sep 12
2025
 Maurmann et al., Immunometabolism, doi:10.1097/in9.0000000000000078 Immunoregulatory effect of metformin in monocytes exposed to SARS-CoV-2 spike protein subunit 1
In vitro study showing that metformin suppresses inflammatory responses in human monocytes exposed to SARS-CoV-2 spike protein subunit 1.
Sep 1
2025
 Chaichana et al., Clinical Infectious Diseases, doi:10.1093/cid/ciaf429 Effect of Metformin on the Risk of Post-coronavirus Disease 2019 Condition Among Individuals With Overweight or Obese: A Population-based Retrospective Cohort Study
62% lower long COVID (p<0.0001). Retrospective 624,308 overweight or obese patients showing reduced risk of post-COVID-19 condition (PCC) with metformin initiation within 90 days of COVID-19 diagnosis.
Aug 26
2025
 Yang et al., Frontiers in Pharmacology, doi:10.3389/fphar.2025.1584230 Correlation between metformin use and mortality in acute respiratory failure: a retrospective ICU cohort study
Retrospective 1,429 ICU patients with acute respiratory failure showing significantly lower mortality with metformin use.
Aug 12
2025
 Bramante et al., Clinical Infectious Diseases, doi:10.1093/cid/ciag335 (date from preprint) Metformin on the Presence of COVID-19 Symptoms 6 Months after Infection: The ACTIV-6 Randomized Clinical Trial
RCT 2,983 outpatients showing lower risk of long COVID with metformin, without statistical significance. Results are reported with the main study entry [Bramante].
Jul 26
2025
 Lin et al., ResearchGate, 7/2025 The Association Between Metformin Use and Outcomes of Hospitalized COVID-19 Patients
33% lower mortality (p=0.76) and 45% higher ventilation (p=0.52). Retrospective 285 hospitalized COVID-19 patients in Taiwan with 41 treated with metformin, showing no significant difference in mortality with metformin use. Authors note higher ventilation with use ≥17.5 days, however this requires hospi..
Jul 8
2025
 Sjögren et al., bioRxiv, doi:10.1101/2025.07.07.663218 Shedding of mitochondrial Voltage-Dependent Anion Channel-1 (VDAC1) Reflects COVID-19 Severity and Reveals Macrophage Dysfunction
In vitro, ex vivo, and retrospective observational study showing that VDAC1 (Voltage-Dependent Anion Channel-1) levels reflect COVID-19 severity and that VDAC1 inhibitors (VBIT-4, metformin, and VDAC1-specific antibody) restore macrophage..
Jun 30
2025
 Mylonas et al., International Journal of Molecular Sciences, doi:10.3390/ijms26136332 A Mathematical Model of Metformin Action on COVID-19 Risk Infection in Cardiovascular Diabetic Patients Studied by FTIR Spectroscopy
Ex vivo Fourier-transform infrared (FTIR) spectroscopy of coronary-artery tissue and fractional-calculus risk modelling showing that metformin use is associated with lower predicted COVID-19 infection and mortality than insulin or thiazol..
May 29
2025
 Rao et al., Journal of Cellular and Molecular Medicine, doi:10.1111/jcmm.70581 Pathological Glucose Levels Enhance Entry Factor Expression and Hepatic SARS‐CoV‐2 Infection
Analysis of high glucose levels on SARS-CoV-2 infection, showing that hyperglycemia significantly increases expression of viral entry factors (ACE2, TMPRSS2, TMPRSS4, FURIN, NRP1) in liver cells but not in lung and pancreatic cells, which..
Apr 11
2025
 Johnson et al., Journal of Clinical and Translational Science, doi:10.1017/cts.2024.1162 Is PHASTR faster? A target trial emulation case study in the N3C
53% lower long COVID (p=0.02). N3C target trial emulation study with 9,660 adult COVID-19 patients, showing metformin associated with lower risk of long COVID or death.
Apr 8
2025
 Joshi et al., Clinical and Translational Medicine, doi:10.1002/ctm2.70275 Severe SARS‐CoV‐2 infection in diabetes was rescued in mice supplemented with metformin and/or αKG, and patients taking metformin, via HIF1α‐IFN axis
In vitro and mouse study showing that metformin and/or alpha-ketoglutarate (αKG) supplementation reduces SARS-CoV-2 infection severity in diabetic mice by modulating the HIF1α-interferon axis. Diabetic mice exhibited elevated viral loads,..
Mar 4
2025
 Granvik et al., medRxiv, doi:10.1101/2025.02.28.25323075 Identifying DNA Methylation Patterns in Post COVID-19 Condition: Insights from a One-Year Prospective Cohort Study
Prospective cohort study with 22 Post COVID-19 condition (PCC+) patients and 22 matched COVID-19 convalescents (PCC-), showing distinct DNA methylation patterns diminishing over time. The study identified TXNRD1 methylation changes associ..
Feb 21
2025
 Monsalve et al., Journal of Translational Autoimmunity, doi:10.1016/j.jtauto.2025.100280 NETosis: A key player in autoimmunity, COVID-19, and long COVID
Review of neutrophil extracellular traps (NETs) and their role in autoimmunity, COVID-19, and long COVID. Authors explain that NETosis is a process where neutrophils release web-like structures (NETs) containing DNA, proteases, and enzyme..
Feb 4
2025
 Soff et al., BMJ Open Diabetes Research & Care, doi:10.1136/bmjdrc-2024-004536 Association of glycemic control with Long COVID in patients with type 2 diabetes: findings from the National COVID Cohort Collaborative (N3C)
18% lower long COVID (p=0.001). Retrospective 7,430 COVID-positive patients with type 2 diabetes showing lower risk of long COVID or death with metformin use, and higher risk with insulin use.
Jan 31
2025
 Tavares et al., Biophysica, doi:10.3390/biophysica5010004 Investigation of Interactions Between the Protein MPro and the Vanadium Complex VO(metf)2∙H2O: A Computational Approach for COVID-19 Treatment
In silico study showing that the vanadium complex VO(metf)2∙H2O (VC) and metformin (MF) may be beneficial for COVID-19 treatment by interacting with the main protease (Mpro) of SARS-CoV-2. Using docking simulations, authors found that VC ..
Jan 14
2025
 Bramante et al., JAMA Internal Medicine, doi:10.1001/jamainternmed.2025.2570 (date from preprint) Metformin and Time to Sustained Recovery in Adults With COVID-19
20% lower progression (p=0.52), 4% worse recovery (p=0.28), and 21% lower long COVID (p=0.34). RCT 2,991 low-risk outpatients including patients up to 12 days from symptoms (despite the protocol being up to 7 days), showing no significant differences with metformin. Remote trial with 2 days shipping delay. Median days to symptom re..
Jan 11
2025
 Benfathallah et al., Cureus, doi:10.7759/cureus.77288 Does the Consumption of Metformin Correlate With a Reduction in Mortality Among Patients With Type 2 Diabetes and COVID-19 in Morocco?
54% lower mortality (p=0.04). Retrospective 115 hospitalized type 2 diabetes patients in Morocco showing significantly lower mortality with metformin use.
Jan 6
2025
 Keels et al., Frontiers in Endocrinology, doi:10.3389/fendo.2024.1482853 Antidiabetic agent use and clinical outcomes in patients with diabetes hospitalized for COVID-19: a systematic review and meta-analysis
59% lower mortality (p=0.002). Systematic review and meta-analysis of 35 studies showing lower mortality with metformin and DPP-4 inhibitor treatment for COVID-19 patients with diabetes.
Dec 18
2024
 Halabitska et al., Viruses, doi:10.3390/v16121938 Metformin in Antiviral Therapy: Evidence and Perspectives
Review of metformin as a promising broad-spectrum antiviral agent, focusing on its potential for treating SARS-CoV-2 infection. Authors highlight metformin's ability to activate AMPK and inhibit mTOR signaling, which can help reduce hyper..
Dec 11
2024
 Matviichuk et al., Frontiers in Endocrinology, doi:10.3389/fendo.2024.1459171 Unveiling risk factors for post-COVID-19 syndrome development in people with type 2 diabetes
5% higher long COVID (p=0.64). Retrospective 469 patients with type 2 diabetes in Ukraine showing no significant difference in post-COVID-19 syndrome (PCS) with metformin. There was higher risk with insulin analogs, but lower risk with human insulin.
Nov 30
2024
 He et al., IJC Heart & Vasculature, doi:10.1016/j.ijcha.2024.101574 Clinical characteristics and risk factors for in-hospital mortality of COVID-19 patients in Hubei Province: A multicenter retrospective study
74% lower mortality (p<0.0001). Retrospective 53,030 COVID-19 patients from 138 hospitals in Hubei, China showing lower mortality with metformin.
Nov 29
2024
 Chertok Shacham et al., Diabetes and Vascular Disease Research, doi:10.1177/14791641241288390 Impact of blood glucose control on clinical outcomes in type 2 diabetes patients hospitalized with COVID-19 infection
70% lower mortality (p=0.01). Retrospective 857 hospitalized type 2 diabetes patients showing lower mortality with pre-admission metformin use. Authors report no significant difference in mortality with in-hospital metformin use, but do not report the actual result.
