Diabetes drug metformin may keep severe COVID at bay – Consumer Health News

WEDNESDAY, Nov. 23, 2022 (HealthDay News) — A century-old diabetes drug appears to help prevent high-risk COVID-19 patients from becoming fatally ill, reports a new study.

Metformin reduced the risk of dying from COVID-19 by 44% in a group of diabetics who were taking the drug when they became infected with the coronavirus, researchers found.

Diabetics taking metformin were also 50% less likely to require ventilation while fighting COVID-19 infection, the results showed.

These results are in line with previous studies and a clinical trial that demonstrated metformin’s protective effects against COVID-19, said lead investigator Dr. Carolyn Bramante, an assistant professor of medicine at the University of Minnesota School of Medicine in Minneapolis.

“All of this research points to the fact that there is a role for metformin in preventing SARS-CoV-2 and preventing severe COVID-19,” said Bramante.

Metformin was first discovered in French lilacs in the early 1920s, she noted.

“Some of the first articles published on metformin were in the context of flu and metformin prevented or was associated with less severe flu. That was in the 1940s and 1950s,” said Bramante.

The US Food and Drug Administration approved metformin as a diabetes medication in 1994. The drug helps diabetics by reducing the liver’s ability to release blood sugar from its stores, according to Johns Hopkins.

But metformin also appears to have antiviral and anti-inflammatory effects, so in the 2010s researchers began testing it against other viruses, such as Zika and hepatitis C, Bramante said.

This made metformin a natural candidate for use in treating COVID-19, the researchers concluded.

A clinical trial found that metformin reduces the odds of emergency room visits, hospitalizations or death from COVID-19 in overweight or obese patients by more than 40% and more than 50% if prescribed at the onset of symptoms, according to published findings. in august New England Journal of Medicine🇧🇷

“What we saw in our study is that the sooner someone started metformin, the better it worked to prevent severe COVID-19,” said Bramante, who led the clinical trial. “Therefore, in individuals who started with less than four days of symptoms, they had the greatest effect in preventing ER visits, hospitalization and death from COVID-19.”

However, these results were not considered conclusive because metformin failed the main objective of the clinical trial, which was to prevent people from developing life-threatening low blood oxygen levels due to COVID.

Bramante continued his research on metformin with this new study, which involved more than 6,600 type 2 diabetics who were infected with COVID-19.

The research team compared the performance of diabetics taking metformin compared to those prescribed other diabetes medications.

It found that people taking metformin had a lower risk of death or ventilation compared to those taking a class of diabetes drugs called sulfonylureas, the researchers found.

“There was about a 50% reduction in mortality and the need for a breathing tube,” said Bramante. “This is similar to what we saw in the clinical trial with regard to preventing the need for hospitalization or death from COVID-19. And in other observational studies that have been published, there has also been about a 40% to 50% reduction in these severe outcomes.”

Metformin has been shown to prevent the COVID virus from multiplying in a test tube, and Bramante believes this antiviral action is what protects patients.

“The mechanism by which we think that metformin stops SARS-CoV-2 from multiplying is by inhibiting a protein called MTOR that the virus uses to assemble itself before becoming a new set of viruses outside the cell,” said Bramante.

The Doctor. William Schaffner, medical director of the National Foundation for Infectious Diseases, believes that metformin may be helpful in treating COVID-19.

But Schaffner thinks the drug’s anti-inflammatory effects likely explain the COVID benefits reported by the studies.

“Metformin clearly has anti-inflammatory activity. There are also suggestions that it may have a direct antiviral activity, but I think it’s more of an anti-inflammatory response,” Schaffner said.

“The virus sets in and then, of course, that triggers an inflammatory response. And the inflammatory response that we’ve learned is what really causes serious disease, because it causes collateral damage throughout the body,” he noted. “And if you could silence, reduce that inflammatory response, you would probably protect yourself against more severe and severe disease.”

Since metformin has already been approved by the FDA, doctors can use it off-label to help high-risk COVID patients — and Bramante thinks they should consider doing so.

“The evidence is definitely there to justify a prescriber’s decision to use it. That would not be in question, in my opinion,” said Bramante. “We have a few more articles coming out of the clinical trial,” she noted, adding that it will be important for guideline committees to synthesize available evidence and consider whether or not to add metformin to treatment guidelines.

If adopted, metformin would be a very safe and affordable COVID treatment, Bramante said.

Metformin is approved for use in pregnant women and children, with few drug interactions, she added. Its most common side effect is gastrointestinal disturbances, which usually disappear if the dose is reduced.

The cost of immediate-release metformin is less than $4 a month, Bramante said.

Schaffner would like to see more evidence, however, before the drug is used to treat or prevent COVID-19.

“Before we make that leap — and it’s a big leap, it’s a big leap — I think we need confirmatory studies and some prospective trials before we start giving a drug to large populations,” he said.

The results of the study were recently published online in the journal PLOS ONE🇧🇷

More information

Johns Hopkins has more on metformin.

SOURCES: Carolyn Bramante, MD, MPH, assistant professor, medicine, University of Minnesota School of Medicine, Minneapolis; William Schaffner, medical director, National Foundation for Infectious Diseases, Bethesda, Md.; PLOS ONENovember 17, 2022, online

Diabetes drug metformin may keep severe COVID at bay – Consumer Health News

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