Conv. Plasma
Nigella Sativa
Nitric Oxide
Peg.. Lambda

Home   COVID-19 treatment studies for Metformin  COVID-19 treatment studies for Metformin  C19 studies: Metformin  Metformin   Select treatmentSelect treatmentTreatmentsTreatments
Alkalinization Meta Lactoferrin Meta
Melatonin Meta
Bromhexine Meta Metformin Meta
Budesonide Meta Molnupiravir Meta
Cannabidiol Meta
Colchicine Meta Nigella Sativa Meta
Conv. Plasma Meta Nitazoxanide Meta
Curcumin Meta Nitric Oxide Meta
Ensovibep Meta Paxlovid Meta
Famotidine Meta Peg.. Lambda Meta
Favipiravir Meta Povidone-Iod.. Meta
Fluvoxamine Meta Quercetin Meta
Hydroxychlor.. Meta Remdesivir Meta
Iota-carragee.. Meta
Ivermectin Meta Zinc Meta

Other Treatments Global Adoption
All Studies   Meta Analysis   Recent:  
0 0.5 1 1.5 2+ Mortality 60% Improvement Relative Risk Ventilation 76% Hospitalization time 34% Usman et al. Metformin for COVID-19 Prophylaxis Is prophylaxis with metformin beneficial for COVID-19? Retrospective 75 patients in the USA Lower mortality (p=0.21) and ventilation (p=0.054), not stat. sig. Usman et al., J. Thrombosis and Thrombolysis, doi:10.1007/s11239-022-02631-7 Favors metformin Favors control

Metformin use in patients hospitalized with COVID-19: lower inflammation, oxidative stress, and thrombotic risk markers and better clinical outcomes

Usman et al., Journal of Thrombosis and Thrombolysis, doi:10.1007/s11239-022-02631-7
Usman et al., Metformin use in patients hospitalized with COVID-19: lower inflammation, oxidative stress, and thrombotic.., Journal of Thrombosis and Thrombolysis, doi:10.1007/s11239-022-02631-7
Jan 2022   Source   PDF  
  All Studies   Meta
Retrospective 75 diabetes patients, 34 on metformin, showing improved clinical outcomes with treatment, without statistical significance.
risk of death, 59.8% lower, RR 0.40, p = 0.21, treatment 3 of 34 (8.8%), control 9 of 41 (22.0%), NNT 7.6.
risk of mechanical ventilation, 75.9% lower, RR 0.24, p = 0.05, treatment 2 of 34 (5.9%), control 10 of 41 (24.4%), NNT 5.4.
hospitalization time, 33.7% lower, relative time 0.66, p = 0.13, treatment 34, control 41.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Usman et al., 18 Jan 2022, retrospective, USA, peer-reviewed, 10 authors.
All Studies   Meta Analysis   Submit Updates or Corrections
This PaperMetforminAll
Metformin use in patients hospitalized with COVID-19: lower inflammation, oxidative stress, and thrombotic risk markers and better clinical outcomes
Abira Usman, Kevin P Bliden, Alastair Cho, Naval Walia, Christophe Jerjian, Arvind Singh, Parshotam Kundan, Sanchit Duhan, Udaya S Tantry, Paul A Gurbel
Journal of Thrombosis and Thrombolysis, doi:10.1007/s11239-022-02631-7
Diabetes mellitus (DM) is associated with a greater risk of COVID-19 and an increased mortality when the disease is contracted. Metformin use in patients with DM is associated with less COVID-19-related mortality, but the underlying mechanism behind this association remains unclear. Our aim was to explore the effects of metformin on markers of inflammation, oxidative stress, and hypercoagulability, and on clinical outcomes. Patients with DM on metformin (n = 34) and metformin naïve (n = 41), and patients without DM (n = 73) were enrolled within 48 h of hospital admission for COVID-19. Patients on metformin compared to naïve patients had a lower white blood cell count (p = 0.02), d-dimer (p = 0.04), urinary 11-dehydro thromboxane B 2 (p = 0.01) and urinary liver-type fatty acid binding protein (p = 0.03) levels and had lower sequential organ failure assessment score (p = 0.002), and intubation rate (p = 0.03), fewer hospitalized days (p = 0.13), lower in-hospital mortality (p = 0.12) and lower mortality plus nonfatal thrombotic event occurrences (p = 0.10). Patients on metformin had similar clinical outcomes compared to patients without DM. In a multiple regression analysis, metformin use was associated with less days in hospital and lower intubation rate. In conclusion, metformin treatment in COVID-19 patients with DM was associated with lower markers of inflammation, renal ischemia, and thrombosis, and fewer hospitalized days and intubation requirement. Further focused studies are required to support these findings. Keywords COVID-19 • Diabetes • Metformin • Thromboelastography • Biomarker • Death • Intubation Highlights • Fasting blood glucose level in patients with has been shown to be associated with severity of the disease and poor outcomes, including mortality. • Metformin use in patients with DM is associated with less COVID-19-related mortality, but the underlying mechanism behind this association remains unclear. • In this single center study, metformin treatment in COVID-19 patients with DM was associated with lower markers of inflammation, renal ischemia, and thrombosis, and fewer hospitalized days and intubation requirement. • In a multiple regression analysis, metformin use was associated with less days in hospital and lower intubation rate.