Nov 9
2024
 Somasundaram et al., Annals of Medicine, doi:10.1080/07853890.2024.2425829 Metformin use and its association with various outcomes in COVID-19 patients with diabetes mellitus: a retrospective cohort study in a tertiary care facility
89% lower mortality (p<0.0001). Retrospective 421 hospitalized COVID-19 patients with type 2 diabetes in India, showing significantly lower mortality with metformin use compared to other antidiabetic medications.
Sep 27
2024
 Sakamaki et al., Discover Public Health, doi:10.1186/s12982-024-00225-7 Insights from a multicenter nationwide cohort analysis in Japan on the association of underlying conditions and pharmacological interventions with COVID-19 disease severity
23% lower severe cases (p<0.0001). Retrospective 650,317 COVID-19 patients in Japan showing lower risk of severe COVID-19 with metformin use.
Sep 19
2024
 Harmon et al., Journal of General Internal Medicine, doi:10.1007/s11606-024-08864-x Preadmission Metformin Use Is Associated with Reduced Mortality in Patients with Diabetes Mellitus Hospitalized with COVID-19
18% lower mortality (p<0.0001). Retrospective 11,993 hospitalized COVID-19 patients with diabetes mellitus but without chronic kidney disease or need for hemodialysis, showing lower mortality with metformin use.
Sep 17
2024
 Johnson et al., Diabetes Care, doi:10.2337/DCa24-0032 Prevalent Metformin Use in Adults With Diabetes and the Incidence of Long COVID: An EHR-Based Cohort Study From the RECOVER Program
N3C/PCORnet retrospective adults with type 2 diabetes in the USA showing lower incidence of mortality or long COVID with metformin use.
Jul 21
2024
 Sugimoto et al., medRxiv, doi:10.1101/2024.07.20.24310736 Biguanides Associate with Decreased Early Mortality and Risk of Acute Kidney Injury In Hospitalized COVID-19 Patients: a nationwide retrospective cohort study in Japan
40% lower mortality (p<0.0001). Retrospective 168,370 hospitalized COVID-19 patients with diabetes in Japan showing lower mortality and reduced risk of acute kidney injury with biguanide (likely primarily or only metformin) use. Authors hypothesize that metformin's acti..
Jun 30
2024
 Hussein et al., The Review of Diabetic Studies, doi:10.1900/RDS.2024.20.12 The Proportion and Associated Factors for Mortality among COVID-19 Infection with Diabetes in Iraq
64% lower mortality (p=0.05). Retrospective 545 hospitalized COVID-19 patients with diabetes showing high mortality (33%). Metformin, SGLT inhibitors, and DPP4 inhibitors were associated with lower mortality compared with insulin.
Jun 8
2024
 Chen et al., Translational Medicine of Aging, doi:10.1016/j.tma.2024.04.001 Metformin alleviates inflammatory response and severity rate of COVID-19 infection in elderly individuals
81% lower ICU admission (p=0.008), 39% lower progression (p=0.009), and 17% shorter hospitalization (p=0.001). Retrospective 413 hospitalized COVID-19 patients with type 2 diabetes in China showing lower ICU admission, lower pneumonia incidence, and shorter hospital stay with metformin use.
May 31
2024
 Chang et al., Biomedicines, doi:10.3390/biomedicines12061223 SARS-CoV-2 Spike Protein 1 Causes Aggregation of α-Synuclein via Microglia-Induced Inflammation and Production of Mitochondrial ROS: Potential Therapeutic Applications of Metformin
In vitro and rat study showing that the SARS-CoV-2 spike protein S1 subunit causes aggregation of α-synuclein and microglial activation, which may contribute to the neurological symptoms seen in long COVID. In rats, intranasal administrat..
May 31
2024
 Olawore et al., Clinical Epidemiology, doi:10.2147/CLEP.S458901 Risk of Post-Acute Sequelae of SARS-CoV-2 Infection (PASC) Among Patients with Type 2 Diabetes Mellitus on Anti-Hyperglycemic Medications
19% lower long COVID (p=0.29). Retrospective 7,047 outpatients with type 2 diabetes showing a lower risk of PASC (long COVID) with metformin compared to sulfonylurea or DPP-4 inhibitor use, without statistical significance.
May 30
2024
 Hou et al., Scientific Reports, doi:10.1038/s41598-024-63081-0 Metformin is a potential therapeutic for COVID-19/LUAD by regulating glucose metabolism
In silico and in vitro study showing metformin as a potential therapeutic for COVID-19/LUAD by regulating glucose metabolism. Authors identified PTEN and mTOR as potential core target genes of metformin for treating COVID-19/LUAD. Bioinfo..
May 17
2024
 Xu et al., Molecular Biomedicine, doi:10.1186/s43556-024-00183-1 Effects of different treatments for type 2 diabetes mellitus on mortality of coronavirus disease from 2019 to 2021 in China: a multi-institutional retrospective study
52% lower mortality (p=0.01), 54% lower ventilation (p=0.007), and 72% lower ARDS (p=0.04). Retrospective 4,922 COVID-19 patients with type 2 diabetes in China, showing lower mortality with metformin and alpha-glucosidase inhibitor treatment and higher mortality with insulin treatment.
May 10
2024
 Plowman et al., International Journal of Molecular Sciences, doi:10.3390/ijms25105190 Anti-Inflammatory Potential of the Anti-Diabetic Drug Metformin in the Prevention of Inflammatory Complications and Infectious Diseases Including COVID-19: A Narrative Review
Review of the potential of metformin for preventing inflammatory complications and infectious diseases including COVID-19. Authors discuss evidence from preclinical and clinical studies suggesting metformin may help prevent symptoms of CO..
Apr 29
2024
 Song et al., Therapeutic Innovation & Regulatory Science, doi:10.1007/s43441-024-00633-6 The Effect of Antihyperglycemic Medications on COVID-19: A Meta-analysis and Systematic Review from Observational Studies
34% lower mortality (p<0.0001), 35% lower severe cases (p=0.002), and 23% lower hospitalization (p=0.02). Meta analysis of 56 studies showing lower mortality and hospitalization with metformin, GLP-1 receptor agonists, and SGLT-2 inhibitors in COVID-19 patients with type 2 diabetes, while insulin was associated with increased risks.
Apr 16
2024
 Agamah et al., ScienceOpen, doi:10.58647/DRUGARXIV.PR000010.v1 Network-based multi-omics-disease-drug associations reveal drug repurposing candidates for COVID-19 disease phases
In silico study identifying potential drugs beneficial for COVID-19 by integrating transcriptomics, proteomics, metabolomics, lipidomics, and drug data. Authors explore interactions between drugs, molecular features, and disease severity...
Apr 5
2024
 Lockwood, T., BioMetals, doi:10.1007/s10534-024-00590-5 Coordination chemistry suggests that independently observed benefits of metformin and Zn2+ against COVID-19 are not independent
In silico analysis suggesting potential benefits of metformin and zinc for COVID-19. Author proposes that metformin can form a complex with zinc ions, increasing zinc bioavailability, and that the metformin-zinc complex may slow viral mul..
Mar 30
2024
 Qiu et al., Global Epidemiology, doi:10.1016/j.gloepi.2024.100142 Estimating the effect of realistic improvements of metformin adherence on COVID-19 mortality using targeted machine learning
Retrospective 61,180 COVID-19 positive patients with chronic metformin prescriptions showing lower COVID-19 mortality with improved metformin adherence, as measured by proportion of days covered.
Mar 27
2024
 Dimnjaković et al., PLOS ONE, doi:10.1371/journal.pone.0301056 Association of anti-diabetic drugs and covid-19 outcomes in patients with diabetes mellitus type 2 and chronic kidney disease: Nationwide registry analysis
23% lower hospitalization (p=0.004) and 12% fewer cases (p=0.04). Retrospective 7,539 patients with diabetes mellitus type 2 and chronic kidney disease in Croatia showing lower risk of SARS-CoV-2 infection with SGLT-2 inhibitors, metformin, and repaglinide use, and lower risk of COVID-19 hospitalization..
Mar 24
2024
 Silverii et al., Journal of Clinical Medicine, doi:10.3390/jcm13071874 Is Metformin Use Associated with a More Favorable COVID-19 Course in People with Diabetes?
29% lower mortality (p=0.5). Retrospective 524 hospitalized COVID-19 patients with diabetes in Italy, showing lower risk of mortality with metformin use, without statistical significance. The results adjusted only for COVID-19 MRS differ between the text and Figure 2.
Mar 7
2024
 Lewandowski et al., Biomedicines, doi:10.3390/biomedicines12030605 Insulin and Metformin Administration: Unravelling the Multifaceted Association with Mortality across Various Clinical Settings Considering Type 2 Diabetes Mellitus and COVID-19
23% lower mortality (p=0.15). Retrospective 430 hospitalized COVID-19 patients with type 2 diabetes in Poland showing lower mortality with metformin and higher mortality with remdesivir, convalescent plasma, and aspirin in univariable analysis. These results were not..
Feb 13
2024
 De Jesús-González et al., Microorganisms, doi:10.3390/microorganisms12020383 A Dual Pharmacological Strategy against COVID-19: The Therapeutic Potential of Metformin and Atorvastatin
Review of the therapeutic potential of metformin and atorvastatin against COVID-19. Authors discuss the immunomodulatory and antiviral capabilities of these commonly prescribed diabetes and cholesterol medications. They note metformin's a..
