Metformin, a diabetes medication, could potentially lower the risk of long COVID by an impressive 64%
In a recent study published in Clinical Infectious Diseases, researchers explored the potential intervention of metformin in preventing long COVID in adults with obesity or overweight. The study, which primarily focused on white individuals, utilised primary care data from individuals in England via the Clinical Practice Research Datalink Aurum.
The researchers defined long COVID by two specific diagnostic codes or as having one or more of twenty-five symptoms noted by the World Health Organization (WHO) three months to one year after COVID-19 diagnosis. They found that participants who started metformin within three months of SARS-CoV-2 infection diagnosis had a decreased risk of long COVID. The benefits of metformin in preventing long COVID may not apply to people outside the body mass index range of obesity or overweight.
Metformin is a medication used to treat high blood sugar levels caused by type 2 diabetes. Jimmy Johannes, a pulmonologist and critical care medicine specialist, noted that the potential for metformin to help prevent Long COVID is intriguing, given its wide availability and good safety record. However, the study did not account for the dose and formulation of metformin that participants were taking, presenting a risk for residual confounding.
People who started taking metformin were more likely to have reasons for using metformin, both on-label and off-label, than those who did not start taking metformin. The code used by researchers to identify long COVID was introduced in October 2021, which may have underestimated cases of Long COVID that occurred before this.
Researchers acknowledge the challenge of distinguishing the effects of COVID-19 from other conditions and suggest further research to investigate this relationship. They also noted that the study lacked statistical power for some subgroups, limiting the ability to draw conclusions from subgroup analysis results.
The study did not account for other antivirals that could possibly decrease the risk for long COVID-19, aside from nirmatrelvir. Researchers may have missed relevant information and had to make assumptions due to the nature of the study and available data.
Despite these limitations, the study's findings suggest that metformin may help prevent long COVID syndrome. Overweight or obese adults who start metformin treatment early after a COVID-19 diagnosis could potentially benefit from a substantially reduced risk of Long COVID, with studies showing risk reductions of 36% to 64% when metformin is initiated within days of symptom onset. Further research, such as randomized controlled trials, is needed to verify these findings.
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