Declarations Conflict of interest Dr. Gurbel reports grants and personal fees from Bayer HealthCare LLC, Otitopic Inc, Amgen, Janssen, and US World-Meds LLC; grants from Instrumentation Laboratory, Haemonetics, Medicure Inc, Idorsia Pharmaceuticals, and Hikari Dx; personal fees from UpToDate; Dr Gurbel is a relator and expert witness in litigation involving clopidogrel; in addition, Dr. Gurbel has two patents, Detection of restenosis risk in patients issued and Assessment of cardiac health and thrombotic risk in a patient. Dr. Tantry reports receiving honoraria from UptoDate and Aggredyne. Other authors report no disclosures. Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Alberti, Zimmet, Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation, Diabet Med
Apicella, Campopiano, Mantuano, Mazoni, Coppelli et al., COVID-19 in people with diabetes: understanding the reasons for worse outcomes, Lancet Diabetes Endocrinol
Bai, Chen, Metformin: a novel weapon against inflammation, Front Pharmacol
Bigagli, Lodovici, Circulating oxidative stress biomarkers in clinical studies on type 2 diabetes and its complications, Oxid Med Cell Longev
Chen, Liu, Ye, Effects of metformin on blood and urine pro-inflammatory mediators in patients with type 2 diabetes, J Inflamm (Lond)
Chen, Yang, Cheng, Clinical characteristics and outcomes of patients with diabetes and COVID-19 in association with glucose-lowering medication, Diabetes Care
Crouse, Grimes, Li, Metformin use is associated with reduced mortality in a diverse population with COVID-19 and diabetes, Front Endocrinol
Eikelboom, Hankey, Thom, Clopidogrel for High Atherothrombotic Risk and Ischemic Stabilization, Management and Avoidance (CHARISMA) Investigators. Incomplete inhibition of thromboxane biosynthesis by acetylsalicylic acid: determinants and effect on cardiovascular risk, Circulation
Eikelboom, Hirsh, Weitz, Aspirin-resistant thromboxane biosynthesis and the risk of myocardial infarction, stroke, or cardiovascular death in patients at high risk for cardiovascular events, Circulation
Endo, Miyashita, Sasaki, Probucol and atorvastatin decrease urinary 8-hydroxy-2'-deoxyguanosine in patients with diabetes and hypercholesterolemia, J Atheroscler Thromb
Ghany, Palacio, Dawkins, Metformin is associated with lower hospitalizations, mortality and severe coronavirus infection among elderly medicare minority patients in 8 states in USA, Diabetes Metab Syndr
Graille, Wild, Sauvain, Urinary 8-OHdG as a biomarker for oxidative stress: a systematic literature review and meta-analysis, Int J Mol Sci
Gurbel, Bliden, Tantry, Defining platelet response to acetylsalicylic acid: the relation between inhibition of serum thromboxane B2 and agonist-induced platelet aggregation, J Thromb Thrombolysis, doi:10.1007/s11239-020-02334-x
Gurbel, Bliden, Tantry, First report of the point-of-care TEG: a technical validation study of the TEG-6S system, Platelets
Han, Ma, Sun, The association between antidiabetic agents and clinical outcomes of COVID-19 in patients with diabetes: a systematic review and meta-analysis, Arch Med Res
Holman, Knighton, Kar, Risk factors for COVID-19-related mortality in people with type 1 and type 2 diabetes in England: a population-based cohort study, Lancet Diabetes Endocrinol
Kajiwara, Kusaka, Kimura, Metformin mediates protection against legionella pneumonia through activation of AMPK and mitochondrial reactive oxygen species, J Immunol
Kaneto, Kimura, Obata, Multifaceted mechanisms of action of metformin which have been unraveled one after another in the long history, Int J Mol Sci
Katagiri, Doi, Honda, Negishi, Combination of two urinary biomarkers predicts acute kidney injury after adult cardiac surgery, Ann Thorac Surg