Feb 11
2024
 Petakh et al., Viruses, doi:10.3390/v16020281 Metformin Alters mRNA Expression of FOXP3, RORC, and TBX21 and Modulates Gut Microbiota in COVID-19 Patients with Type 2 Diabetes
Retrospective 30 COVID-19 patients with type 2 diabetes showing improved T lymphocyte gene expression, gut microbiota diversity, and lower inflammatory markers with metformin treatment. Metformin-treated patients had a 1.96-fold increase ..
Jan 30
2024
 Halma et al., Endocrine and Metabolic Science, doi:10.1016/j.endmts.2024.100163 Exploring autophagy in treating SARS-CoV-2 spike protein-related pathology
Review of autophagy pathways for treating SARS-CoV-2 spike protein-related pathology. Authors note that the spike protein is implicated in long COVID and post-vaccination syndrome through mechanisms like inflammation, vascular damage, and..
Jan 29
2024
 Jang et al., Endocrinology and Metabolism, doi:10.3803/EnM.2024.1857 Impact of Antidiabetic Drugs on Clinical Outcomes of COVID-19: A Nationwide Population-Based Study
60% lower mortality (p=0.02), 72% lower ventilation (p=0.008), 39% lower ICU admission (p=0.12), and 30% lower need for oxygen therapy (p=0.23). Retrospective 556 diabetic patients in South Korea with COVID-19 showing lower risk of mechanical ventilation and death with metformin, lower risks of oxygen treatment and death with DPP-4 inhibitors, and increased risk of mechanical vent..
Jan 17
2024
 Yang et al., Cell Stem Cell, doi:10.1016/j.stem.2023.12.012 SARS-CoV-2 infection causes dopaminergic neuron senescence
In vitro study suggesting that metformin may protect against SARS-CoV-2-induced neurological disorders. Authors show that SARS-CoV-2 infection induces senescence and inflammation in human pluripotent stem cell-derived midbrain dopamine ne..
Jan 14
2024
 Zhang et al., Pathogens, doi:10.3390/pathogens13010075 SARS-CoV-2 ORF3a Protein as a Therapeutic Target against COVID-19 and Long-Term Post-Infection Effects
Review of the ORF3a protein of SARS-CoV-2 as a therapeutic target for COVID-19 due to its role in viral pathogenesis, triggering cytokine storms, tissue damage, and disease severity. Existing drugs doxycycline, metformin, and ibrutinib ar..
Dec 18
2023
 Mehrizi et al., Frontiers in Public Health, doi:10.3389/fpubh.2023.1280434 Drug prescription patterns and their association with mortality and hospitalization duration in COVID-19 patients: insights from big data
44% lower mortality (p<0.0001). Retrospective study of 917,198 hospitalized COVID-19 cases covered by the Iran Health Insurance Organization over 26 months showing that antithrombotics, corticosteroids, and antivirals reduced mortality while diuretics, antibiotics, and..
Dec 1
2023
 Al-kuraishy et al., European Review for Medical and Pharmacological Sciences, doi:10.26355/eurrev_202312_34583 The potential therapeutic effect of metformin in type 2 diabetic patients with severe COVID-19
78% lower mortality (p=0.01) and 41% improved recovery (p=0.0002). Prospective study of 60 hospitalized type 2 diabetes patients with COVID-19 on metformin monotherapy compared to 40 patients on other diabetes treatments, showing significantly lower inflammatory biomarkers, oxidative stress, and mortalit..
Nov 30
2023
 Mamari et al., Research Journal of Pharmacy and Technology, doi:10.52711/0974-360X.2023.00831 The effect of Chronic treatments of Type 2-diabetes mellitus on COVID-19 Morbidity and Symptoms Severity
50% lower mortality (p=0.01). Retrospective 109 hospitalized COVID-19 patients in Syria, 68 with diabetes, showing significantly lower mortality with metformin vs. sulfonylureas, and significantly higher mortality with discontinuation of metformin.
Nov 17
2023
 Miguel et al., Redox Biology, doi:10.1016/j.redox.2023.102957 Enhanced fatty acid oxidation through metformin and baicalin as therapy for COVID-19 and associated inflammatory states in lung and kidney
37% lower ICU admission (p=0.24). Mouse models showing reduced lung and kidney injury with metformin. Metformin minimized lung damage and fibrosis in a mouse model of LPS-induced ARDS, and reduced UUO and FAN-induced kidney fibrosis. In vitro study showing that metformin ..
Nov 13
2023
 Gomaa et al., Inflammopharmacology, doi:10.1007/s10787-023-01383-x Pharmacological evaluation of vitamin D in COVID-19 and long COVID-19: recent studies confirm clinical validation and highlight metformin to improve VDR sensitivity and efficacy
Review of 58 studies with 14,071,273 patients showing a beneficial effect of vitamin D supplementation in COVID-19 and long COVID. 49 studies (86%) with 14,029,411 patients (99.7%) found vitamin D effective, including 12 meta-analyses. Ob..
Nov 7
2023
 Avula et al., Journal of Clinical and Translational Science, doi:10.1017/cts.2023.668 Strategies used for the COVID-OUT decentralized trial of outpatient treatment of SARS-CoV-2
Report on the operation of the COVID-OUT trial noting several issues affecting the reliability of the results: - Use of home pulse oximeters for measuring oxygen saturation: authors note that the FDA warned about inaccuracies with home pu..
Oct 19
2023
 Bidari et al., Cureus, doi:10.7759/cureus.47354 Development of a Scoring Method Based on a Chest CT Scan to Determine the Outcomes of COVID-19 Patients
10% lower severe cases (p=0.53). Retrospective 406 COVID-19 patients in Iran, showing lower risk of severe cases with metformin use in unadjusted results, without statistical significance.
Oct 10
2023
 Petakh et al., Frontiers in Molecular Biosciences, doi:10.3389/fmolb.2023.1260633 Unveiling the potential pleiotropic effects of metformin in treating COVID-19: a comprehensive review
Review of the potential pleiotropic effects of metformin in treating COVID-19. Authors explore the potential of metformin, a medication commonly used for type 2 diabetes, as an antiviral and anti-inflammatory agent in COVID-19. Metformin ..
Sep 28
2023
 Wang et al., Frontiers in Pharmacology, doi:10.3389/fphar.2023.1215307 Effects of metformin on acute respiratory distress syndrome in preclinical studies: a systematic review and meta-analysis
Systematic review and meta-analysis of 15 non-COVID-19 preclinical studies of metformin for acute respiratory distress syndrome (ARDS) or acute lung injury (ALI), showing that metformin inhibits pulmonary inflammation and oxidative stress..
Sep 28
2023
 Lee et al., Heliyon, doi:10.1016/j.heliyon.2023.e20284 Metformin reduces the risk of developing influenza A virus related cardiovascular disease
Retrospective clinical study, in vitro study, and mouse study of metformin for influenza A virus (IAV) infection. Authors performed a retrospective analysis of 654 diabetic patients, finding that metformin treatment was associated with a ..
Sep 20
2023
 Farah et al., Journal of International Medical Research, doi:10.1177/03000605231198413 Prevalence and risk factors of COVID-19 infection, mortality, and post-infection lung fibrosis in patients with type 2 diabetes: a cross-sectional study
3% more cases (p=0.87). Retrospective 1,039 diabetes patients in Jordan, showing no significant difference in COVID-19 cases with metformin use in unadjusted results. Severity outcomes are not provided for metformin.
Sep 10
2023
 Zihono et al., Folia Medica Indonesiana, doi:10.20473/fmi.v59i3.46944 Metformin Effectiveness in Reducing Mortality among Covid-19 Patients with Type 2 Diabetes Mellitus at a Tertiary Hospital in Indonesia
49% lower mortality (p=0.02). Retrospective 137 hospitalized mild to moderate COVID-19 patients with type 2 diabetes in Indonesia, showing a significantly lower mortality with metformin treatment.
Aug 30
2023
 Petrelli et al., Acta Biomedica Atenei Parmensis, doi:10.23750/abm.v94iS3.14405 Metformin and Covid-19: a systematic review of systematic reviews with meta-analysis
31% lower mortality (p<0.0001) and 20% lower severe cases (p=0.03). Systematic review and meta analysis of 36 studies showing significantly lower COVID-19 mortality and severity with metformin use.
Aug 24
2023
 Guo et al., Diabetes, Metabolic Syndrome and Obesity, doi:10.2147/DMSO.S417925 Effects of Metformin on COVID-19 Patients with Type 2 Diabetes: A Retrospective Study
62% lower combined mortality/intubation (p=0.03) and 81% lower progression (p=0.003). Retrospective 571 type 2 diabetes patients with COVID-19 in China, showing lower combined mortality/mechanical ventilation with metformin.
Aug 18
2023
 Greco et al., Biomedicines, doi:10.3390/biomedicines11082292 The Impact of GLP-1 RAs and DPP-4is on Hospitalisation and Mortality in the COVID-19 Era: A Two-Year Observational Study
22% lower hospitalization (p=0.11). Retrospective 76,764 diabetes patients in Italy, showing that patients on metformin had lower rates of COVID-19 hospitalization compared to those on insulin/insulin secretagogues, GLP-1 receptor agonists, and DPP-4 inhibitors. Metformin v..
Aug 12
2023
 Zhou et al., Frontiers in Endocrinology, doi:10.3389/fendo.2023.1237832 Clinical characteristics and acute complication of COVID-19 patients with diabetes: a multicenter, retrospective study in Southern China
Retrospective 298 hospitalized type 2 diabetes patients in China showing metformin use associated with not having COVID-19, however the analysis considers treatment during hospitalization, and authors note that in this population metformi..
