Your browser doesn't support javascript.
loading
Favorable Antiviral Effect of Metformin on SARS-CoV-2 Viral Load in a Randomized, Placebo-Controlled Clinical Trial of COVID-19.
Bramante, Carolyn T; Beckman, Kenneth B; Mehta, Tanvi; Karger, Amy B; Odde, David J; Tignanelli, Christopher J; Buse, John B; Johnson, Darrell M; Watson, Ray H B; Daniel, Jerry J; Liebovitz, David M; Nicklas, Jacinda M; Cohen, Ken; Puskarich, Michael A; Belani, Hrishikesh K; Siegel, Lianne K; Klatt, Nichole R; Anderson, Blake; Hartman, Katrina M; Rao, Via; Hagen, Aubrey A; Patel, Barkha; Fenno, Sarah L; Avula, Nandini; Reddy, Neha V; Erickson, Spencer M; Fricton, Regina D; Lee, Samuel; Griffiths, Gwendolyn; Pullen, Matthew F; Thompson, Jennifer L; Sherwood, Nancy E; Murray, Thomas A; Rose, Michael R; Boulware, David R; Huling, Jared D.
Afiliación
  • Bramante CT; General Internal Medicine, University of Minnesota, Minneapolis, Minnesota, USA.
  • Beckman KB; Genomics Center, University of Minnesota, Minneapolis, Minnesota, USA.
  • Mehta T; Division of Biostatistics and Health Data Science, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA.
  • Karger AB; Department of Laboratory Medicine and Pathology, Medical School, University of Minnesota, Minneapolis, Minnesota, USA.
  • Odde DJ; Department of Biomedical Engineering, University of Minnesota, Minneapolis, Minnesota, USA.
  • Tignanelli CJ; Department of Surgery, Medical School, University of Minnesota, Minneapolis, Minnesota, USA.
  • Buse JB; Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA.
  • Johnson DM; Genomics Center, University of Minnesota, Minneapolis, Minnesota, USA.
  • Watson RHB; Genomics Center, University of Minnesota, Minneapolis, Minnesota, USA.
  • Daniel JJ; Genomics Center, University of Minnesota, Minneapolis, Minnesota, USA.
  • Liebovitz DM; General Internal Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
  • Nicklas JM; General Internal Medicine, University of Colorado, School of Medicine, Aurora, Colorado, USA.
  • Cohen K; UnitedHealth Group, Optum Labs, Minnetonka, Minnesota, USA.
  • Puskarich MA; Emergency Medicine, Hennepin County Medical Center, Minneapolis, Minnesota, USA.
  • Belani HK; Department of Medicine, Olive View-University of California, Los Angeles, California, USA.
  • Siegel LK; Division of Biostatistics and Health Data Science, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA.
  • Klatt NR; Department of Surgery, Medical School, University of Minnesota, Minneapolis, Minnesota, USA.
  • Anderson B; Atlanta Veterans Affairs Medical Center, Atlanta, Georgia, USA.
  • Hartman KM; Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
  • Rao V; General Internal Medicine, University of Minnesota, Minneapolis, Minnesota, USA.
  • Hagen AA; General Internal Medicine, University of Minnesota, Minneapolis, Minnesota, USA.
  • Patel B; General Internal Medicine, University of Minnesota, Minneapolis, Minnesota, USA.
  • Fenno SL; General Internal Medicine, University of Minnesota, Minneapolis, Minnesota, USA.
  • Avula N; General Internal Medicine, University of Minnesota, Minneapolis, Minnesota, USA.
  • Reddy NV; General Internal Medicine, University of Minnesota, Minneapolis, Minnesota, USA.
  • Erickson SM; General Internal Medicine, University of Minnesota, Minneapolis, Minnesota, USA.
  • Fricton RD; General Internal Medicine, University of Minnesota, Minneapolis, Minnesota, USA.
  • Lee S; General Internal Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
  • Griffiths G; General Internal Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
  • Pullen MF; General Internal Medicine, University of Minnesota, Minneapolis, Minnesota, USA.
  • Thompson JL; Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA.
  • Sherwood NE; Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
  • Murray TA; Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA.
  • Rose MR; Division of Biostatistics and Health Data Science, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA.
  • Boulware DR; Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
  • Huling JD; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Clin Infect Dis ; 79(2): 354-363, 2024 Aug 16.
Article en En | MEDLINE | ID: mdl-38690892
ABSTRACT

BACKGROUND:

Metformin has antiviral activity against RNA viruses including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The mechanism appears to be suppression of protein translation via targeting the host mechanistic target of rapamycin pathway. In the COVID-OUT randomized trial for outpatient coronavirus disease 2019 (COVID-19), metformin reduced the odds of hospitalizations/death through 28 days by 58%, of emergency department visits/hospitalizations/death through 14 days by 42%, and of long COVID through 10 months by 42%.

METHODS:

COVID-OUT was a 2 × 3 randomized, placebo-controlled, double-blind trial that assessed metformin, fluvoxamine, and ivermectin; 999 participants self-collected anterior nasal swabs on day 1 (n = 945), day 5 (n = 871), and day 10 (n = 775). Viral load was quantified using reverse-transcription quantitative polymerase chain reaction.

RESULTS:

The mean SARS-CoV-2 viral load was reduced 3.6-fold with metformin relative to placebo (-0.56 log10 copies/mL; 95% confidence interval [CI], -1.05 to -.06; P = .027). Those who received metformin were less likely to have a detectable viral load than placebo at day 5 or day 10 (odds ratio [OR], 0.72; 95% CI, .55 to .94). Viral rebound, defined as a higher viral load at day 10 than day 5, was less frequent with metformin (3.28%) than placebo (5.95%; OR, 0.68; 95% CI, .36 to 1.29). The metformin effect was consistent across subgroups and increased over time. Neither ivermectin nor fluvoxamine showed effect over placebo.

CONCLUSIONS:

In this randomized, placebo-controlled trial of outpatient treatment of SARS-CoV-2, metformin significantly reduced SARS-CoV-2 viral load, which may explain the clinical benefits in this trial. Metformin is pleiotropic with other actions that are relevant to COVID-19 pathophysiology. CLINICAL TRIALS REGISTRATION NCT04510194.
Asunto(s)
Palabras clave

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Antivirales / Carga Viral / SARS-CoV-2 / COVID-19 / Tratamiento Farmacológico de COVID-19 / Metformina Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Clin Infect Dis Asunto de la revista: DOENCAS TRANSMISSIVEIS Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Antivirales / Carga Viral / SARS-CoV-2 / COVID-19 / Tratamiento Farmacológico de COVID-19 / Metformina Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Clin Infect Dis Asunto de la revista: DOENCAS TRANSMISSIVEIS Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos