Metformin & Long COVID: Prevention Across Risk Groups – Trials

Metformin Substantially Reduces Risk of Long COVID, Landmark Trials Show

A widely used medication, metformin, has emerged as a potential breakthrough in the fight against long COVID, with multiple randomized clinical trials and electronic health record studies demonstrating a significant reduction in risk when taken during or shortly after acute SARS-CoV-2 infection. The findings, published in Clinical Infectious Diseases on January 29, 2026, offer a promising new avenue for preventing the debilitating long-term effects of COVID-19.

Researchers at the University of minnesota medical School have synthesized data from several studies encompassing individuals with varying risk profiles – from low to high – and consistently found that early metformin treatment prevents the advancement of long COVID.On average, the research indicates that for every 50 cases of acute SARS-CoV-2 treated with 14 days of metformin, one case of long COVID is prevented.

Did you know? – Metformin is an oral medication commonly prescribed for type 2 diabetes. It improves the body’s sensitivity to insulin and lowers glucose production in the liver.

“Metformin has emerged as the first intervention to prevent long COVID in low to high risk adults and across multiple clinical trials and high-quality electronic health record studies,” stated a lead researcher. “This body of evidence means that starting metformin at the time of infection can reduce the risk of long COVID for most adults who get COVID-19 today.”

further analysis of the research reveals several key benefits beyond long COVID prevention:

• Compared to a placebo, metformin significantly decreases SARS-CoV-2 viral load and prevents viral rebound.
• Metformin is the first intervention tested in two large, placebo-controlled, randomized trials across diverse risk groups, including those with prior infection.
• Two studies included participants also receiving FDA-approved SARS-CoV-2 treatments like nirmatrelvir-ritonavir, molnupiravir, and remdesivir, suggesting potential synergistic effects.
• The medication is generally well-tolerated by most adults, though consultation with a clinician is advised.
• Metformin administered during acute COVID-19 is safe and does not induce hypoglycemia or serious adverse effects.

Pro tip – Early treatment is key.Metformin appears most effective when started at the time of COVID-19 infection or shortly thereafter.

The research team emphasizes that these findings apply to the majority of adults currently contracting COVID-19. Metformin can be utilized as a standalone treatment or in conjunction with other acute infection therapies. However, the study notes a critical gap in knowledge: the efficacy of metformin in preventing long COVID in pediatric populations remains unknown, as does it’s ability to treat long COVID in both adults and children.

Reader question – While metformin shows promise, it’s not a substitute for vaccination. Staying up-to-date on COVID-19 vaccines remains the best defense against infection.

The study, led by Carolyn T. Bramante and colleagues, provides a compelling case for considering metformin as a proactive intervention against the growing threat of long COVID. The full study,”Preventing Long COVID With Metformin,” is available in clinical Infectious Diseases (DOI: 10.1093/cid/ciaf

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