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0 0.5 1 1.5 2+ Mortality 37% Improvement Relative Risk Metformin for COVID-19  Parveen et al.  META ANALYSIS Favors metformin Favors control

Association of Metformin with Mortality in COVID-19 Patients: A Systematic Review and Meta-Analysis

Parveen et al., Annals of the National Academy of Medical Sciences (India), doi:10.1055/s-0042-1760353
Jan 2023  
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Metformin for COVID-19
3rd treatment shown to reduce risk in July 2020
*, now known with p < 0.00000000001 from 88 studies.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
4,100+ studies for 60+ treatments.
Systematic review and meta analysis showing significantly lower mortality with metformin.
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%].
risk of death, 37.0% lower, RR 0.63, p < 0.001.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Parveen et al., 31 Jan 2023, peer-reviewed, 5 authors. Contact:
This PaperMetforminAll
Association of Metformin with Mortality in COVID-19 Patients: A Systematic Review and Meta-Analysis
Rizwana Parveen, Pinki Mishra, Reva Luthra, Ram Bajpai, PhD Nidhi Agarwal
Annals of the National Academy of Medical Sciences (India), doi:10.1055/s-0042-1760353
Studies have demonstrated high prevalence of mortality in coronavirus disease (COVID-19) patients with type 2 diabetes mellitus; however, the effects of antidiabetic pharmacotherapy on COVID-19 complications need further exploration. The aim of the study was to explore the association of metformin use and mortality in COVID-19 patients. A literature search was conducted using the databases Medline (via PubMed) and Cochrane Central Register of Controlled Trials until February 09, 2021. Nine studies were included in the meta-analysis, including 12,684 COVID-19 patients. The metaanalysis suggested 37% lower risk of mortality in patients receiving metformin (risk ratio: 0.63; 95% confidence interval: 0.50-0.78; p < 0.001). However, no significant difference in hospitalization days between the two groups (p ¼ 0.197) was observed. The analysis revealed significantly lower risk of having obesity (p < 0.001), hypertension (p < 0.001), heart failure (p < 0.001), and cerebrovascular disease (p ¼ 0.015) in the group receiving metformin. The analysis also demonstrated significantly lower risk of using anticoagulants (p ¼ 0.015), diuretics (p < 0.001), and antiplatelets (p ¼ 0.010) in patients receiving metformin. Our findings suggest that metformin use decreases mortality in COVID-19 patients. However, randomized studies demonstrating the consequences of metformin use are needed to understand the magnitude of the beneficial effects of metformin.
Conflict of Interest None declared.
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