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Outcomes in COVID-19 metformin studies
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Outcomes in metformin 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.
All studies   Exclusions   Mortality   ICU   Hospitalization   Serious outcomes   Cases   Viral clearance   RCTs   Peer-reviewed   All outcomes  
0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ All studies 14% 11 25,758 Improvement, Studies, Patients Relative Risk, 95% CI With exclusions 15% 9 10,165 Mortality 19% 8 7,303 ICU admission 2% 1 0 Hospitalization 3% 1 0 Progression -1% 1 2,805 Cases 3% 2 15,227 Viral clearance 4% 1 423 RCTs -15% 1 423 Peer-reviewed 16% 9 10,108 Prophylaxis 15% 10 25,335 Early -15% 1 423 Metformin for COVID-19 c19early.com/mf Dec 5, 2021 Favors metformin Favors control
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 c19early.com/mf Dec 5, 2021 Tau​2​ = 0.01; I​2​ = 73.2%; Z = 2.80 Effect extraction pre-specified Favors metformin Favors control 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 Khunti 23% 0.77 [0.73-0.81] death population-based cohort Wander 15% 0.85 [0.80-0.90] death Tau​2​ = 0.01; I​2​ = 78.5% Prophylaxis 16% 0.84 [0.76-0.94] 514/2,837 1,649/6,905 16% improvement All studies 15% 0.85 [0.77-0.95] 546/3,054 1,676/7,111 15% improvement 9 metformin COVID-19 studies after exclusions c19early.com/mf Dec 5, 2021 Tau​2​ = 0.01; I​2​ = 76.9%; Z = 2.92 Effect extraction pre-specified Favors metformin Favors control 0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Luo 75% 0.25 [0.07-0.84] 3/104 22/179 Improvement, RR [CI] Treatment Control Wang 58% 0.42 [0.01-1.98] 1/9 13/49 Chen 33% 0.67 [0.20-1.78] 4/43 15/77 Bramante 7% 0.93 [0.81-1.06] 394/2,333 791/3,923 Crouse 61% 0.39 [0.16-0.87] 8/76 34/144 Khunti 23% 0.77 [0.73-0.81] population-based cohort Ravindra 30% 0.70 [0.28-1.56] 5/53 57/313 Wander 15% 0.85 [0.80-0.90] Tau​2​ = 0.01; I​2​ = 71.6% Prophylaxis 19% 0.81 [0.73-0.90] 415/2,618 932/4,685 19% improvement All studies 19% 0.81 [0.73-0.90] 415/2,618 932/4,685 19% improvement 8 metformin COVID-19 mortality results c19early.com/mf Dec 5, 2021 Tau​2​ = 0.01; I​2​ = 71.6%; Z = 3.89 Favors metformin Favors control 0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Wander 2% 0.98 [0.92-1.06] Improvement, RR [CI] Treatment Control Tau​2​ = 0.00; I​2​ = 0.0% Prophylaxis 2% 0.98 [0.92-1.06] 2% improvement All studies 2% 0.98 [0.91-1.05] 2% improvement 1 metformin COVID-19 ICU result c19early.com/mf Dec 5, 2021 Tau​2​ = 0.00; I​2​ = 0.0%; Z = 0.52 Favors metformin Favors control 0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Wander 3% 0.97 [0.94-1.01] hosp. Improvement, RR [CI] Treatment Control Tau​2​ = 0.00; I​2​ = 0.0% Prophylaxis 3% 0.97 [0.94-1.01] 3% improvement All studies 3% 0.97 [0.93-1.00] 3% improvement 1 metformin COVID-19 hospitalization result c19early.com/mf Dec 5, 2021 Tau​2​ = 0.00; I​2​ = 0.0%; Z = 1.71 Favors metformin Favors control 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 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​ = 75.5% Prophylaxis 16% 0.84 [0.76-0.93] 519/2,890 1,706/7,218 16% improvement All studies 15% 0.85 [0.77-0.94] 551/3,107 1,733/7,424 15% improvement 10 metformin COVID-19 serious outcomes c19early.com/mf Dec 5, 2021 Tau​2​ = 0.01; I​2​ = 74.1%; Z = 3.04 Effect extraction pre-specified Favors metformin Favors control 0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Huh 4% 0.96 [0.82-1.12] population-based cohort Improvement, RR [CI] Treatment Control Holt -27% 1.27 [0.72-2.22] 12/429 434/14,798 Tau​2​ = 0.00; I​2​ = 0.0% Prophylaxis 3% 0.97 [0.88-1.07] 12/429 434/14,798 3% improvement All studies 3% 0.97 [0.88-1.07] 12/429 434/14,798 3% improvement 2 metformin COVID-19 case results c19early.com/mf Dec 5, 2021 Tau​2​ = 0.00; I​2​ = 0.0%; Z = 0.64 Favors metformin Favors control 0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Reis (DB RCT) 4% 0.96 [0.85-1.10] viral+ 217 (n) 206 (n) Improvement, RR [CI] Treatment Control Tau​2​ = 0.00; I​2​ = 0.0% Early treatment 4% 0.96 [0.85-1.10] 0/217 0/206 4% improvement All studies 4% 0.96 [0.84-1.09] 0/217 0/206 4% improvement 1 metformin COVID-19 viral clearance result c19early.com/mf Dec 5, 2021 Tau​2​ = 0.00; I​2​ = 0.0%; Z = 0.59 Favors metformin Favors control 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 All studies -15% 1.15 [0.71-1.85] 32/217 27/206 -15% improvement 1 metformin COVID-19 Randomized Controlled Trials c19early.com/mf Dec 5, 2021 Tau​2​ = 0.00; I​2​ = 0.0%; Z = 0.58 Effect extraction pre-specified Favors metformin Favors control 0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ 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 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​ = 75.5% Prophylaxis 16% 0.84 [0.76-0.93] 519/2,890 1,706/7,218 16% improvement All studies 16% 0.84 [0.76-0.93] 519/2,890 1,706/7,218 16% improvement 9 metformin COVID-19 peer reviewed trials c19early.com/mf Dec 5, 2021 Tau​2​ = 0.01; I​2​ = 75.5%; Z = 3.25 Effect extraction pre-specified Favors metformin Favors control 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 Reis (DB RCT) -18% 1.18 [0.74-1.89] hosp./ER 217 (n) 206 (n) Reis (DB RCT) 4% 0.96 [0.85-1.10] viral+ 217 (n) 206 (n) Luo 75% 0.25 [0.07-0.84] death 3/104 22/179 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 Bramante 24% 0.76 [0.60-0.96] death 1,129 (n) 2,173 (n) Bramante -3% 1.03 [0.84-1.27] death 1,204 (n) 1,750 (n) Huh -1% 1.01 [0.75-1.37] progression 104/272 774/2,533 Huh 4% 0.96 [0.82-1.12] cases population-based cohort 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 Wander 2% 0.98 [0.92-1.06] ICU Wander 3% 0.97 [0.94-1.01] hosp. metformin COVID-19 outcomes c19early.com/mf Dec 5, 2021 Favors metformin Favors control
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