Evidence mapPaperPMID 39287394Full record

ArticleDiabetes care2024

Prevalent Metformin Use in Adults With Diabetes and the Incidence of Long COVID: An EHR-Based Cohort Study From the RECOVER Program.

Steven G Johnson, Sajjad Abedian, Til Stürmer, Jared D Huling, Colby Lewis V, John B Buse, Shari B Brosnahan, Praveen C Mudumbi, Kristine M Erlandson, Grace A McComsey and 9 more

Abstract read
In one paragraph

Article in Diabetes care, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 1 pooled it
field-weighted citation impact
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

10 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Guideline
  2. Article
  3. Article
  4. 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
  5. Review
  6. Review
  7. Article
  8. Article
  9. Oxidative stress is a shared characteristic of ME/CFS and Long COVID.Proceedings of the National Academy of Sciences of the United States of America · 2025
    Article
  10. 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

19 authors.

Steven G JohnsonInstitute for Health Informatics, University of Minnesota, Minneapolis, MN.ORCID 0000-0002-2983-6384
Sajjad AbedianInformation Technologies and Services Department, Weill Cornell Medicine, New York, NY.
Til StürmerDepartment of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC.
Jared D HulingDivision of Biostatistics and Health Data Science, University of Minnesota School of Public Health, Minneapolis, MN.
Colby Lewis VDepartment of Population Health Sciences, Weill Cornell Medicine, New York, NY.
John B BuseDivision of Endocrinology, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC.ORCID 0000-0002-9723-3876
Shari B BrosnahanDepartment of Medicine, New York University Grossman School of Medicine, New York, NY.
Praveen C MudumbiDepartment of Population Health, New York University Grossman School of Medicine, New York, NY.
Kristine M ErlandsonUniversity of Colorado, Anschutz Medical Campus, Aurora, CO.
Grace A McComseyCase Western Reserve University, Cleveland, OH.
Jonathan ArnoldDivision of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA.
Talia D WiggenInstitute for Health Informatics, University of Minnesota, Minneapolis, MN.
Rachel WongDepartment of Biomedical Informatics and the Department of Internal Medicine, Stony Brook University, Stony Brook, NY.
Shawn MurphyMass General Brigham, Boston, MA.
Clifford RosenMaineHealth Institute for Research, Scarborough, ME.
Rainu KaushalDepartment of Population Health Sciences, Weill Cornell Medicine, New York, NY.
Mark G WeinerDepartment of Population Health Sciences, Weill Cornell Medicine, New York, NY.
Carolyn BramanteDivision of General Internal Medicine, Department of Medicine, University of Minnesota Medical School, Minneapolis, MN.
RECOVER PCORnet EHR Cohort and the N3C Consortium

Funding

OTA-21-015A Post-Acute Sequelae of SARS-CoV-2 Infection Initiative: NYU Langone Health Clinical Science Core, Data Resource Core, and PASC Biorepository CoreOT2HL161847 · NHLBI · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · 2021 to 2025
$481.6M
North Carolina Translational and Clinical Sciences Institute (NC TraCS)UM1TR004406 · UNIV OF NORTH CAROLINA CHAPEL HILL · 2025 to 2025
$8.6M
Clinical and Translational Science Collaborative of Northern Ohio, Catalyzing Linkages for Everyone's Health (CLE Health)UM1TR004528 · CASE WESTERN RESERVE UNIVERSITY · 2025 to 2025
$7.9M
University of Minnesota Clinical and Translational Science Institute (UMN CTSI)UM1TR004405 · UNIVERSITY OF MINNESOTA · 2025 to 2025
$7.7M
Pilot & Feasibility ProgramP30DK124723 · WAKE FOREST UNIVERSITY HEALTH SCIENCES · 2025 to 2025
$1.6M
Propensity scores and preventive drug use in the elderlyR01AG056479 · UNIV OF NORTH CAROLINA CHAPEL HILL · 2025 to 2025
$558k
NCATS NIH HHS U24 TR002306NCATS NIH HHS UM1 TR004405NCATS NIH HHS UM1 TR004406NCATS NIH HHS UM1TR004406NCATS NIH HHS UM1 TR004528NC Diabetes Research Center P30DK124723NHLBI NIH HHS OT2 HL161847NHLBI NIH HHS OT2HL16184701NIA NIH HHS AG056479NIA NIH HHS R01 AG056479NIDDK NIH HHS DK124654NIDDK NIH HHS K23 DK124654NIDDK NIH HHS P30 DK124723
6 · The paper itself

Abstract

objectiveStudies show metformin use before and during SARS-CoV-2 infection reduces severe COVID-19 and postacute sequelae of SARS-CoV-2 (PASC) in adults. Our objective was to describe the incidence of PASC and possible associations with prevalent metformin use in adults with type 2 diabetes mellitus (T2DM). RESEARCH DESIGN AND

methodsThis is a retrospective cohort analysis using the National COVID Cohort Collaborative (N3C) and Patient-Centered Clinical Research Network (PCORnet) electronic health record (EHR) databases with an active comparator design that examined metformin-exposed individuals versus nonmetformin-exposed individuals who were taking other diabetes medications. T2DM was defined by HbA1c ≥6.5 or T2DM EHR diagnosis code. The outcome was death or PASC within 6 months, defined by EHR code or computable phenotype.

resultsIn the N3C, the hazard ratio (HR) for death or PASC with a U09.9 diagnosis code (PASC-U09.0) was 0.79 (95% CI 0.71-0.88; P < 0.001), and for death or N3C computable phenotype PASC (PASC-N3C) was 0.85 (95% CI 0.78-0.92; P < 0.001). In PCORnet, the HR for death or PASC-U09.9 was 0.87 (95% CI 0.66-1.14; P = 0.08), and for death or PCORnet computable phenotype PASC (PASC-PCORnet) was 1.04 (95% CI 0.97-1.11; P = 0.58). Incident PASC by diagnosis code was 1.6% metformin vs. 2.0% comparator in the N3C, and 2.1% metformin vs. 2.5% comparator in PCORnet. By computable phenotype, incidence was 4.8% metformin and 5.2% comparator in the N3C and 24.7% metformin vs. 26.1% comparator in PCORnet.

conclusionsPrevalent metformin use is associated with a slightly lower incidence of death or PASC after SARS-CoV-2 infection. PASC incidence by computable phenotype is higher than by EHR code, especially in PCORnet. These data are consistent with other observational analyses showing prevalent metformin is associated with favorable outcomes after SARS-CoV-2 infection in adults with T2DM.

Indexed as

COVID-19Diabetes Mellitus, Type 2Electronic Health RecordsHypoglycemic AgentsMetforminAdultAgedCohort StudiesFemaleHumansIncidenceMaleMiddle AgedRetrospective StudiesSARS-CoV-2Hypoglycemic AgentsMetformin

Identifiers

PMID39287394
PMCPMC11502533

What Socratic holds

Texttitle and abstract
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.