Aug 1
2023
 Tseng, K., 內科學誌, doi:10.6314/JIMT.202308_34(4).04 Metformin and Coronavirus Disease 2019: A New Deal for an Old Drug
Review of metformin for COVID-19, particularly in patients with preexisting type 2 diabetes. Author summarizes the evidence that metformin has broad anti-inflammatory, immunomodulatory, antiviral, and endothelial protective effects, in ad..
Jul 13
2023
 Taher et al., Experimental and Therapeutic Medicine, doi:10.3892/etm.2023.12114 Anti‑inflammatory effect of metformin against an experimental model of LPS‑induced cytokine storm
Mouse study showing that metformin attenuated LPS-induced increases in inflammatory cytokines, demonstrating an anti-inflammatory effect that may be useful against cytokine storm. 60 female mice were pretreated with oral or intraperitonea..
Jun 24
2023
 Piarulli et al., Nutrition, Metabolism and Cardiovascular Diseases, doi:10.1016/j.numecd.2023.06.016 Association of renin-angiotensin-aldosterone system inhibitors with best COVID-19 outcomes in a diabetic population of the Veneto Region (north-east Italy): a lesson for endemic phase?
53% lower combined mortality/ICU admission (p=0.08) and 45% lower hospitalization (p=0.0002). Retrospective diabetic COVID-19 patients in Italy, showing lower risk of hospitalization with metformin use.
Jun 8
2023
 Obiri-Yeboah et al., Endocrine Practice, doi:10.1016/j.eprac.2023.06.001 Association of metformin, dipeptidyl dipeptidase-4 inhibitors, and insulin with COVID-19-related hospital outcomes in patients with type 2 diabetes
1% higher mortality (p=0.98), 4% higher ventilation (p=0.87), and 8% lower ICU admission (p=0.72). Retrospective 529 hospitalized COVID-19 patients with type 2 diabetes, showing no significant difference in outcomes with metformin use. This does not account for the different risk of being hospitalized based on metformin use. Authors no..
Jun 6
2023
 Alieva et al., Obesity and metabolism, doi:10.14341/omet12801 Factors influencing the severity of COVID-19 course for patients with diabetes mellitus in tashkent: a retrospective cohort study
15% lower hospitalization (p=0.56). Retrospective 763 COVID-19 patients with type 2 diabetes in Uzbekistan, showing lower hospitalization with metformin use in unadjusted results, without statistical significance.
May 27
2023
 Akinosoglou et al., Microorganisms, doi:10.3390/microorganisms11061416 COVID-19 Outcomes and Diabetes Mellitus: A Comprehensive Multicenter Prospective Cohort Study
37% lower mortality (p=0.12), 39% higher ICU admission (p=0.26), and 3% higher ARDS (p=0.92). Prospective multicenter study of 354 hospitalized type 2 diabetes patients with COVID-19 in Greece showing increased risk with DPP4 inhibitor use as part of chronic diabetes treatment. There was no significant difference with metformin us..
May 19
2023
 Araldi et al., medRxiv, doi:10.1101/2023.05.19.23290214 Effects of antidiabetic drugs on mortality risks in individuals with type 2 diabetes: A prospective cohort study of UK Biobank participants
60% lower mortality (p<0.0001). UK Biobank retrospective including 43,610 type 2 diabetes patients, showing lower mortality with metformin use within matched type 2 diabetes patients.
May 19
2023
 Schlesinger et al., Diabetologia, doi:10.1007/s00125-023-05928-1 Risk phenotypes of diabetes and association with COVID-19 severity and death: an update of a living systematic review and meta-analysis
31% lower mortality (p<0.0001) and 22% lower severe cases (p<0.0001). Systematic review and meta analysis showing significantly lower COVID-19 mortality and severity with metformin use. Authors analyze 169 studies of diabetes patients, with 23 reporting mortality results and 34 reporting severity results fo..
May 15
2023
 Petakh et al., Biomedicine & Pharmacotherapy, doi:10.1016/j.biopha.2023.114892 The F/B ratio as a biomarker for inflammation in COVID-19 and T2D: Impact of metformin
Analysis of 115 pateints in Ukraine, providing evidence that the gut microbiome may play a role in the inflammatory response of COVID-19 patients, that the firmicutes/bacteroidetes ratio may be a potential biomarker for inflammation, and ..
May 6
2023
 Yen et al., Diabetes Research and Clinical Practice, doi:10.1016/j.diabres.2023.110692 Metformin use before COVID-19 vaccination and the risks of COVID-19 incidence, medical utilization, and all-cause mortality in patients with type 2 diabetes mellitus
25% lower mortality (p=0.001), 25% lower ventilation (p=0.01), 19% lower ICU admission (p=0.005), and 15% lower hospitalization (p<0.0001). TriNetX retrospective 123,709 vaccinated patients with type 2 diabetes, showing significantly lower risk of COVID-19 mortality, mechanical ventilation, and hospitalization with metformin use. There was no significant difference for cases...
Apr 28
2023
 Petakh et al., Preprints, doi:10.20944/preprints202304.1127.v1 Metformin Therapy Changes Gut Microbiota Alpha-Diversity in COVID-19 Patients with Type 2 Diabetes: The Role of SARS-CoV-2 Variants and Antibiotic Treatment
Retrospective 120 hospitalized COVID-19 patients showing lower alpha diversity of gut microbiota associated with antibiotic use, type 2 diabetes, longer hospital stays, higher CRP levels, and higher NLR. Metformin therapy was associated w..
Mar 31
2023
 Sandhu et al., PLOS ONE, doi:10.1371/journal.pone.0282961 Outpatient medications associated with protection from COVID-19 hospitalization
3% lower hospitalization (p=0.004). Retrospective 3,974,272 COVID-19 patients in the USA, showing 3% lower risk of hospitalization with pre-existing metformin use.
Feb 23
2023
 Ma et al., PLOS ONE, doi:10.1371/journal.pone.0282210 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
Meta analysis of 22 metformin studies, showing significantly lower mortality with metformin use prior to hospitalization.
Jan 31
2023
 Parveen et al., Annals of the National Academy of Medical Sciences (India), doi:10.1055/s-0042-1760353 Association of Metformin with Mortality in COVID-19 Patients: A Systematic Review and Meta-Analysis
37% lower mortality (p<0.0001). Systematic review and meta analysis showing significantly lower mortality with metformin.
Jan 23
2023
 Nassar et al., Journal of Diabetes, doi:10.1111/1753-0407.13359 Noninsulin‐based antihyperglycemic medications in patients with diabetes and COVID‐19: A systematic review and meta‐analysis
40% lower mortality (p<0.0001) and 4% improvement (p=0.86). Meta analysis of 26 studies showing lower mortality with metformin and glucagon-like peptide-1 receptor agonists (GLP-1RA), higher hospitalization and ICU admission with dipeptidyl peptidase-4 inhibitors (DPP-4i), and lower hospitalizatio..
Jan 20
2023
 Chertok Shacham et al., Medicine, doi:10.1097/md.0000000000032650 Blood glucose control with different treatment regimens in type 2 diabetes patients hospitalized with COVID-19 infection: A retrospective study
45% lower mortality (p=0.0001) and 7% shorter hospitalization (p=0.5). Retrospective 359 COVID-19 patients with diabetes in Israel, showing lower mortality in the other treatments group compared to the insulin group, with 80% of the other treatments group receiving metformin. Groups refer to use during hospi..
Jan 6
2023
 Pinchera et al., Microorganisms, doi:10.3390/microorganisms11010145 Diabetes and SARS-CoV-2 Infection: The Potential Role of Antidiabetic Therapy in the Evolution of COVID-19
15% lower severe cases (p=0.05). Retrospective 43 diabetes patients hospitalized for COVID-19 in Italy, showing lower risk of severe cases with metformin vs. insulin.
Dec 31
2022
 Khafri et al., Current Research in Medical Sciences, doi:10.22088/crms.6.2.32 Comparison of clinical and laboratory parameters of COVID-19 in diabetic patients using different glucose-lowering drugs: a retrospective study
Retrospective 157 diabetic patients in Iran reporting shorter hospitalization with metformin, however numbers in this paper are inconsistent. The counts and percentages for death in Table 1 are not possible - 11 (13.92%) for metformin cou..
Dec 24
2022
 Bramante et al., The Lancet Infectious Diseases, doi:10.1016/S1473-3099(23)00299-2 Outpatient treatment of COVID-19 and incidence of post-COVID-19 condition over 10 months (COVID-OUT): a multicentre, randomised, quadruple-blind, parallel-group, phase 3 trial
41% lower long COVID (p=0.01). Long-term 10 month followup for NCT04510194, showing significantly lower incidence of PASC with metformin treatment. Adjusted results are provided for metformin but not for ivermectin or fluvoxamine. For many issues with this trial, see.
Dec 7
2022
 Servais et al., Annals of Endocrinology, doi:10.1016/j.ando.2023.08.002 Mortality-related risk factors of inpatients with diabetes and COVID-19: a multicenter retrospective study in Belgium
49% lower mortality (p=0.002). Retrospective 375 hospitalized diabetes patients in Belgium, showing lower risk of COVID-19 mortality with metformin use.
