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Unveiling the potential pleiotropic effects of metformin in treating COVID-19: a comprehensive review

Petakh et al., Frontiers in Molecular Biosciences, doi:10.3389/fmolb.2023.1260633
Oct 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 87 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.
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 has demonstrated inhibitory effects on SARS-CoV-2 growth in cell culture models and promising results in reducing viral load and achieving undetectable viral levels in clinical trials. Additionally, metformin exhibits anti-inflammatory properties by reducing pro-inflammatory cytokines and modulating immune cell function, which may help prevent cytokine storm. The drug's ability to regulate Th17/Treg balance suggests its potential in mitigating inflammation and restoring T cell functionality. Furthermore, metformin's modulation of the gut microbiota and production of short-chain fatty acids may contribute to its therapeutic effects.
Reviews covering metformin for COVID-19 include De Jesús-González, Halma, Petakh, Tseng, Zhang.
Petakh et al., 10 Oct 2023, placebo-controlled, multiple countries, peer-reviewed, 3 authors. Contact:,
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Unveiling the potential pleiotropic effects of metformin in treating COVID-19: a comprehensive review
Pavlo Petakh, Iryna Kamyshna, Aleksandr Kamyshnyi
Frontiers in Molecular Biosciences, doi:10.3389/fmolb.2023.1260633
This review article explores the potential of metformin, a medication commonly used for type 2 diabetes, as an antiviral and anti-inflammatory agent in the context of coronavirus disease 2019 . Metformin has demonstrated inhibitory effects on the growth of SARS-CoV-2 in cell culture models and has shown promising results in reducing viral load and achieving undetectable viral levels in clinical trials. Additionally, metformin exhibits anti-inflammatory properties by reducing the production of pro-inflammatory cytokines and modulating immune cell function, which may help prevent cytokine storms associated with severe COVID-19. The drug's ability to regulate the balance between pro-inflammatory Th17 cells and anti-inflammatory Treg cells suggests its potential in mitigating inflammation and restoring T cell functionality. Furthermore, metformin's modulation of the gut microbiota, particularly changes in bacterial taxa and the production of short-chain fatty acids, may contribute to its therapeutic effects. The interplay between metformin, bile acids, the gut microbiome, glucagon-like peptide-1 secretion, and glycemic control has implications for the management of diabetes and potential interventions in COVID-19. By refreshing the current evidence, this review highlights the potential of metformin as a therapeutic option in the management of COVID-19, while also exploring its effects on the gut microbiome and immunometabolism.
Author contributions PP: Visualization, Writing-original draft. IK: Writing-review and editing. AK: Conceptualization, Formal Analysis, Writing-review and editing. Conflict of interest The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Publisher's note All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.
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