Diabetes drugs linked to lower long COVID risk
Metformin use was linked to lower relative risk of post-COVID complications, with an adjusted hazard ratio of 0.80 compared with nonusers.
Our read
Populations- Studied:
- Cohort study of 71,698 patients with T2DM and COVID-19, against patients without prior metformin use
- What changed:
- Long COVID risk was lower among prior metformin users than nonusers (adjusted hazard ratio 0.80)
- The catch:
- Body mass index was unavailable for adjustment, leaving a potential confounder unaccounted for
- In the record:
- The 611th paper on metformin with results in people; 2,326 on record in all.
Editor of record: Boris Djordjevic · AgingResearch.News
In Singapore, 71,698 adults with type 2 diabetes and COVID-19 were included in a retrospective observational cohort. After statistical adjustment, metformin comparison groups had a median age of about 60 and were 49% female. Researchers compared people prescribed each drug in the preceding year with people taking other diabetes medicines but not that drug. They tracked newly recorded complications and symptoms 31–300 days after infection.
Metformin use was linked to lower risks of post-COVID complications and symptoms. Prior use of sodium-glucose cotransporter-2 inhibitors, a class of diabetes drugs, was associated with lower risks of brain and nerve complications and post-COVID symptoms. The adjusted hazard ratio for brain and nerve complications was 0.60 versus nonusers, indicating lower relative risk. Among metformin users, concurrent use of the other drug class was also linked to lower risks of these complications and symptoms.
Why it matters
For older adults with type 2 diabetes, the findings bear on whether medicines used to control blood sugar might also help limit lasting illness after COVID-19.
Caveats
Outcomes came from healthcare claims, which may miss unreported problems; differences in who received each drug may also have influenced the links despite adjustment. The cohort excluded people with chronic kidney disease, those who died within 30 days and those reinfected within 300 days.
From the paper
- Participants
A total of 71,698 individuals with T2DM who had a documented COVID-19 infection between July 1, 2021 and February 28, 2023 were included.
- Primary outcome
In the primary outcome analysis, metformin use was associated with a lower risk of composite outcomes (adjusted hazard ratio [aHR] = 0.80, 95% confidence interval [CI] 0.68–0.96, p = 0.0149) and composite symptoms (aHR = 0.77, 95% CI 0.63–0.93, p = 0.0084).
- Limitation
The use of SGLT2i was not randomly assigned, and treatment decisions were made at the discretion of managing physicians, which may have introduced selection bias due to unmeasured confounders.
Quoted word for word from the full text on PubMed Central.
Metformin is part of Bryan Johnson's Blueprint and David Sinclair's daily regimen in Lifespan
The paper
National University Health System; National University of Singapore
Infectious Diseases and Therapy, Jun 3, 2026, Open access
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