Nov 9
2022
 Miao et al., Frontiers in Endocrinology, doi:10.3389/fendo.2022.1002834 Metformin use and mortality and length of stay among hospitalized patients with type 2 diabetes and COVID-19: A multiracial, multiethnic, urban observational study
1% lower mortality (p=0.91) and 5% shorter hospitalization (p=0.23). Retrospective 4,462 COVID+ diabetes patients in the USA, showing no significant difference in outcomes with metformin use.
Nov 9
2022
 Milosavljevic et al., Journal of Community Hospital Internal Medicine Perspectives, doi:10.55729/2000-9666.1127 Evaluation of Glycemic Control and Predictors of Severe Illness and Death in Patients With Diabetes Hospitalized With COVID-19
33% lower severe cases (p=0.03). Retrospective 733 hospitalized COVID-19 patients with diabetes in the USA, showing lower risk of severity with metformin use.
Oct 31
2022
 Mannucci et al., Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, doi:10.2147/DMSO.S385646 Infection Rates and Impact of Glucose Lowering Medications on the Clinical Course of COVID-19 in People with Type 2 Diabetes: A Retrospective Observational Study
38% lower mortality (p=0.02) and 15% lower hospitalization (p=0.25). Retrospective 54,009 diabetes patients in Italy, showing lower mortality with metformin use.
Oct 29
2022
 Zhan et al., Annals of Pharmacotherapy, doi:10.1177/10600280221133577 Effect of Antidiabetic Therapy on Clinical Outcomes of COVID-19 Patients With Type 2 Diabetes: A Systematic Review and Meta-Analysis
34% lower mortality (p<0.0001), 65% lower ventilation (p=0.57), and 1% lower ICU admission (p=0.92). Meta analysis of 54 studies (34 for metformin) with a total of over 314,000 patients showing lower mortality with metformin, SGLT-2 inhibitors, and GLP-1 receptor agonists in COVID-19 patients with type 2 diabetes. Metformin, SGLT-2i, and..
Oct 10
2022
 Morrison et al., PLOS ONE, doi:10.1371/journal.pone.0275787 COVID-19 outcomes in patients taking cardioprotective medications
41% lower mortality (p=0.003), 16% higher ventilation (p=0.49), 3% lower ICU admission (p=0.85), and 4% higher hospitalization (p=0.72). Retrospective 13,585 COVID+ patients in the USA, showing lower mortality with metformin use, but no significant difference for ventilation, ICU admission, and hospitalization.
Oct 4
2022
 Ouchi et al., Primary Care Diabetes, doi:10.1016/j.pcd.2022.10.001 Antidiabetic treatment and COVID-19 Outcomes: A population-based cohort study in primary health care in Catalonia during the first wave of the pandemic
10% lower mortality (p=0.19) and 8% lower combined mortality/hospitalization (p=0.12). Retrospective 31,006 diabetic COVID-19 patients in Spain, showing lower mortality with metformin treatment, without statistical significance. Authors provide results for metformin compared with untreated patients rather than all non-metfo..
Oct 1
2022
 Petakh et al., Medical Archives, doi:10.5455/medarh.2022.76.329-332 Effects of Metformin, Insulin on Hematological Parameters of COVID-19 Patients with Type 2 Diabetes
Analysis of hematologic parameters in COVID-19 patients with diabetes in Ukraine, showing significantly lower CRP for patients taking metformin.
Sep 21
2022
 Yip et al., SSRN Electronic Journal, doi:10.2139/ssrn.4225660 Metformin Does Not Reduce Hospitalisation for COVID-19
7% lower combined mortality/hospitalization (p=0.61) and 15% lower progression (p=0.16). Retrospective 12,331 diabetes patients in Hong Kong, showing no significant difference in outcomes with metformin use.
Sep 13
2022
 Zaccardi et al., Diabetes, Obesity and Metabolism, doi:10.1111/dom.14872 Ethnicity and risks of severe COVID-19 outcomes associated with glucose-lowering medications: A cohort study
34% lower mortality (p<0.0001) and 31% lower hospitalization (p<0.0001). Retrospective 624,771 people with type 2 diabetes in the UK, showing lower COVID-19 mortality and hospitalization with metformin use.
Aug 31
2022
 Ventura-López et al., Biomedicine & Pharmacotherapy, doi:10.1016/j.biopha.2022.113223 Treatment with metformin glycinate reduces SARS-CoV-2 viral load: An in vitro model and randomized, double-blind, Phase IIb clinical trial
44% lower need for oxygen therapy (p=0.03), 10% shorter hospitalization (p=0.35), and 41% faster viral clearance (p=0.03). RCT 20 hospitalized COVID-19 patients showing faster viral load reduction and lower oxygen use with metformin glycinate 620mg twice daily for 14 days compared to placebo. The in vitro portion demonstrated inhibition of viral replication a..
Aug 30
2022
 Chan et al., medRxiv, doi:10.1101/2022.08.29.22279355 Metformin is Associated with Reduced COVID-19 Severity in Patients with Prediabetes
59% lower mortality (p=0.66), 54% lower severe cases (p=0.37), and 42% lower progression (p=0.37). Retrospective 3,136 patients with prediabetes and 282 with PCOS, showing metformin associated with reduced COVID-19 severity.
Aug 18
2022
 Bramante et al., NEJM, doi:10.1056/NEJMoa2201662 Randomized Trial of Metformin, Ivermectin, and Fluvoxamine for Covid-19
52% lower combined mortality/hospitalization (p=0.09), 40% lower progression (p=0.03), and 37% improved viral clearance (p=0.0008). COVID-OUT remotely operated RCT, showing lower combined ER/hospitalization/death with metformin. Results for other treatments are listed separately - ivermectin , fluvoxamine . The "control" group includes patients receiving active treatm..
Aug 16
2022
 Loucera et al., Virology Journal, doi:10.1186/s12985-023-02195-9 (date from preprint) Real-world evidence with a retrospective cohort of 15,968 COVID-19 hospitalized patients suggests 21 new effective treatments
30% lower mortality (p<0.0001). Retrospective 15,968 COVID-19 hospitalized patients in Spain, showing lower mortality with existing use of several medications including metformin, HCQ, azithromycin, aspirin, vitamin D, vitamin C, and budesonide. Since only hospitalized ..
Aug 9
2022
 Shestakova et al., Frontiers in Endocrinology, doi:10.3389/fendo.2022.909874 Risk factors for COVID-19 case fatality rate in people with type 1 and type 2 diabetes mellitus: A nationwide retrospective cohort study of 235,248 patients in the Russian Federation
22% lower mortality (p=0.001). Retrospective 224,190 type 2 diabetes patients in Russia, showing lower mortality with metformin use.
Jul 6
2022
 Cousins et al., Cell Reports Methods, doi:10.1016/j.crmeth.2023.100503 (date from preprint) Integrative analysis of functional genomic screening and clinical data identifies a protective role for spironolactone in severe COVID-19
50% lower ventilation (p=0.01) and 51% lower ICU admission (p<0.0001). PSM retrospective 64,349 COVID-19 patients in the USA, showing metformin associated with lower ICU admission and mechanical ventilation.
Jul 2
2022
 Shaseb et al., Advanced Pharmaceutical Bulletin, doi:10.34172/apb.2023.066 Long and Short-term Metformin Consumption as a Potential Therapy to Prevent Complications of COVID-19
74% lower mortality (p=0.06), 79% lower ventilation (p=0.05), 63% lower ICU admission (p=0.07), and 5% shorter hospitalization (p=0.52). RCT 189 hospitalized patients showing lower mortality, ICU admission, and intubation with metformin, statistically significant only for intubation. Treatment patients may have also taken metformin prior to admission. Authors note that pat..
Jun 30
2022
 Nguyen et al., Metabolism, doi:10.1016/j.metabol.2022.155196 Preadmission use of antidiabetic medications and mortality among patients with COVID-19 having type 2 diabetes: A meta-analysis
46% lower mortality (p<0.0001). Meta analysis of 61 studies showing lower mortality with preadmission metformin (42 studies), GLP-1RA, and SGLT-2i use in COVID-19 patients with diabetes. DPP-4i and insulin use were associated with increased mortality, while sulfonylurea..
Jun 29
2022
 Hunt et al., Journal of General Internal Medicine, doi:10.1007/s11606-022-07701-3 Medications Associated with Lower Mortality in a SARS-CoV-2 Positive Cohort of 26,508 Veterans
67% lower mortality (p<0.0001). Retrospective 26,508 consecutive COVID+ veterans in the USA, showing lower mortality with multiple treatments including metformin. Treatment was defined as drugs administered ≥50% of the time within 2 weeks post-COVID+, and may be a cont..
Jun 9
2022
 Yeh et al., BMJ Open Diabetes Research & Care, doi:10.1136/bmjdrc-2022-002774 Hospitalization and mortality in patients with COVID-19 with or at risk of type 2 diabetes: data from five health systems in Pennsylvania and Maryland
44% lower progression (p<0.0001) and 37% lower hospitalization (p<0.0001). Retrospective 4,944 COVID-19 patients with type 2 diabetes in the USA, showing lower risk of hospitalization and combined ICU/intubation/death with metformin use.
May 27
2022
 Chen et al., Frontiers in Endocrinology, doi:10.3389/fendo.2022.895458 The Association Between Antidiabetic Agents and Clinical Outcomes of COVID-19 Patients With Diabetes: A Bayesian Network Meta-Analysis
26% lower mortality (p<0.0001). Meta-analysis of 42 studies (25 for metformin) with 7 antidiabetic agents, showing metformin, DPP4i, SGLT2i, and GLP1RA were associated with lower COVID-19 mortality in patients with diabetes compared to non-users, while insulin was assoc..
