Metformin for Treatment of Acute COVID-19: Systematic Review of Clinical Trial Data Against SARS-CoV-2
Authors' conclusion
Future trials will help define the role of metformin in COVID-19 treatment guidelines.
Study context
- Population
- Adults with COVID-19 (SARS-CoV-2 infection) in randomised trials3 RCTs
- Comparison
- Metformin vs control
- Outcome
- Clinical outcomes
Methodological detailssynthesis without meta-analysis (SWiM), narrative synthesis, Cochrane Risk of Bias 2, Grading of Recommendations Assessment, Development and Evaluation (GRADE), Largest trial enrolled during delta and omicron waves; vaccinated individuals included, Limitations: only three trials and heterogeneity between trials
- Synthesis without meta-analysis (SWiM)
- Narrative synthesis
- Cochrane Risk of Bias 2
- GRADE
- Largest trial enrolled during delta and omicron waves; vaccinated individuals included
- Limitations: only three trials and heterogeneity between trials
Pooled result
As reported in the abstract
- In 2 trials metformin improved clinical outcomes (prevented need for oxygen and need for acute health care use)
- Third trial (more adults with diabetes): direction of benefit similar in the per-protocol group
- Certainty of evidence that metformin prevents health care use due to COVID-19: moderate (GRADE)
Further pooled results
Preclinical data
- Many preclinical studies have shown metformin to be effective against SARS-CoV-2
Original publication
Metformin for Treatment of Acute COVID-19: Systematic Review of Clinical Trial Data Against SARS-CoV-2. Diabetes Care. Published 20 June 2023. doi:10.
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