Metformin does not speed up COVID-19 recovery

Treatment with metformin does not appear to shorten the time to symptom resolution in low-risk patients with COVID-19, according to the ACTIV-6* trial.

ACTIV-6 included 2,991 participants at least 30 years of age (median age 47 years, 63.4 percent female, 80.1 percent White) with confirmed SARS-CoV-2 infection and two or more COVID-19 symptoms for ≤7 days, recruited across 90 US sites.

The participants were randomly assigned to receive metformin titrated to 1,500 mg daily (n=1,443) or placebo (n=1,548) for 14 days. Time to sustained recovery (3 consecutive days without COVID-19 symptoms) within 28 days of receiving the study drug was assessed as the primary outcome. Secondary outcomes included time to clinic visit, emergency department (ED) visit, hospitalization, or death. Safety events of interest were hypoglycaemia and lactic acidosis.

Time to sustained recovery did not significantly differ between the metformin and placebo groups, at a median of 9 and 10 days, respectively (adjusted hazard ratio, 0.96, 95 percent credible interval [CrI], 0.89–1.03; p=0.11).

Clinic visits, ED visits, or hospitalization were reported in 54 patients in the metformin group and 49 in the placebo group (hazard ratio, 1.25, 95 percent CrI, 0.82–1.78; p=0.13). None of the patients died.

Serious adverse events occurred in seven patients in the metformin group and three in the placebo group over 180 days. There were two and four episodes of participant-reported hypoglycaemia in the respective groups.

*Accelerating COVID-19 Therapeutic Interventions and Vaccines