Apr 1
2022
 Ma et al., Scientific Reports, doi:10.1038/s41598-022-09639-2 Metformin is associated with favorable outcomes in patients with COVID-19 and type 2 diabetes mellitus
74% lower mortality (p=0.03) and 25% lower ventilation (p=0.44). PSM/IPTW retrospective 1,356 hospitalized COVID-19 patients with type 2 diabetes in China, showing lower mortality/hospice with metformin use.
Mar 29
2022
 MacFadden et al., Open Forum Infectious Diseases, doi:10.1093/ofid/ofac156 Screening Large Population Health Databases for Potential COVID-19 Therapeutics: A Pharmacopeia-Wide Association Study (PWAS) of Commonly Prescribed Medications
1% fewer cases (p=0.45). Retrospective 26,121 cases and 2,369,020 controls ≥65yo in Canada, showing no significant difference in cases with chronic use of metformin.
Mar 7
2022
 Wong et al., Frontiers in Endocrinology, doi:10.3389/fendo.2022.810914 Metformin Use in Relation to Clinical Outcomes and Hyperinflammatory Syndrome Among COVID-19 Patients With Type 2 Diabetes: A Propensity Score Analysis of a Territory-Wide Cohort
59% lower mortality (p=0.01), 61% improved recovery (p=0.005), 64% greater improvement (p=0.009), and 56% higher hospital discharge (p=0.009). Retrospective 1,214 COVID+ type 2 diabetes patients in Hong Kong, showing lower mortality and improved recovery with metformin use.
Feb 28
2022
 Han et al., Archives of Medical Research, doi:10.1016/j.arcmed.2021.08.002 Association Between Anti-diabetic Agents and Clinical Outcomes of COVID-19 in Patients with Diabetes: A Systematic Review and Meta-Analysis
27% lower mortality (p=0.001). Meta analysis of 31 studies (23 for metformin) showing metformin was associated with significantly lower mortality and poor composite outcomes in diabetic COVID-19 patients. DPP-4 inhibitors, sulfonylurea/glinides, SGLT-2 inhibitors, and ..
Feb 24
2022
 Wong et al., Diabetes Care, doi:10.2337/dc21-2186 Glycemic Control and Clinical Outcomes in U.S. Patients With COVID-19: Data From the National COVID Cohort Collaborative (N3C) Database
51% lower mortality (p<0.0001), 41% lower ventilation (p<0.0001), and 40% lower hospitalization (p<0.0001). N3C retrospective 39,616 COVID-19 patients with diabetes in the USA, showing lower mortality, ventilation, and hospitalization with metformin use.
Feb 23
2022
 Ganesh et al., British Journal of Clinical Pharmacology, doi:10.1111/bcp.15258 Does metformin affect outcomes in COVID‐19 patients with new or pre‐existing diabetes mellitus? A systematic review and meta‐analysis
22% lower mortality (p<0.0001). Meta analysis of 32 cohort studies with 2,916,231 patients showing significantly lower mortality with metformin treatment in COVID-19 patients with diabetes, with an unadjusted odds ratio of 0.61 (95% CI: 0.53-0.71) and an adjusted odds r..
Jan 18
2022
 Usman et al., Journal of Thrombosis and Thrombolysis, doi:10.1007/s11239-022-02631-7 Metformin use in patients hospitalized with COVID-19: lower inflammation, oxidative stress, and thrombotic risk markers and better clinical outcomes
60% lower mortality (p=0.21), 76% lower ventilation (p=0.05), and 34% shorter hospitalization (p=0.13). Retrospective 75 diabetes patients, 34 on metformin, showing improved clinical outcomes with treatment, without statistical significance.
Jan 17
2022
 Fu et al., International Journal of Endocrinology, doi:10.1155/2022/9322332 Prognostic Factors for COVID-19 Hospitalized Patients with Preexisting Type 2 Diabetes
72% improved recovery (p=0.03). Retrospective 108 T2D patients hospitalized with COVID-19, showing lower risk of unfavorable outcomes with metformin use vs. other diabetic medications.
Jan 10
2022
 Ojeda-Fernández et al., Diabetes, Obesity and Metabolism, doi:10.1111/dom.14648 Metformin use is associated with a decrease in risk of hospitalization and mortality in COVID-19 diabetic patients: a population-based study in Lombardy
16% lower mortality (p<0.0001), 22% lower ICU admission (p=0.01), and 3% lower hospitalization (p=0.11). Retrospective 31,966 COVID+ patients using anti-hyperglycemic drugs in Italy, showing lower mortality and ICU admission with metformin use.
Dec 31
2021
 Wallace et al., BMJ Open, doi:10.1136/bmjopen-2021-050051 Association of the patterns of use of medications with mortality of COVID-19 infection: a hospital-based observational study
72% lower mortality (p<0.0001). Retrospective 9,532 hospitalized COVID+ veterans in the USA, showing lower mortality with metformin use. The study provides results for use before, after, and before+after. Before+after should more accurately represent prophylaxis up to C..
Nov 30
2021
 Al-Salameh et al., Diabetes & Metabolism, doi:10.1016/j.diabet.2021.101297 The association between metformin treatment and COVID-19 outcomes according to metformin continuation during hospitalisation
55% lower combined mortality/ICU admission (p=0.04). Retrospective 140 diabetic patients in France, showing lower mortality for patients where metformin use was continued after hospitalization.
Nov 19
2021
 Parthasarathy et al., bioRxiv, doi:10.1101/2021.11.18.469078 Metformin Suppresses SARS-CoV-2 in Cell Culture
In vitro study showing metformin inhibits SARS-CoV-2 in Caco2 cells. Metformin reduced viral titers by nearly 99%, and by about 90% when cells were treated prior to infection.
Nov 8
2021
 Bliden et al., Circulation, 144:A12228 Metformin Use in Patients Hospitalized With COVID-19: Lower Inflammation, Oxidative Stress, and Thrombotic Risk Markers and Better Clinical Outcomes
60% lower mortality (p=0.21) and 76% lower ventilation (p=0.05). Retrospective 75 diabetes patients, 34 on metformin, showing lower mortality with treatment in unadjusted results with minimal group details.
Nov 8
2021
 Pazoki et al., Journal of Diabetes & Metabolic Disorders, doi:10.1007/s40200-021-00901-4 Association of clinical characteristics, antidiabetic and cardiovascular agents with diabetes mellitus and COVID-19: a 7-month follow-up cohort study
13% higher mortality (p=0.58) and 24% higher severe cases (p=0.58). Retrospective 393 hospitalized diabetic COVID-19 patients showing no significant difference in mortality with metformin and insulin use.
Oct 20
2021
 Luk et al., BMJ Open, doi:10.1136/bmjopen-2021-052310 Glucose-lowering drugs and outcome from COVID-19 among patients with type 2 diabetes mellitus: a population-wide analysis in Hong Kong
49% lower mortality (p=0.04), 49% lower ventilation (p=0.04), and 47% lower ICU admission (p=0.01). Retrospective 1,220 hospitalized COVID-19 patients with type 2 diabetes in Hong Kong showing reduced risk of ICU admission, mechanical ventilation, and death with metformin and DPP-4 inhibitors, but increased risk with insulin and sulphon..
Oct 30
2021
 Ong et al., Journal of the ASEAN Federation of Endocrine Societies, doi:10.15605/jafes.036.02.20 Association Between Metformin Use and Mortality Among Patients with Type 2 Diabetes Mellitus Hospitalized for COVID-19 Infection
47% lower mortality (p=0.02). Retrospective 355 diabetic hospitalized COVID-19 patients in the Philippines, showing lower mortality with metformin use.
Oct 29
2021
 Saygili et al., Irish Journal of Medical Science, doi:10.1007/s11845-021-02823-9 Preadmission usage of metformin and mortality in COVID-19 patients including the post-discharge period
42% lower mortality (p=0.02). Retrospective 586 diabetic hospitalized COVID-19 patients in Turkey, showing lower mortality with existing metformin use.
Oct 6
2021
 Wander et al., Diabetes Care, doi:10.2337/dc21-1351 Prior Glucose-Lowering Medication Use and 30-Day Outcomes Among 64,892 Veterans With Diabetes and COVID-19
15% lower mortality (p<0.0001), 2% lower ICU admission (p=0.62), and 3% lower hospitalization (p=0.09). Retrospective 64,892 veterans with diabetes in the USA, showing lower mortality with existing metformin use.
Sep 29
2021
 Li et al., Endocrinology, Diabetes & Metabolism, doi:10.1002/edm2.301 Inpatient use of metformin and acarbose is associated with reduced mortality of COVID-19 patients with type 2 diabetes mellitus
76% lower mortality (p=0.02). Retrospective 131 hospitalized COVID-19 patients with type 2 diabetes, showing lower mortality with metformin treatment and acarbose treatment.
Sep 16
2021
 Kan et al., Frontiers in Endocrinology, doi:10.3389/fendo.2021.708494 Mortality Risk of Antidiabetic Agents for Type 2 Diabetes With COVID-19: A Systematic Review and Meta-Analysis
31% lower mortality (p=0.001). Meta analysis of 14 studies showing significantly lower COVID-19 mortality with metformin use.
