Common diabetes drug lowers SARS-CoV-2 levels, clinical trial finds

Now, researchers from the University of Minnesota published evidence that metformin, a common diabetes medication, decreases the amount of SARS-CoV-2 in the body and helps reduce the risk of rebound symptoms if given early in the course of non-serious illness.

The study, published in Clinical infectious diseasessuggests that metformin may also help prevent long COVID.

Researchers tested metformin against a placebo in 999 adults infected with COVID-19. More than 50% of study participants were vaccinated, and treatment took place when the Omicron variant was the most dominant strain in the United States.

The study included people at standard risk

Additionally, according to Carolyn Bramante, MD, the study’s principal investigator and assistant professor at the University of Minnesota, the study participants represented a standard-risk population, a group that currently lacks effective treatment options against the new coronavirus.

“This is not a high risk population,” Bramante told CIDRAP News. Instead, participants were aged 30 or older, had a body mass index of 25 or higher (overweight), and did not need to be hospitalized for their COVID-19 infection.

In several trials, Paxlovid has been shown to prevent deaths and hospitalizations in unvaccinated high-risk people, but standard-risk populations showed no improvement in either time to symptom resolution or incidence. hospitalizations or deaths.

Bramante said these patient population demographics suggest that metformin could be a clinical tool for outpatient medications that could be widely used.

“The data supports that someone would be justified if they prescribed it for outpatient treatment,“ she says.

Four-fold reduction in viral load by day 10

Participants received a 14-day course of metformin and had nasal swabs collected on days 1, 5 and 10. Bramante said early treatment was key: participants were enrolled within 3 days of a positive test and, if they had symptoms, reported having symptoms. for 7 days or less.

The average SARS-CoV-2 viral load was reduced 3.6-fold with metformin compared to placebo at day 10, the authors found, and those who received metformin were less likely to have a detectable viral load than placebo on days 5 or 10 (odds ratio (OR), 0.72; 95% confidence interval (CI), 0.55 to 0.94).

Metformin reduced the risk of hospitalization or death by 58% within 28 days; emergency room visits, hospitalizations and deaths within 14 days by 42%; and a 10-month long COVID of 42%.

Viral rebound, defined as a higher viral load on day 10 than on day 5, was less common with metformin (3.28%) than with placebo (5.95%; OR, 0.68; CI at 95%, 0.36 to 1.29).

Although the mechanism of action is not known, Bramante said metformin likely reduces inflammation and inhibits virus translation.

This study makes a strong case for a potential effect of metformin on the virological degradation of COVID-19.

In a comment on the study, write the authors, “This study makes a strong case for a potential effect of metformin on the virological breakdown of COVID-19 and prompts reevaluation of existing data supporting its use.“