Evidence map›Paper›PMID 42465953›Full record

ArticlemedRxiv : the preprint server for health sciences2026

Metformin and Severe Post-COVID-19 Outcomes Among Individuals with Diabetes Mellitus.

Zachary Butzin-Dozier, Lin-Chiun Wang, Yunwen Ji, A Jerrod Anzalone, Oluwasolape Olawore, Ryan Hafen, Eric Hurwitz, Manav Kumar, Rena C Patel, Ariana Budhihartanto and 10 more

Abstract readPreprint
PubMed Full text at PMC Publisher
In one paragraph

Article in medRxiv : the preprint server for health sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

20 authors.

Zachary Butzin-DozierStanford University School of Medicine, Stanford, CA, USA.ORCID 0000-0001-6419-0008
Lin-Chiun WangSchool of Public Health, University of California, Berkeley, Berkeley, CA USA.
Yunwen JiSchool of Public Health, University of California, Berkeley, Berkeley, CA USA.
A Jerrod AnzaloneUniversity of Nebraska Medical Center, Omaha, NE, USA.
Oluwasolape OlaworeUniversity of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Ryan HafenPurdue University, West Lafayette, IN, USA.
Eric HurwitzUniversity of North Carolina at Chapel Hill, Chapel Hill, NC, USA.ORCID 0000-0002-6581-7754
Manav KumarSchool of Public Health, University of California, Berkeley, Berkeley, CA USA.
Rena C PatelUniversity of Alabama at Birmingham, Birmingham, AL, USA.
Ariana BudhihartantoSchool of Public Health, University of California, Berkeley, Berkeley, CA USA.
Mark van der LaanSchool of Public Health, University of California, Berkeley, Berkeley, CA USA.
John M ColfordSchool of Public Health, University of California, Berkeley, Berkeley, CA USA.
Alan E HubbardSchool of Public Health, University of California, Berkeley, Berkeley, CA USA.ORCID 0000-0002-3769-0127
John B BuseUniversity of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Steven JohnsonUniversity of Minnesota, Minneapolis, MN, USA.
Jane ReuschUniversity of Colorado, Anschutz, Aurora, CO, USA.
Lauren E ChanUniversity of Chicago, Chicago, IL, USA.
Richard MoffittRenaissance School of Medicine, Stony Brook University, New York, NY, USA.ORCID 0000-0003-2723-5902
Rachel WongRenaissance School of Medicine, Stony Brook University, New York, NY, USA.
Carolyn BramanteUniversity of Minnesota, Minneapolis, MN, USA.ORCID 0000-0001-5858-2080

Funding

Applying a Targeted Machine Learning and Causal Inference Approach to Analyzing Long-Term Sequelae of COVID-19 Infection Through the National COVID Cohort Collaborative.K01AI182501 · UNIVERSITY OF CALIFORNIA BERKELEY · 2025 to 2025
$56k
NIAID NIH HHS K01 AI182501NIDDK NIH HHS R01 DK130351
6 · The paper itself

Abstract

Background: Metformin is one of the most commonly prescribed medications for individuals with diabetes and may provide protection against long-term sequelae of COVID-19. Methods: We evaluated a retrospective cohort of individuals in the National Clinical Cohort Collaborative with type 2 diabetes mellitus and COVID-19 who were prescribed metformin or a dipeptidyl peptidase-4 inhibitor (DPP4i) at least 30 days before the onset of acute COVID-19 between October 1, 2021, and November 15, 2023. We compared the 12-month cumulative incidence of Long COVID diagnosis (ICD-10 U09.9: Post COVID-19 condition, unspecified), probable Long COVID (based on a model-derived phenotype), and mortality between individuals prescribed metformin vs. DPP4i. We applied Super Learner and targeted maximum likelihood estimation to obtain risk ratios while adjusting for covariates of interest. Results: In our sample of 53,332 individuals with type 2 diabetes and COVID-19, we found that metformin prescription was associated with a lower risk of all-cause mortality after COVID-19 (adjusted risk ratio [aRR] 0.61, 95% CI 0.51, 0.73). We also observed that metformin users, compared to DPP4i users, had a slightly lower risk of probable Long COVID (aRR 0.87, 95% CI 0.81, 0.94) but did not detect a significant relationship with Long COVID diagnosis (aRR 0.90, 95% CI 0.68, 1.20), although we observed similar point estimates across Long COVID outcomes. Conclusions: These findings support the hypothesis that metformin prescription during acute COVID-19 may be associated with lower mortality among adults with diabetes. These analyses also provide modest evidence of a protective association against Long COVID in adults with diabetes, although estimates were imprecise.

Identifiers

PMID42465953
PMCPMC13370604

What Socratic holds

Textmetadata
LicenceCC BY
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Registered trials

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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.