U of M is strengthening the case for treating COVID-19 with metformin, not ivermectin

Patients with COVID-19 had lower viral loads when treated with metformin, according to new research from the University of Minnesota that argues for wider use of the cheap anti-diabetes drug and against the controversial use of ivermectin.

The findings published Thursday helped connect the dots and explain why metformin reduced the risk of COVID-related hospitalizations or development of long-term COVID illness in a U-led clinical trial. The amount of virus in patients is often linked to the severity of illness and complications, and was found to be almost four times lower in patients in the study taking metformin than on non-drug placebo pills.

The results “could be a tipping point” that convinces doctors to prescribe metformin to treat COVID, said Dr. Carolyn Bramante, the drug trial’s lead investigator. “But people don’t want to be wrong,” so she predicted that many will wait for the results of a larger, federally funded drug trial called ACTIV-6.

The results of the U study also showed that metformin users were less likely to see a recovery in their viral load within 10 days, which could also be an indicator of the development of post-COVID complications, or long COVID.

Researchers on the U-led study, called COVID-OUT, found no statistically significant evidence of lower viral loads in participants taking ivermectin, an antiparasitic drug championed by some doctors, politicians and vaccine skeptics. A third drug, fluvoxamine, also showed no benefit.

All three drugs had been identified as promising targets early in the pandemic, but a computer simulation of the United States highlighted metformin for its potential to disrupt the life cycle of the coronavirus that causes COVID-19.

Metformin’s benefits seemed statistically stronger in unvaccinated participants, but the drug also seemed to work in vaccinated participants. It also reduced viral loads in those infected with the alpha, delta or omicron coronavirus variants that caused marked COVID-19 waves during the three years of the pandemic.

COVID has become something of an afterthought in 2024. The number of hospitalizations related to the infectious disease has fallen sharply since December, according to Thursday’s state update. Signs of the coronavirus in Minnesota wastewater samples were at their lowest levels since August.

COVID-19-related deaths have fallen from 113 in February in Minnesota, to 62 in March, and to 40 so far in April — almost all among seniors. Health officials warned that this is still an elevated death rate that has just been normalized by the earlier severity of the pandemic.

Long COVID also remains a concern, with federal survey data showing more than 7% of Minnesota adults were dealing with the lingering condition last month.

Federal health officials earlier this year urged people 65 and older who are most at risk for severe COVID-19 to seek additional vaccine boosters. The uptake was slow; The most recent state data showed only 3% of seniors were up to date on COVID vaccinations since the last recommendations.