Preliminary data from a randomized clinical trial could point to a possible way to prevent a long covid. The study found that Covid-19 patients taking metformin, a commonly prescribed diabetes drug, were significantly less likely to be diagnosed with long-term Covid-19 10 months later than people in the control group. However, more research is needed to confirm the implications of this study.
In late 2020, a large group of researchers at various universities in the US began the COVID-OUT study. The original aim was to test whether three readily available and affordable oral drugs could prevent worsening of Covid-19 cases when taken early in a person’s illness. These drugs — metformin, ivermectin, and fluvoxamine — had shown some potential antiviral and/or anti-inflammatory effects in previous studies, but mainly in the laboratory or in animals.
The outpatients were randomized into six groups, with each group receiving two pills each. Half of these groups received metformin, either with a placebo or in combination with the other two drugs, and the other half received a placebo that looks like metformin, with either a second placebo or the other two drugs. This study design meant that many treatment comparisons could be made at once, even against a fully placebo-controlled group.
The study involved just over 1,300 patients over the age of 30 who were believed to be at higher risk of severe Covid-19. Sadly it is found that none of the drugs met the target set by the researchers, implying a significantly significantly reduced risk of a serious Covid-related event such as hypoxemia (low blood oxygen). However, some data suggest that metformin may reduce the risk of a covid-related emergency room visit, hospitalization, or death. And even before the study ended, the researchers decided to continue examining their patients after the first phase of the trial, hoping to see if any of these drugs could have a preventive effect on long Covid.
you held Track of 1,125 patients for 300 days or more10 months out. The team surveyed patients about monthly Survey if they had received a long covid diagnosis from a medical provider during this time. Overall, 8.4% of patients (94/1,125) said yes, but those taking metformin did so significantly less frequently. 6.3% in the metformin group reported being diagnosed compared to 10.6% in the control group – an over 40% reduction in relative risk. However, those taking ivermectin or fluvoxamine were no less likely to report a long-term Covid diagnosis than the control group.
“In adults with Covid-19, outpatient treatment with metformin reduced the development of long covid by 42% in a randomized phase 3 study whose sample was mainly vaccinated and included enrollment during the Omicron wave,” the authors wrote in her work. Approved as a preprint over the weekend on medRxiv.
It is important to note the caveats of this research. On the one hand, the data still have to be formally subjected to a peer review. Second, although these results come from a randomized controlled trial — often considered the gold standard of clinical research — they are not technically part of the original study design. Another limitation common to long Covid studies is that the The definition of this chronic disease remains elusive. And, of course, no single study should be taken as definitive proof of the effectiveness of any treatment.
At the same time, very little clinical research has been done to date that even attempted to look for possible preventative treatments for long Covid. Much of the data shows That vaccines can reduce the risk of long-term Covid-19 illness, for example, is evident from retrospective observational studies, which are valuable but typically have even more limitations than data from a randomized controlled trial. The researchers also openly made the decision to examine Long Covid very early in the study, known as setting a pre-determined outcome. This helps avoid someone picking good-sounding dates after the fact. And while there are likely multiple reasons why long covid occurs, metformin’s antiviral and anti-inflammatory effects could provide a plausible mechanism for its potential benefits.
There are clinical trials ongoing now and in the future who will explore possible treatments and preventatives for long covid. So these results at least suggest that metformin should be further explored as one of those options, the authors say, including in combination with other drugs like the antiviral Paxlovid.
“Further clinical trials are warranted to assess whether there is synergy with other treatments,” they wrote.
https://gizmodo.com/metformin-long-covid-trial-1849931810 A Common Diabetes Drug May Reduce Long Covid Risk, Trial Data Finds