HealthDay News — Outpatient treatment with metformin reduces the incidence of long COVID, especially when started within 3 days of symptom onset, according to a study published online in The Lancet Infectious Diseases.

Carolyn T. Bramante, MD, from the University of Minnesota in Minneapolis, and colleagues conducted a randomized trial involving adults aged 30 to 85 years with overweight or obesity who had COVID-19 symptoms for fewer than 7 days and a documented severe acute respiratory syndrome coronavirus 2-positive polymerase chain reaction or antigen test within 3 days before enrollment. Participants were randomly assigned to receive metformin plus ivermectin, metformin plus fluvoxamine, metformin plus placebo, ivermectin plus placebo, fluvoxamine plus placebo, or placebo plus placebo. Data were included for 1126 patients who received a dose of study treatment, consented for long-term follow-up, and completed at least 1 survey after assessment for long COVID at day 180 (564 and 562 received metformin and matched placebo, respectively).

The researchers found that by day 300, the cumulative incidence of long COVID was 6.3% among participants who received metformin and 10.4% among those who received placebo (hazard ratio, 0.59). The beneficial effect of metformin was consistent across prespecified subgroups. The hazard ratio was 0.37 when metformin was started within three days of symptom onset. No effect was seen on the cumulative incidence of long COVID with ivermectin or fluvoxamine vs placebo.

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“Long COVID is a significant public health emergency that may have lasting physical health, mental health, and economic impacts, especially in socioeconomically marginalized groups,” Bramante said in a statement. “There is an urgent need to find potential treatments and ways to prevent this disease.”

Several authors disclosed ties to the biopharmaceutical industry.

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