A recently conducted clinical trial in the US states that an antidiabetic medication named metformin could help to prevent COVID and further reduce significant disruptions in people’s lives.
According to the lead author, Ms. Carolyn Bramante, MD, assistant professor of internal medicine and pediatrics at the University of Minnesota, clinical trials called COVID-OUT were conducted across the United States between January 2021 and February 2022.
These studies apparently tested three oral medications: the antidepressant fluvoxamine, the antiparasitic ivermectin, and the diabetes medicine metformin.
The randomized treatments were concealed from the participants in the study, the researchers, the healthcare professionals, and other study participants. There was no face-to-face interaction with participants during the decentralized trial.
Patients with obesity or overweight, documented Coronavirus-19 infection, less than seven days of symptoms, no known prior infection, and enrollment within three days of a positive test was included in the study. Patients between the ages of 30 and 85 were included.
Participants were asked if they had received a long Coronavirus diagnosis from a doctor during the study’s 300-day period of monthly follow-up. After participants gave their consent, the researchers verified this information in medical records.
When started at the beginning of a COVID-19 infection, metformin seems to help prevent long Coronavirus. Metformin in particular reduced long coronavirus by 42% in individuals with mild to moderate COVID-19 infection.
A total of 1,125 of the 1,323 participants in the study, including 564 in the metformin group and 561 in the blinded placebo group, agreed to participate in long-term follow-up for Coronavirus. The average age was 45, and 56% of the population were women, including 7% of pregnant women.
The median time from the onset of symptoms to the start of treatment was 5 days, and 47% of patients started taking their medication in less than 4 days. Before participating in the study, about 55% had completed the initial COVID-19 vaccination series, with 5.1% receiving a first booster.
A medical professional diagnosed 8.4% of participants with long Coronavirus overall. Those who took metformin had a lower rate of long coronavirus development (6.3% vs. 10.6% among those who took the identical-matched placebo).
Metformin decreased the risk by 42% compared to placebo, and this effect was observed in all COVID-19 variants and subgroups, including vaccination status. A 64% reduction was seen when metformin was started less than 4 days after the onset of COVID-19 symptoms, which may have had an even greater impact than the 36% reduction seen in those who started taking it 4 days or more after symptoms.
Ivermectin and fluvoxamine did not demonstrate any advantages in the prevention of long COVID.
At the same time, the study’s authors emphasize the importance of further research.
“The COVID-OUT trial does not suggest whether metformin would be useful at preventing long COVID if begun at the time of an emergency department visit or hospitalization for COVID-19, nor if metformin would be effective as a treatment in those who had long COVID,” they wrote.
Confirmation in a trial that takes into account the limitations of our study is urgently required, given the burden long COVID has on society, in order to apply these findings to practice and policy.