Katagiri, Ishikane, Asai, Evaluation of coronavirus disease 2019 severity using urine biomarkers, Crit Care Explor
Kelly, Tannahill, Murphy, Neill, Metformin inhibits the production of reactive oxygen species from NADH: ubiquinone oxidoreductase to limit induction of Interleukin-1b (IL-1b) and boosts Interleukin-10 (IL-10) in Lipopolysaccharide (LPS)-activated macrophages, J Biol Chem
Khunti, Knighton, Zaccardi, Prescription of glucose-lowering therapies and risk of COVID-19 mortality in people with type 2 diabetes: a nationwide observational study in England, Lancet Diabetes Endocrinol
Kumar, Arora, Sharma, Anikhindi, Bansal et al., Is diabetes mellitus associated with mortality and severity of COVID-19? A meta-analysis, Diabetes Metab Syndr
Lalau, Al-Salameh, Hadjadj, Metformin use is associated with a reduced risk of mortality in patients with diabetes hospitalised for COVID-19, Diabetes Metab
Lazarus, Audrey, Wangsaputra, High admission blood glucose independently predicts poor prognosis in COVID-19 patients: a systematic review and dose-response metaanalysis, Diabetes Res Clin Pract
Lukito, Pranata, Henrina, The effect of metformin consumption on mortality in hospitalized COVID-19 patients: a systematic review and meta-analysis, Diabetes Metab Syndr
Luo, Qiu, Liu, Metformin treatment was associated with decreased mortality in COVID-19 patients with diabetes in a retrospective analysis, Am J Trop Med Hyg
Minno, Turnu, Porro, 8-Hydroxy-2-deoxyguanosine levels and cardiovascular disease: a systematic review and meta-analysis of the literature, Antioxid Redox Signal
Negishi, Noiri, Doi, Monitoring of urinary L-type fatty acid-binding protein predicts histological severity of acute kidney injury, Am J Pathol
Petrilli, Jones, Yang, Factors associated with hospitalization and critical illness among 4,103 patients with COVID-19 disease in New York City, BMJ
Rocca, Buck, Petrucci, Thromboxane metabolite excretion is associated with serious vascular events in diabetes mellitus: a sub-study of the ASCEND trial, Eur Heart J
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
Saha, Al-Rifai, Saha, Diabetes prevalence and mortality in COVID-19 patients: a systematic review, meta-analysis, and meta-regression, J Diabetes Metab Disord
Samuel, Varghese, Büsselberg, Therapeutic potential of metformin in COVID-19: reasoning for its protective role, Trends Microbiol
Scheen, Metformin and COVID-19: from cellular mechanisms to reduced mortality, Diabetes Metab
Tantry, Mahla, Gurbel, Aspirin resistance, Prog Cardiovasc Dis
Torigoe, Muta, Tsuji, Urinary liver-type fatty acid-binding protein predicts residual renal function decline in patients on peritoneal dialysis, Med Sci Monit
Tousoulis, Papageorgiou, Androulakis, Diabetes mellitus-associated vascular impairment: novel circulating biomarkers and therapeutic approaches, J Am Coll Cardiol
Valavanidis, Vlachogianni, Fiotakis, 8-Hydroxy2'-deoxyguanosine (8-OHdG): a critical biomarker of oxidative stress and carcinogenesis, J Environ Sci Health C
Viswanathan, Puvvula, Jamthikar, Bidirectional link between diabetes mellitus and coronavirus disease 2019 leading to cardiovascular disease: a narrative review, World J Diabetes
White-Dzuro, Gibson, Zazzeron, Multisystem effects of COVID-19: a concise review for practitioners, Postgrad Med
Yang, Lin, Ji, Guo, Binding of SARS coronavirus to its receptor damages islets and causes acute diabetes, Acta Diabetol
Zhu, She, Cheng, Association of blood glucose control and outcomes in patients with COVID-19 and preexisting type 2 diabetes, Cell Metab
Please send us corrections, updates, or comments. Vaccines and treatments are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment, vaccine, 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