Sep 9
2021
 Ando et al., Scientific Reports, doi:10.1038/s41598-021-96720-x Impact of overlapping risks of type 2 diabetes and obesity on coronavirus disease severity in the United States
39% lower hospitalization (p=0.04). Retrospective 28,093 COVID+ patients in the USA, showing lower risk of hospitalization with metformin use.
Sep 7
2021
 Wang et al., BMJ Open Diabetes Research & Care, doi:10.1136/bmjdrc-2021-002299 Evaluation and management of COVID-19-related severity in people with type 2 diabetes
12% lower ICU admission (p=0.005). Retrospective 16,504 COVID-19 type 2 diabetes patients, showing lower risk of ICU admission with existing metformin use.
Aug 31
2021
 Yang et al., Diabetes Research and Clinical Practice, doi:10.1016/j.diabres.2021.108977 The effect of metformin on mortality and severity in COVID-19 patients with diabetes mellitus
36% lower mortality (p<0.0001). Meta analysis of 17 studies including 20,719 COVID-19 patients with diabetes, showing lower risk of mortality and severity with metformin.
Aug 31
2021
 Reis et al., The Lancet Regional Health - Americas, doi:10.1016/j.lana.2021.100142 (date from preprint) RETRACTED: Effect of early treatment with metformin on risk of emergency care and hospitalization among patients with COVID-19: The TOGETHER randomized platform clinical trial
27% lower mortality (p=0.53), 6% lower hospitalization (p=0.88), 14% more combined hospitalization/ER visits (p=0.58), and 31% lower progression (p=0.48). This study was retracted due to incorrect data and compromised integrity [sciencedirect.com]. Data for the primary outcome in this trial appears to be impossible [doyourownresearch.substack.com]. For example, considering the..
Aug 20
2021
 Cheng et al., Cell Metabolism, doi:10.1016/j.cmet.2020.08.013 Metformin Is Associated with Higher Incidence of Acidosis, but Not Mortality, in Individuals with COVID-19 and Pre-existing Type 2 Diabetes
65% higher mortality (p=0.25). Retrospective 1,213 hospitalized diabetic COVID-19 patients in China, showing no significant difference in mortality with pre-existing metformin use.
Aug 19
2021
 Li et al., Frontiers in Medicine, doi:10.3389/fmed.2021.704666 Metformin in Patients With COVID-19: A Systematic Review and Meta-Analysis
34% lower mortality (p<0.0001). Meta analysis of 19 studies showing metformin use associated with lower COVID-19 mortality and hospitalization.
Aug 9
2021
 Poly et al., Journal of Clinical Medicine, doi:10.3390/jcm10163507 Metformin Use Is Associated with Decreased Mortality in COVID-19 Patients with Diabetes: Evidence from Retrospective Studies and Biological Mechanism
34% lower mortality (p<0.0001). Meta analysis of 16 studies of diabetic patients showing significantly lower COVID-19 mortality with metformin use.
Jul 31
2021
 Do et al., Diabetes & Metabolism, doi:10.1016/j.diabet.2020.10.006 Is there an association between metformin use and clinical outcomes in diabetes patients with COVID-19?
8% higher mortality (p=0.81) and 35% higher ventilation (p=0.16). Retrospective 1,865 diabetes patients with COVID-19 in South Korea showing no significant differences in survival with metformin use.
Jul 18
2021
 Boye et al., Diabetes Therapy, doi:10.1007/s13300-021-01110-1 Risk Factors Associated with COVID-19 Hospitalization and Mortality: A Large Claims-Based Analysis Among People with Type 2 Diabetes Mellitus in the United States
10% lower hospitalization (p<0.0001). Retrospective 9531 COVID+ diabetes patients in the USA, showing lower risk of hospitalization with existing biguanides treatment (defined as mainly metformin in the abstract and entirely metformin in the text).
Jul 17
2021
 Blanc et al., GeroScience, doi:10.1007/s11357-021-00397-z Therapeutic prevention of COVID-19 in elderly: a case–control study
79% lower mortality (p=0.06) and 44% more cases (p=0.12). Retrospective 179 patients in France exposed to COVID-19 showing, without statistical significance, a higher risk of cases, and a lower risk of mortality among cases with existing metformin treatment.
Jul 13
2021
 Tamura et al., Diabetology & Metabolic Syndrome, doi:10.1186/s13098-021-00695-8 Outcome and death risk of diabetes patients with Covid-19 receiving pre-hospital and in-hospital metformin therapies
97% lower mortality (p=0.02). Retrospective 188 hospitalized patients in Brazil, showing lower risk of mortality with metformin use. Authors note that, although pre-hospital metformin use improved clinical parameters at admission, continuous use during hospitalization..
May 24
2021
 Oscanoa et al., Clinical Diabetology, doi:10.5603/DK.a2021.0035 Metformin therapy and severity and mortality of SARS-CoV-2 infection: a meta-analysis
44% lower mortality (p<0.0001) and 15% lower severe cases (p=0.08). Meta analysis of 32 studies showing significantly lower COVID-19 mortality with metformin use.
May 5
2021
 Ravindra et al., medRxiv, doi:10.1101/2021.04.20.21255792 Retrospective Assessment of Treatments of Hospitalized Covid-19 Patients
30% lower mortality (p=0.42). Retrospective 1,035 hospitalized patients in India. Of 366 diabetic patients, there was lower mortality for the 53 that were on metformin.
May 1
2021
 Sun et al., Journal of the Endocrine Society, doi:10.1210/jendso/bvab048.709 Is Metformin Use Associated With a Decreased Mortality for COVID-19 Diabetic Patients? A Meta-Analysis
47% lower mortality (p=0.005). Meta analysis of 8 studies with 11,169 participants showing lower mortality with metformin use.
Apr 14
2021
 Gálvez-Barrón et al., Gerontology, doi:10.1159/000515159 COVID-19: Clinical Presentation and Prognostic Factors of Severe Disease and Mortality in the Oldest-Old Population: A Cohort Study
16% higher mortality (p=0.46) and 16% higher severe cases (p=0.46). Analysis of 103 elderly hospitalized COVID-19 patients in Spain, showing higher mortality with metformin, without statistical significance.
Apr 6
2021
 Alamgir et al., medRxiv, doi:10.1101/2021.03.22.21254110 Drug repositioning candidates identified using in-silico quasi-quantum molecular simulation demonstrate reduced COVID-19 mortality in 1.5M patient records
27% lower mortality (p<0.0001). In silico study followed by PSM analysis of the National COVID Cohort Collaborative data in the USA, showing 27% lower mortality with metformin use.
Mar 31
2021
 Ghany et al., Diabetes & Metabolic Syndrome: Clinical Research & Reviews, doi:10.1016/j.dsx.2021.02.022 Metformin is associated with lower hospitalizations, mortality and severe coronavirus infection among elderly medicare minority patients in 8 states in USA
66% lower mortality (p=0.0002), 29% lower hospitalization (p=0.008), and 68% lower ARDS (p<0.0001). Retrospective 1,139 elderly COVID+ patients in the USA, 392 with pre-existing metformin use, showing significantly lower mortality, hospitalization, and ARDS with treatment.
Mar 31
2021
 Jiang et al., Diabetes Research and Clinical Practice, doi:10.1016/j.diabres.2020.108619 Association of metformin with mortality or ARDS in patients with COVID-19 and type 2 diabetes: A retrospective cohort study
46% lower mortality (p=0.4) and 80% lower progression (p=0.02). Retrospective 328 COVID-19 patients with type 2 diabetes in China, showing significantly lower risk of ARDS with existing metformin use.
Mar 30
2021
 Khunti et al., The Lancet Diabetes & Endocrinology, doi:10.1016/S2213-8587(21)00050-4 Prescription of glucose-lowering therapies and risk of COVID-19 mortality in people with type 2 diabetes: a nationwide observational study in England
23% lower mortality (p<0.0001). Retrospective 2,851,465 people with type 2 diabetes in the UK, showing lower mortality with existing metformin use. Results are subject to confounding by indication because metformin is typically used early in the progression of type 2 di..
Mar 30
2021
 Holt et al., Thorax, doi:10.1136/thoraxjnl-2021-217487 Risk factors for developing COVID-19: a population-based longitudinal study (COVIDENCE UK)
27% more cases (p=0.42). Prospective survey-based study with 15,227 people in the UK, showing lower risk of COVID-19 cases with vitamin A, vitamin D, zinc, selenium, probiotics, and inhaled corticosteroids; and higher risk with metformin and vitamin C. Statistica..
Mar 23
2021
 Bramante et al., Journal of Medical Virology, doi:10.1002/jmv.26873 Outpatient metformin use is associated with reduced severity of COVID‐19 disease in adults with overweight or obesity
62% lower mortality (p=0.03), 9% higher ICU admission (p=0.78), and 22% lower hospitalization (p=0.1). Retrospective 17,396 PCR+ patients in the USA, showing lower mortality with metformin use.
Feb 17
2021
 Wargny et al., Diabetologia, doi:10.1007/s00125-020-05351-w Predictors of hospital discharge and mortality in patients with diabetes and COVID-19: updated results from the nationwide CORONADO study
28% lower mortality (p=0.03) and 15% higher hospital discharge (p=0.02). Retrospective 2,796 hospitalized diabetes patients with COVID-19 in France, showing lower mortality with metformin use.
