Yet Another Study, This Time Led By Scientists From The University of Minnesota Shows That Metformin Decreases Risk Of COVID-19 Severity!
: Study findings from yet another research led by scientists from the University of Minnesota Medical School has added to the growing evidence that metformin, a common and cheap generic diabetic drug is able to decrease the risk of COVID-19 severity.
Thailand Medical News had previously covered on various past studies that showed metformin not only reduced the risk of COVID-19 severity but also reduced risk of mortality.
Interestingly as well, a recent study showed that metformin can also be used to treat atrial fibrillation, which is quite relevant in COVID-19 as many post-COVID-19 individuals tend to experience those as well.
Although vaccination is the most important way to combat the SARS-CoV-2 pandemic, the current newer emerging SARS-CoV-2 omicron variants and sub-lineages along with newer recombinant variants are even more immune evasive and are able to cause breakthrough infections even in the fully vaccinated.
Hence there is a dire need for early outpatient treatment that is safe, inexpensive, and currently widely available in parts of the world that do not have access to the vaccine.
Numerous past studies suggests that metformin inhibits the viral life cycle, as well as observational data suggesting that metformin use before infection with SARS-CoV2 is associated with less severe COVID-19. (Refer to studies mentioned above)
However past observational analyses from single-center cohorts have been limited by size.
The COVID-19 Drugs
study team from University of Minnesota Medical School along with researchers from Stony Brook University Hospital - New York, National Institute of Diabetes and Digestive and Kidney Disease - Maryland, Johns Hopkins School of Public Health - Maryland University of Pennsylvania and University of North Carolina at Chapel Hill conducted a retrospective cohort analysis in adults with type 2 diabetes (T2DM) for associations between metformin use and COVID-19 outcomes with an active comparator design of prevalent users of therapeutically equivalent diabetes monotherapy: metformin versus dipeptidyl-peptidase-4-inhibitors (DPP4i) and sulfonylureas (SU).
This study took place in the National COVID Cohort Collaborative (N3C) longitudinal U.S. cohort of adults with +SARS-CoV-2 result between January 1 2020 to June 1 2021. Findings included hospitalization or ventilation or mortality from COVID-19. Back pain was assessed as a negative control outcome.
A total of 6,626 adults with T2DM and +SARS-CoV-2 from 36 sites were involved. Mean age was 60.7 +/- 12.0 years; 48.7% male; 56.7% White, 21.9% Black, 3.5% Asian, and 16.7% Latinx. Mean BMI was 34.1 +/- 7.8kg/m2. Overall, 14.5% of the sample was hospitalized; 1.5% received mechanical ventilation; and 1.8% died.
In adjusted outcomes, compared to DPP4i, metformin had non-significant associations with reduced need for ventilation (RR 0.68, 0.32–1.44), and mortality (RR 0.82, 0.41–1.64). Compared to SU, metformin was associated with a lower risk of ventilation (RR 0.5, 95% CI 0.28–0.98, p = 0.044) and mortality (RR 0.56, 95%CI 0.33–0.97, p = 0.037). There was no difference in unadjusted or adjusted results of the negative control.
The study findings showed that there were clinically significant associations between metformin use and less severe COVID-19 compared to SU, but not compared to DPP4i.
The study team stressed that new-user studies and randomized trials are needed to assess early outpatient treatment and post-exposure prophylaxis with therapeutics that are safe in adults, children, pregnancy and available worldwide.
The study findings were published in the peer reviewed journal: PLOS One.
The study findings clearly showed an association with less severe cases of COVID-19 in those prescribed metformin. These study findings were part of an observational study that analyzed electronic medical charts and compared adults who were taking either metformin, a sulfonylurea or a DPP-4 inhibitor.
Corresponding author, Dr Carolyn Bramante, MD, an assistant professor at the University of Minnesota Medical School and an internist and pediatrician with M Health Fairview told Thailand Medical News, "This study continues to provide justification for further research on metformin for COVID-19. We're fortunate to have biostatisticians and informatics experts in our Clinical and Translational Science Institute who are exceptional in observational analyses."
The research found that among adults with type 2 diabetes who were taking one oral medication for their condition, those taking metformin had a 45% lower risk of needing a breathing machine or dying from COVID-19 than similar individuals who were not taking metformin.
It was noted that of the similar analyses that have been done, this study used a database large enough to allow a rigorous study of the utilization and effect of these drugs in a larger, well-defined population. The study team collaborated with national experts in pharmaco-epidemiology.
The study findings add to the growing body of data that suggests metformin reduces the severity of COVID-19.
Dr Carolyn Bramante led the COVID-OUT trial, which published findings earlier this year that showed metformin lowers the odds of emergency department visits, hospitalizations or death due to COVID-19. (Refer to studies mentioned above.)
However, some of this most recent data includes test-tube experiments in which metformin stopped the virus from multiplying.
The study team says metformin is safe, inexpensive and widely available, thus more clinical trials are warranted.
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