Can Diabetes Drug Metformin Help Prevent Long COVID?

According to the Centers for Disease Prevention and Control (CDC), 1 in 5 Americans who were diagnosed with COVID-19 are now dealing with long COVID. 

Long COVID symptoms include:

• difficulty breathing
• chest pain
• fevers
• headaches
• chronic fatigue
• “brain fog”
• anxiety
• stress
• “pins and needles” sensations
• sleep problems
• joint pain
• diarrhea
• tummy pain

Long COVID symptoms are defined as lasting three or more months after first contracting the virus, and that were not existent before the COVID-19 infection.

Long COVID can be a debilitating condition. Now, a recent study suggests that the diabetes drug Metformin may be exactly what’s needed to cut long COVID short. 

Metformin: A Long COVID Treatment?

Metformin is a diabetes drug that, in recent years, has been found to have a broad range of benefits that include weight loss and boosting longevity and is now protecting against long COVID.

As previous studies have indicated metformin’s anti-inflammatory and antiviral properties, researchers sought to examine if metformin, as well as ivermectin and fluvoxamine, could reduce the risk of long COVID. 

“Those of us who do diabetes and obesity research had seen, over the last decade or two, articles coming out periodically about how metformin inhibited other viruses in test tubes,” explained Carolyn Bramante, MD, MPH, the principal investigator of the trial, to Health. “It made sense that metformin could also inhibit SARS-COV-2.”

The study included 1,323 participants aged 30 to 85 who, based on their BMI, were classified as having obesity or being overweight, which places them at a higher risk for developing severe COVID-19. All the participants had tested positive for COVID-19 in the previous three days and had symptoms for less than seven days.

The participants were then assigned either a placebo, metformin, and fluvoxamine or ivermectin, or just metformin, ivermectin, or fluvoxamine for two weeks. They were then followed for 10 months before being asked about a diagnosis of long COVID over the follow-up period.

Can a diabetes drug treat long COVID?

“Metformin is a cheap and effective drug that, when taken within a few days of the onset of COVID symptoms, can reduce the risk of longer-term symptoms that we refer to as long COVID,” John Buse, MD, PhD, study co-author

The study’s findings, published in The Lancet Infectious Diseases, found that 6.3% of the patients that received metformin developed long COVID, compared to 10.4% who received a placebo. The metformin group, compared to a placebo, faced a 60% reduced risk of developing long COVID after taking the diabetes drug within three days of developing symptoms. 

They also faced a 41% reduced risk of developing long COVID after taking metformin after having symptoms for an extended period of time.

How does metformin affect long COVID risk?

Speaking to Medical News Today, endocrinologist Dr. Mark Guido, who was not involved in the study, suggested that metformin’s effect on long COVID risk may be anti-inflammatory,

“Metformin has also been shown to potentially reduce severe COVID and to stop [SARS-CoV-2] virus replication in a lab setting, both of which might also play a role.” he hypothesized.

Is metformin the future of long COVID Treatment?

“Long COVID is quickly becoming a public health crisis. If it can be successfully reduced by an inexpensive, well-tolerated, and readily available medication such as metformin, it would have a great benefit on public health in the long run,” Dr. Guido, Medical News Today

As promising as the findings appear to be, it’s still too early to be prescribing metformin for long COVID symptoms. 

For one, the study focused on people with high BMIs. As such, it’s unknown if the results would extend to people with lower BMIs and those under 30. The study also doesn’t show if metformin would benefit those already diagnosed with long COVID, and if vaccination rates may affect the findings,

“A little bit over half of the sample [group] was vaccinated,” Dr. Bramante said. 

“That is some evidence of including people with some degree of immunity, but we did not enroll individuals who had a known prior infection. And so that’s an open question.”

How can I prevent long COVID?

Per the Centers for Disease Control and Prevention (CDC), the best way to prevent long COVID is to protect yourself from getting COVID-19. This includes:

• getting vaccinated
• staying up to date on vaccinations
• improving ventilation
• getting tested for COVID-19 if needed
• seeking out treatment if eligible

Want to know more?

Millions around the world have been slogging through long Covid, an aftermath illness that can go on for months. Yet, long Covid does not have to be a life sentence.

References

Bramante CT, Buse JB, Liebovitz DM, Nicklas JM, et al. (2023). Outpatient treatment of COVID-19 and incidence of post-COVID-19 condition over 10 months (COVID-OUT): a multicentre, randomised, quadruple-blind, parallel-group, phase 3 trial. Lancet Infect Dis. 2023 Jun 8:S1473-3099(23)00299-2. doi: 10.1016/S1473-3099(23)00299-2. Epub ahead of print. PMID: 37302406.

Chen, X., Guo, H., Qiu, L., Zhang, C., Deng, Q., & Leng, Q. (2020). Immunomodulatory and Antiviral Activity of Metformin and Its Potential Implications in Treating Coronavirus Disease 2019 and Lung Injury. Frontiers in Immunology, 11. https://doi.org/10.3389/fimmu.2020.02056