Evidence mapPaperPMID 37339345Full record

SynthesisDiabetes care2023

Metformin for Treatment of Acute COVID-19: Systematic Review of Clinical Trial Data Against SARS-CoV-2.

Spencer M Erickson, Sarah L Fenno, Nir Barzilai, George Kuchel, Jenna M Bartley, Jamie Nicole Justice, John B Buse, Carolyn T Bramante

Open access · bronzeAbstract readSystematic Review
In one paragraph

Synthesis in Diabetes care, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed, 4 pooled it
3.1field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

19 citing papers in PubMed, 4 syntheses or guidelines pooled it, 20 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Article
  6. Effect of Metformin on the Risk of Post-COVID-19 Condition Among Individuals With Overweight or Obese: A Population-based Retrospective Cohort Study.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026
    Article
  7. Review
  8. Article
  9. Review
  10. Article
  11. Article
  12. Review
  13. Article
  14. Coordination chemistry suggests that independently observed benefits of metformin and ZnBiometals : an international journal on the role of metal ions in biology, biochemistry, and medicine · 2024
    Article
  15. Article
  16. Article
  17. Review
  18. Article
  19. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 6 institutions in 1 country.

Spencer M Erickson1University of Minnesota Medical School, Minneapolis, MN.ORCID 0000-0003-0220-4712
Sarah L Fenno1University of Minnesota Medical School, Minneapolis, MN.
Nir Barzilai2Institute for Aging Research, Albert Einstein College of Medicine, Bronx, NY.
George Kuchel3UConn Center on Aging, University of Connecticut Health Center, Farmington, CT.
Jenna M Bartley3UConn Center on Aging, University of Connecticut Health Center, Farmington, CT.
Jamie Nicole Justice4Sticht Center for Healthy Aging and Alzheimer's Prevention, Wake Forest University School of Medicine, Winston-Salem, NC.
John B Buse5Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC.
Carolyn T Bramante6Division of General Internal Medicine, Department of Medicine, University of Minnesota Medical School, Minneapolis, MN.ORCID 0000-0001-5858-2080
UConn Health · USUniversity of Minnesota Medical Center · USAlbert Einstein College of Medicine · USUniversity of Minnesota · USUniversity of North Carolina at Chapel Hill · USWake Forest University · US

Funding

NYR-Diabetes Research Center (NYR-DRC)P30DK020541 · ALBERT EINSTEIN COLLEGE OF MEDICINE · 2025 to 2025
$2.4M
NIDDK NIH HHS K23 DK124654NIDDK NIH HHS P30 DK020541
6 · The paper itself

Abstract

backgroundObservational and preclinical data suggest metformin may prevent severe coronavirus disease 2019 (COVID-19) outcomes. PURPOSE: We conducted a systematic review of randomized, placebo-controlled clinical trials of metformin treatment for COVID-19 to determine whether metformin affects clinical or laboratory outcomes in individuals infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and present a structured summary of preclinical data. STUDY SELECTION: Two independent reviewers searched PubMed, Scopus, Cochrane COVID-19 Study Register, and ClinicalTrials.gov on 1 February 2023 with no date restrictions for trials where investigators randomized adults with COVID-19 to metformin versus control and assessed clinical and/or laboratory outcomes of interest. The Cochrane Risk of Bias 2 tool was used to assess bias. DATA EXTRACTION: Two reviewers extracted data pertaining to prespecified outcomes of each interest from each included trial. DATA SYNTHESIS: The synthesis plan was developed a priori and was guided by Synthesis Without Meta-analysis (SWiM) guidelines. Summary tables and narrative synthesis were used (PROSPERO, 2022, CRD42022349896). Three randomized trials met inclusion criteria. In two of the trials investigators found that metformin improved clinical outcomes (prevented need for oxygen and prevented need for acute health care use), and in the third trial a larger portion of adults with diabetes were enrolled but results did show a direction of benefit similar to that of the other trials in the per-protocol group. In the largest trial, subjects were enrolled during the delta and omicron waves and vaccinated individuals were included. The certainty of evidence that metformin prevents health care use due to COVID-19 was moderate per Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria. Many preclinical studies have shown metformin to be effective against SARS-CoV-2. LIMITATIONS: Limitations include inclusion of only three trials and heterogeneity between trials.

conclusionsFuture trials will help define the role of metformin in COVID-19 treatment guidelines.

Indexed as

COVID-19MetforminAdultBiasCOVID-19 Drug TreatmentHumansSARS-CoV-2Metformin

Identifiers

PMID37339345
PMCPMC10300519
OpenAlexW4381327193

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.