DIET & NUTRITION 
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GUIDELINES/RECOMMENDATIONS Could metformin be the unexpected weapon in our arsenal against long COVID?
Emerging research points to a potential game-changer in managing the prolonged effects of COVID-19. A familiar drug, metformin, when administered early during acute COVID-19 infection, appears to notably reduce the incidence of long COVID.
Key Points:
- A two-week course of metformin administered within three days of a positive SARS-CoV-2 test resulted in 40% fewer long covid diagnoses over the subsequent ten months compared to placebo.
- The randomized controlled trial included 1,126 participants, tested positive for SARS-CoV-2 within the past three days, and were not previously infected or hospitalized for COVID-19.
- The participants were overweight or obese, thus having a higher risk for severe COVID-19. Median age was 45 years; 44% were male and 56% were female.
- The cumulative incidence of long COVID by day 300 was 6.3% in the metformin group, compared to 10.4% in the placebo group.
- The impact of metformin seemed stronger when initiated within three days of symptom onset.
Additional Points:
- Other tested drugs, ivermectin and fluvoxamine, did not decrease the risk of long COVID.
- The trial did not assess metformin’s efficacy in treating existing long COVID.
- The mechanism by which metformin reduces long COVID incidence remains unknown but it may involve hindering SARS-CoV-2 viral replication.
- The study excluded individuals with a BMI under 25 and those under 30 years old; thus, the results may not apply to these populations.
Conclusion:
- This research marks the first suggestion that drugs administered during acute COVID-19 infection could potentially diminish the risk of long covid. Metformin’s wide availability, low cost, and safety profile make it a promising intervention, pending further confirmation.
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