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Metformin and Covid-19: Focused Review of Mechanisms and Current Literature Suggesting Benefit

Sherehan Ibrahim1, Jamie R Lowe2, Carolyn T Bramante1

  • 1Department of Medicine, Division of General Internal Medicine, University of Minnesota, Minneapolis, MN, United States.

Frontiers in Endocrinology
|August 9, 2021
PubMed

Insights

Metformin, a common type 2 diabetes drug, may reduce deaths in COVID-19 patients. Studies suggest it could fight the virus directly or improve the patient's overall health.

Area of Science:

  • Infectious Diseases and Virology
  • Pharmacology and Therapeutics

Background:

  • Metformin is a primary treatment for type 2 diabetes.
  • Metformin has demonstrated efficacy against various infectious agents, including influenza, hepatitis C, and Zika virus.
  • Emerging observational data suggest metformin use may correlate with reduced mortality in COVID-19 patients.

Purpose of the Study:

  • To explore the potential mechanisms by which metformin might reduce mortality in individuals with COVID-19.
  • To investigate whether metformin's effects are due to direct antiviral activity or host-protective mechanisms.

Main Methods:

  • Review of existing observational studies on metformin use and COVID-19 mortality.
  • Analysis of known pharmacological properties of metformin related to infectious diseases.
  • Hypothesizing potential direct antiviral and host-modulating pathways.

Main Results:

  • Four observational studies indicate a potential decrease in mortality among COVID-19 patients using metformin.
  • Metformin has shown both direct anti-infective properties and benefits in improving host health in previous studies.
  • The precise mechanism for reduced COVID-19 mortality in metformin users remains undetermined.

Conclusions:

  • Metformin's established role in managing infectious diseases warrants further investigation for COVID-19.
  • Potential benefits may stem from direct antiviral effects or enhancement of host immunity and metabolic health.
  • Further research is needed to elucidate the specific mechanisms underlying metformin's observed association with lower COVID-19 mortality.
Keywords:
COVID-19mechanisms of actionmetforminmicrobiomeobesity

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