Feb 13
2021
 Oh et al., Acta Diabetologica, doi:10.1007/s00592-020-01666-7 Metformin use and risk of COVID-19 among patients with type II diabetes mellitus: an NHIS-COVID-19 database cohort study
26% higher mortality (p=0.3) and 28% fewer cases (p<0.0001). Retrospective 27,493 type II diabetes patients in the USA, 7,204 on metformin, showing significantly lower COVID-19 cases, but no significant difference in mortality.
Jan 31
2021
 Lally et al., Journal of the American Medical Directors Association, doi:10.1016/j.jamda.2020.10.031 Metformin is Associated with Decreased 30-Day Mortality Among Nursing Home Residents Infected with SARS-CoV2
52% lower mortality (p=0.009). Retrospective 775 nursing home residents in the USA, showing lower mortality with existing metformin use.
Jan 13
2021
 Crouse et al., Frontiers in Endocrinology, doi:10.3389/fendo.2020.600439 Metformin Use Is Associated With Reduced Mortality in a Diverse Population With COVID-19 and Diabetes
61% lower mortality (p=0.02). Retrospective 219 COVID-19+ diabetes patients in the USA, showing lower mortality with existing metformin treatment.
Dec 28
2020
 Ramos-Rincón et al., Research Square, doi:10.21203/rs.3.rs-133358/v1 Association between prior cardiometabolic therapy and in-hospital mortality in very old patients with type 2 diabetes mellitus hospitalized due to COVID-19. A nationwide observational study in Spain
1% lower mortality (p=0.78). Retrospective 790 hospitalized type 2 diabetes patients ≥80 years old in Spain, showing no significant difference in mortality with existing metformin use.
Dec 19
2020
 Huh et al., International Journal of Infectious Diseases, doi:10.1016/j.ijid.2020.12.041 Association of prescribed medications with the risk of COVID-19 infection and severity among adults in South Korea
1% higher progression (p=0.11) and 4% fewer cases (p=0.82). Retrospective database analysis showing no significant differences with pre-existing metformin use.
Dec 10
2020
 Lalau et al., Diabetes & Metabolism, doi:10.1016/j.diabet.2020.101216 Metformin use is associated with a reduced risk of mortality in patients with diabetes hospitalised for COVID-19
22% lower mortality (p=0.16), 18% lower combined mortality/intubation (p=0.21), and 7% lower ventilation (p=0.72). Retrospective 2,449 hospitalized COVID-19 diabetes patients in France, 1,496 with existing metformin use, showing lower mortality with treatment. Statistical significance was reached in model 1 but not in models 2-4 which also adjust for ..
Dec 4
2020
 Sourij et al., Diabetes, Obesity and Metabolism, doi:10.1111/dom.14256 COVID‐19 fatality prediction in people with diabetes and prediabetes using a simple score upon hospital admission
37% lower mortality (p=0.13). Retrospective 247 hospitalized COVID-19 diabetes patients, showing lower mortality with metformin use in unadjusted results.
Dec 3
2020
 Bramante et al., The Lancet Healthy Longevity, doi:10.1016/S2666-7568(20)30033-7 Metformin and risk of mortality in patients hospitalised with COVID-19: a retrospective cohort analysis
12% lower mortality (p=0.65). Retrospective 6,256 COVID-19+ diabetes patients in the USA, showing lower mortality with existing metformin treatment, statistically significant only for women.
Nov 30
2020
 Scheen, A., Diabetes & Metabolism, doi:10.1016/j.diabet.2020.07.006 Metformin and COVID-19: From cellular mechanisms to reduced mortality
25% lower mortality (p<0.0001). Meta analysis of 4 observational studies with a total of 10,508 patients showing 25% lower mortality with metformin treatment in type 2 diabetes patients hospitalized for COVID-19.
Nov 17
2020
 Kolin et al., PLOS ONE, doi:10.1371/journal.pone.0241264 Clinical, regional, and genetic characteristics of Covid-19 patients from UK Biobank
30% more cases (p=0.08). 397,064 patient UK Biobank retrospective showing higher risk of COVID-19 with metformin use, without statistical significance. Metformin is typically prescribed for diabetes, diabetes patients have significantly higher COVID-19 risk, and ..
Nov 16
2020
 Pérez-Belmonte et al., BMC Medicine, doi:10.1186/s12916-020-01832-2 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
10% higher mortality (p=0.48). Retrospective 2,666 type 2 diabetes COVID-19 patients in Spain, showing higher mortality with existing metformin use (not statistically significant).
Nov 11
2020
 Lukito et al., Diabetes & Metabolic Syndrome: Clinical Research & Reviews, doi:10.1016/j.dsx.2020.11.006 The Effect of Metformin Consumption on Mortality in Hospitalized COVID-19 patients: a systematic review and meta-analysis
36% lower mortality (p=0.03). Meta analysis of 9 studies showing lower mortality with metformin use.
Oct 19
2020
 Gao et al., Clinical and Translational Science, doi:10.1111/cts.12897 Risk of Metformin in Patients With Type 2 Diabetes With COVID-19: A Preliminary Retrospective Report
225% higher progression (p=0.05). Retrospective 110 hospitalized COVID-19 patients with diabetes in China, showing increased risk of severity with metformin.
Oct 13
2020
 Goodall et al., Epidemiology and Infection, doi:10.1017/S0950268820002472 Risk factors for severe disease in patients admitted with COVID-19 to a hospital in London, England: a retrospective cohort study
3% lower mortality (p=0.81). Retrospective 981 hospitalized patients in the UK, showing no significant difference with metformin use.
Oct 6
2020
 Mirani et al., Diabetes Care, doi:10.2337/dc20-1340 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
45% lower mortality (p=0.1). Retrospective 90 hospitalized COVID-19 patients with diabetes in Italy, showing lower mortality with metformin use, without statistical significance.
Oct 1
2020
 Li et al., Endocrine Practice, doi:10.4158/EP-2020-0466 Metformin Use in Diabetes Prior to Hospitalization: Effects on Mortality in Covid-19
78% lower mortality (p=0.02). Retrospective 131 type II diabetes patients with COVID pneumonia, showing lower mortality with existing metformin use. Acarbose (commonly used in China as an initial therapy for diabetes) did not have a similar association with mortality,..
Sep 30
2020
 Kow et al., Journal of Medical Virology, doi:10.1002/jmv.26498 Mortality risk with preadmission metformin use in patients with COVID-19 and diabetes: A meta-analysis
Meta analysis of 5 studies showing lower mortality with metformin use.
Aug 23
2020
 Abu-Jamous et al., medRxiv, doi:10.1101/2020.08.20.20174169 Associations of comorbidities and medications with COVID-19 outcome: A retrospective analysis of real-world evidence data
65% lower mortality (p=0.04). Retrospective diabetes patients in the UK, showing lower mortality for metformin treatment (administered within 21 days after a positive PCR test).
Aug 18
2020
 Hariyanto et al., Obesity Medicine, doi:10.1016/j.obmed.2020.100290 Metformin use is associated with reduced mortality rate from coronavirus disease 2019 (COVID-19) infection
Meta analysis of 5 studies showing lower mortality with metformin use.
Aug 12
2020
 Kim et al., Diabetes & Metabolism Journal, doi:10.4093/dmj.2020.0146 The Clinical Characteristics and Outcomes of Patients with Moderate-to-Severe Coronavirus Disease 2019 Infection and Diabetes in Daegu, South Korea
64% lower mortality (p=0.1) and 52% lower progression (p=0.13). Retrospective 235 hospitalized diabetes patients in South Korea, showing lower mortality and lower progression to severe disease with metformin.
Jul 31
2020
 Chen et al., Diabetes Care, doi:10.2337/dc20-0660 Clinical Characteristics and Outcomes of Patients With Diabetes and COVID-19 in Association With Glucose-Lowering Medication
33% lower mortality (p=0.46). Retrospective 120 COVID-19 diabetes patients, showing non-statistically significantly lower mortality with existing metformin treatment.
Jul 14
2020
 Wang et al., Journal of Hematology & Oncology, doi:10.1186/s13045-020-00934-x A tertiary center experience of multiple myeloma patients with COVID-19: lessons learned and the path forward
58% lower mortality (p=0.43). Retrospective 58 multiple myeloma COVID-19 patients in the USA, showing non-statistically significant lower mortality with metformin treatment.
Jun 23
2020
 Choi et al., Journal of Clinical Medicine, doi:10.3390/jcm9061959 Clinical Characteristics and Disease Progression in Early-Stage COVID-19 Patients in South Korea
120% higher progression (p=0.26). Retrospective 293 patients in South Korea, showing higher risk of progression with metformin use, without statistical significance.
May 29
2020
 Cariou et al., Diabetologia, doi:10.1007/s00125-020-05180-x Phenotypic characteristics and prognosis of inpatients with COVID-19 and diabetes: the CORONADO study
20% lower mortality (p=0.46). Analysis of 1,317 hospitalized COVID-19 patients with diabetes showing lower mortality with metformin use, without statistical significance.
May 21
2020
 Luo et al., The American Journal of Tropical Medicine and Hygiene, doi:10.4269/ajtmh.20-0375 Metformin Treatment Was Associated with Decreased Mortality in COVID-19 Patients with Diabetes in a Retrospective Analysis
75% lower mortality (p=0.02). Retrospective 283 COVID-19+ diabetes patients in China, showing lower mortality with existing metformin treatment.