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Other Treatments Global Adoption
0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Reis (DB RCT) -15% 1.15 [0.73-1.83] hosp./ER 32/217 27/206 Improvement, RR [CI] Treatment Control Tau​2 = 0.00; I​2 = 0.0% Early treatment -15% 1.15 [0.73-1.83] 32/217 27/206 -15% improvement Luo 75% 0.25 [0.07-0.84] death 3/104 22/179 Improvement, RR [CI] Treatment Control Wang 58% 0.42 [0.01-1.98] death 1/9 13/49 Chen 33% 0.67 [0.20-1.78] death 4/43 15/77 Bramante 7% 0.93 [0.81-1.06] death 394/2,333 791/3,923 Huh -1% 1.01 [0.75-1.37] progression 104/272 774/2,533 Crouse 61% 0.39 [0.16-0.87] death 8/76 34/144 Holt -27% 1.27 [0.72-2.22] cases 12/429 434/14,798 Khunti 23% 0.77 [0.73-0.81] death population-based cohort Ravindra 30% 0.70 [0.28-1.56] death 5/53 57/313 Wander 15% 0.85 [0.80-0.90] death Tau​2 = 0.01; I​2 = 74.4% Prophylaxis 15% 0.85 [0.77-0.95] 531/3,319 2,140/22,016 15% improvement All studies 14% 0.86 [0.78-0.96] 563/3,536 2,167/22,222 14% improvement 11 metformin COVID-19 studies Dec 5, 2021 Tau​2 = 0.01; I​2 = 73.2%; Z = 2.80 Effect extraction pre-specified Favors metformin Favors control
Database of all metformin COVID-19 studies. Most studies analyze existing use with diabetic patients. Many results are subject to confounding by indication — metformin is typically used early in the progression of type 2 diabetes. Submit updates/corrections.
Restrict:    All    Early    Prophylaxis
Nov 19
In Vitro Tandel et al., bioRxiv, doi:10.1101/2021.11.18.469078 (Preprint) (In Vitro)
in vitro
Metformin Suppresses SARS-CoV-2 in Cell Culture
Details   In Vitro study showing metformin inhibits SARS-CoV-2 in Caco2 cells. Metformin reduced viral titers by nearly 99%, and by about 90% when cells were treated prior to infection.
Oct 6
PrEPPEP Wander et al., Diabetes Care, doi:10.2337/dc21-1351 (Peer Reviewed)
death, ↓15.0%, p<0.0001
Prior Glucose-Lowering Medication Use and 30-Day Outcomes Among 64,892 Veterans With Diabetes and COVID-19
Details   Retrospective 64,892 veterans with diabetes in the USA, showing lower mortality with existing metformin use.
Aug 31
Early Reis et al., Preprint (Preprint)
hosp./ER, ↑15.0%, p=0.56
Effect of Early Treatment with Metformin on Risk of Emergency Care and Hospitalization Among Patients with COVID-19: The TOGETHER Randomized Platform Clinical Trial
Details   RCT with 217 patients treated with metformin and 206 controls, showing no significant difference with treatment. Limited information is provided in the preprint. Time since symptom onset is not specified. The trial may share some similar ..
May 5
PrEPPEP Ravindra et al., medRxiv, doi:10.1101/2021.04.20.21255792 (Peer Reviewed)
death, ↓29.6%, p=0.42
Retrospective Assessment of Treatments of Hospitalized Covid-19 Patients
Details   Retrospective 1,035 hospitalized patients in India. Of 366 diabetic patients, there was lower mortality for the 53 that were on metformin.
Mar 30
PrEPPEP Khunti et al., The Lacent Diabetes & Endocrinology, doi:10.1016/S2213-8587(21)00050-4 (Peer Reviewed)
death, ↓23.0%, p<0.0001
Prescription of glucose-lowering therapies and risk of COVID-19 mortality in people with type 2 diabetes: a nationwide observational study in England
Details   Retrospective 2,851,465 people with type 2 diabetes in the UK, showing lower mortality with existing metformin use. Results are subject to confounding by indication because metformin is typically used early in the progression of type 2 di..
Mar 30
PrEPPEP Holt et al., medRxiv, doi:10.1101/2021.03.27.21254452 (Preprint)
cases, ↑27.0%, p=0.42
Risk factors for developing COVID-19: a population-based longitudinal study (COVIDENCE UK)
Details   Prospective survey-based study with 15,227 people in the UK, showing lower risk of COVID-19 cases with vitamin A, vitamin D, zinc, selenium, probiotics, and inhaled corticosteroids; and higher risk with metformin and vitamin C. Statistica..
Jan 13
PrEPPEP Crouse et al., Front. Endocrinol., doi:10.3389/fendo.2020.600439 (Peer Reviewed)
death, ↓60.8%, p=0.02
Metformin Use Is Associated With Reduced Mortality in a Diverse Population With COVID-19 and Diabetes
Details   Retrospective 219 COVID-19+ diabetes patients in the USA, showing lower mortality with existing metformin treatment.
Dec 19
PrEPPEP Huh et al., International Journal of Infectious Diseases, doi:10.1016/j.ijid.2020.12.041 (Peer Reviewed)
progression, ↑1.0%, p=0.11
Association of prescribed medications with the risk of COVID-19 infection and severity among adults in South Korea
Details   Retrospective database analysis with 17 existing users of HCQ and 5 severe cases, showing no significant difference for cases and higher risk for severe cases. However, HCQ users are likely systemic autoimmune disease patients and authors..
Dec 3
PrEPPEP Bramante et al., The Lancet Healthy Longevity, doi:10.1016/S2666-7568(20)30033-7 (Peer Reviewed)
death, ↓7.2%, p=0.15
Metformin and risk of mortality in patients hospitalised with COVID-19: a retrospective cohort analysis
Details   Retrospective 6,256 COVID-19+ diabetes patients in the USA, showing lower mortality with existing metformin treatment, statistically significant only for women.
Jul 31
PrEPPEP Chen et al., Diabetes Care, doi:10.2337/dc20-0660 (Peer Reviewed)
death, ↓33.0%, p=0.46
Clinical Characteristics and Outcomes of Patients With Diabetes and COVID-19 in Association With Glucose-Lowering Medication
Details   Retrospective 120 COVID-19 diabetes patients, showing non-statistically significantly lower mortality with existing metformin treatment.
Jul 14
PrEPPEP Wang et al., Journal of Hematology & Oncology, doi:10.1186/s13045-020-00934-x (Peer Reviewed)
death, ↓57.7%, p=0.43
A tertiary center experience of multiple myeloma patients with COVID-19: lessons learned and the path forward
Details   Retrospective 58 multiple myeloma COVID-19 patients in the USA, showing non-statistically significant lower mortality with metformin treatment.
May 21
PrEPPEP Luo et al., The American Journal of Tropical Medicine and Hygiene, doi:10.4269/ajtmh.20-0375 (Peer Reviewed)
death, ↓74.7%, p=0.02
Metformin Treatment Was Associated with Decreased Mortality in COVID-19 Patients with Diabetes in a Retrospective Analysis
Details   Retrospective 283 COVID-19+ diabetes patients in China, showing lower mortality with existing metformin treatment.
Please send us corrections, updates, or comments. Vaccines and treatments are both extremely valuable and complementary. All practical, effective, and safe means should be used. Elimination of COVID-19 is a race against viral evolution. No treatment, vaccine, or intervention is 100% available and effective for all current and future variants. Denying the efficacy of any method increases the risk of COVID-19 becoming endemic; and increases mortality, morbidity, and collateral damage. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. Treatment protocols for physicians are available from the FLCCC.
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