Diabetes drug Metformin may lower risk of COVID-19 death in diabetic women

Researchers have found in an observational study that diabetes drug Metformin may lower risk of COVID-19 death in women.

Type2 diabetes (T2DM) and obesity are significant risks for mortality in Covid19. Metformin has been hypothesized as a treatment for COVID19. Metformin has sex specific immunomodulatory effects which may elucidate treatment mechanisms in COVID-19

Women taking the widely used oral diabetes medication metformin may be at lower risk for fatal COVID-19, according to a study posted on Saturday that has not yet been peer-reviewed. Among more than 6,200 adults with diabetes or obesity and commercial insurance who were hospitalized with COVID-19, there were fewer deaths among women who had filled their 90-day metformin prescriptions than among those not taking the medicine. After adjusting for other risk factors, they were roughly 21% to 24% less likely to die of the disease. The link was not seen in men. "We know that metformin has different effects between men and women. In the diabetes prevention trial, metformin reduced CRP (the inflammation marker C-reactive protein) twice as much in women as men," study coauthor Carolyn Bramante of the University of Minnesota told Reuters. Metformin also decreases levels of TNF-alpha, an inflammation protein that appears to make COVID-19 worse, she said. Studies have suggested metformin may bring down TNF-alpha levels to a greater extent in women than in men, she added. "The fact that we saw the benefit in women only, and the fact that metformin lowers TNF-alpha in female mice, might suggest that the TNF-alpha effects of metformin are why it helps in COVID-19," Bramante said.

This sex-specific finding is consistent with metformin reducing TNF-alpha in females over males, and suggests that metformin conveys protection in Covid-19 through TNF-alpha effects. Prospective studies are needed to understand mechanism and causality.

Metformin is a safe, cheap and widely available medicine, making it "a very realistic treatment" if proven in larger trials, she added.

For further reference log on to:

https://doi.org/10.1101/2020.06.19.20135095