Common Diabetes Drug Metformin Cuts Long Covid Risk By 64 Percent In Uk Study

A communal and inexpensive glucosuria supplier could importantly little nan consequence of Long COVID successful overweight individuals, opening caller possibilities for prevention strategies successful nan pandemic’s agelong tail.

Study: Effect of Metformin connected nan Risk of Post-coronavirus Disease 2019 Condition Among Individuals With Overweight aliases Obese: A Population-based Retrospective Cohort Study. Image Credit: luchschenF / Shutterstock

In a caller study published successful nan diary Clinical Infectious Diseases, researchers conducted a large-scale retrospective study to analyse whether nan communal glucosuria medicine metformin could trim nan consequence of overweight aliases obese individuals processing Long COVID successful a real-world setting.

The study leveraged information from complete 1.8 cardinal observations from 624,308 individuals successful nan UK and recovered that overweight/obese patients who initiated metformin wrong 90 days (across 3 sequential proceedings emulations) aft a COVID-19 infection demonstrated a 64% simplification successful their likelihood of a consequent Long COVID diagnosis. 

These findings propose that this inexpensive supplier whitethorn connection a imaginable preventive use for individuals pinch higher weights, thereby improving nan value of life for this at-risk population.

Background

Despite nan acute shape of nan coronavirus illness of 2019 (COVID-19) having passed, wide reports and a increasing assemblage of grounds item that galore survivors proceed to suffer from nan pandemic's aftermath. Colloquially called "Long COVID", post-COVID-19 information (PCC) is an umbrella word for complex, multi-system disorders characterized by complete 200 imaginable symptoms, including persistent fatigue, cognitive impairment ("brain fog"), shortness of breath, and insomnia.

The World Health Organization (WHO) officially defines PCC arsenic symptoms lasting astatine slightest 2 months, typically starting wrong 3 months of nan first infection. UK surveys uncover that much than 1.9 cardinal group (2.9% of nan population) person Long COVID arsenic of March 2023, underscoring nan value of identifying and mitigating consequence factors.

Unfortunately, since nan mechanisms underlying Long COVID stay mostly elusive, caller investigation has aimed to place communal and affordable interventions to thief COVID-19 patients and pass consequence mitigation policies. A erstwhile randomized trial, COVID-OUT, reported reduced PCC incidence arsenic a prespecified secondary result successful overweight/obese individuals, though real-world applicability remained uncertain.

Metformin is simply a first-line therapy for type 2 glucosuria (T2D) and is champion known for its expertise to little humor glucose. However, nan supplier has demonstrated powerful anti-inflammatory properties and has been shown to activate a cardinal cellular power sensor, AMP-activated macromolecule kinase (AMPK), which whitethorn interfere pinch viral replication; however, nan precise mechanisms stay unclear.

About nan study

The coming study intends to found the efficacy of metformin for preventing Long COVID successful a real-world setting. The study creation was retrospective and leveraged anonymized superior attraction information from nan UK's Clinical Practice Research Datalink (CPRD) Aurum database. Notably, nan database covers astir 25% of England's population.

Study inclusion criteria included adults pinch clinically validated overweight aliases obesity (defined arsenic a Body Mass Index [BMI] of 25 kg/m² aliases higher) who were diagnosed pinch COVID-19 betwixt March 2020 and July 2023. Patients pinch medically recorded metformin usage aliases different glucose-lowering narcotics anterior to their COVID-19 infections aliases metformin contraindications were excluded from consequent analyses.

The study employed a statistical method known arsenic "sequential target proceedings emulation" (with 3 introduction points) to simulate nan creation and imaginable findings of a randomized controlled trial. Analyses progressive comparing nan one-year consequence of Long COVID successful patients who initiated metformin wrong 30 days of 3 staggered baselines (diagnosis, 30 days post-diagnosis, and 60 days post-diagnosis) to those who did not. The superior result of liking was a clinically validated PCC test aliases nan emergence of caller WHO-listed symptoms (without pre-infection history) betwixt 90 and 365 days aft infection.

Study findings

After applying nan removal criteria, nan last study included 624,308 adults, 2,976 of whom initiated metformin aft infection. Study findings revealed a statistically important relation betwixt metformin usage and a reduced consequence of Long COVID. Specifically, nan intention-to-treat study recovered that metformin initiators demonstrated a 64% simplification successful PCC consequence (Hazard Ratio [HR] 0.36; 95% Confidence Interval [CI], 0.32–0.41) compared pinch non-initiators.

Notably, these results construe to a one-year absolute consequence quality of -12.58%, suggesting that astir 8 overweight/obese individuals request to beryllium treated pinch metformin to forestall 1 Long COVID case.

Per-protocol study confirmed these findings (HR 0.36; 95% CI, 0.33–0.41), pinch nan observed relation remaining statistically important crossed each investigated subgroups, including different property groups, genders, BMI categories, glucosuria position (51.9% of metformin users had T2DM), and during periods dominated by some nan Delta and Omicron variants. A antagonistic power study revealed nary relation pinch crab consequence (HR 1.13), supporting nan robustness of nan findings.

Conclusions

The coming study demonstrates nan imaginable benefits of metformin successful nan effort to mitigate Long COVID, specifically successful overweight/obese individuals. This extensive, real-world study provides grounds suggesting that early curen pinch metformin whitethorn importantly trim nan consequence of processing Long COVID successful this population. As an observational study, these results bespeak relation but cannot beryllium causation.

While its mechanisms stay unclear, nan drug's imaginable anti-inflammatory and antiviral effects are thought to beryllium imaginable contributors. Crucially, nan findings whitethorn not generalize to individuals of normal weight. The adjacent measurement is to behaviour large-scale, randomized controlled tests to corroborate causality and explain nan domiciled of metformin successful nan world strategy against post-COVID-19 conditions.