Metformin, a well-established medication primarily used to treat type 2 diabetes, is emerging as a potential tool in the fight against long Covid. Recent studies suggest that when given early in the course of a Covid-19 infection, metformin could reduce the likelihood of developing long Covid by 40% to 50%.
Traditionally, metformin’s main function is to improve insulin sensitivity. However, since the early 2000s, scientists have recognized that it also influences immune responses and cellular metabolism, granting it antiviral properties. These characteristics prompted researchers to investigate its effectiveness in Covid-19 treatment soon after the pandemic began.
Long Covid, first recognized in 2020, describes a condition where individuals experience persistent symptoms — such as fatigue, shortness of breath, chest pain, and cognitive difficulties often referred to as “brain fog” — lasting for weeks, months, or even years after their initial Covid infection. This syndrome can significantly impair quality of life and work capacity.
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A key study known as the COVID-OUT trial, initiated in 2021, revealed that metformin reduced the risk of developing long Covid by 41% over a 10-month period. Notably, those who began treatment within three days of symptom onset saw an impressive 63% decrease in risk. This highlights the critical importance of administering metformin promptly after infection.
The COVID-OUT trial also demonstrated that metformin lowered viral load, though participants were limited to individuals with a body mass index (BMI) of 25 or higher and excluded those who had previously contracted Covid-19.
To validate these findings, researchers conducted the ACTIV-6 trial, which involved a more diverse participant group and used the same 500mg dosage regimen as the COVID-OUT study. This trial corroborated the beneficial effect of metformin, showing a 50% reduction in clinically diagnosed long Covid cases among those treated.
Both trials began treatment at a low dose, gradually increasing over two weeks, resulting in a total of 36 doses. Importantly, metformin was well-tolerated, with minimal digestive side effects and no major safety concerns reported.
While further research is needed to fully confirm metformin’s role in preventing long Covid, these promising results suggest that timely administration of this affordable and widely available drug could be a valuable strategy in mitigating long-term Covid complications.