ReviewBiomedicine & pharmacotherapy = Biomedecine & pharmacotherapie2021
Metformin to decrease COVID-19 severity and mortality: Molecular mechanisms and therapeutic potential.
Review in Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 3 of them syntheses that pooled 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.
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.
Who cites it
44 citing papers in PubMed, 3 syntheses or guidelines pooled it, 61 citations in OpenAlex.
- Diabetes Mellitus and COVID-19 in Adults: A Systematic Review of Pathophysiological Connections, Clinical Outcomes, and Therapeutic Considerations.International journal of molecular sciences · 2026Pooled it
- Metformin for Treatment of Acute COVID-19: Systematic Review of Clinical Trial Data Against SARS-CoV-2.Diabetes care · 2023Pooled it
- Efficacy of interferon alpha for the treatment of hospitalized patients with COVID-19: A meta-analysis.Frontiers in immunology · 2023Pooled it
- SARS-CoV-2 Spike Protein as a Target of the COVID-19 Vaccine Disrupts Insulin Signaling in Type 2 Diabetes.MedComm · 2025Article
- Future horizons in diabetes treatment: hypoglycemic activity of [1,2,4]triazino[2,3-Frontiers in endocrinology · 2025Article
- Expression of metabolic genes in NK cells is associated with clinical outcomes in patients with severe COVID-19: a brief report.Frontiers in cellular and infection microbiology · 2025Article
- Metabolic reprogramming in viral infections: the interplay of glucose metabolism and immune responses.Frontiers in immunology · 2025Review
- Unlocking the gut-liver axis: microbial contributions to the pathogenesis of metabolic-associated fatty liver disease.Frontiers in microbiology · 2025Review
- Review
- Metformin use and its association with various outcomes in COVID-19 patients with diabetes mellitus: a retrospective cohort study in a tertiary care facility.Annals of medicine · 2024Article
- Targeting senescent cells in aging and COVID-19: from cellular mechanisms to therapeutic opportunities.Cell regeneration (London, England) · 2024Review
- Exploring the Efficacy of Alpha-Lipoic Acid in Comorbid Osteoarthritis and Type 2 Diabetes Mellitus.Nutrients · 2024Article
- Diabetes and Osteoarthritis: Exploring the Interactions and Therapeutic Implications of Insulin, Metformin, and GLP-1-Based Interventions.Biomedicines · 2024Review
- Anti-Inflammatory Potential of the Anti-Diabetic Drug Metformin in the Prevention of Inflammatory Complications and Infectious Diseases Including COVID-19: A Narrative Review.International journal of molecular sciences · 2024Review
- Metformin Inhibits Zika Virus Infection in Trophoblast Cell Line.Current microbiology · 2024Article
- Metformin Alters mRNA Expression ofViruses · 2024Article
- Article
- The role of SARS-CoV-2-mediated NF-κB activation in COVID-19 patients.Hypertension research : official journal of the Japanese Society of Hypertension · 2024Review
- Exploring Paxlovid Efficacy in COVID-19 Patients with MAFLD: Insights from a Single-Center Prospective Cohort Study.Viruses · 2024Article
- Genomic insight into COVID-19 severity in MAFLD patients: a single-center prospective cohort study.Frontiers in genetics · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The COVID-19 pandemic caused by the coronavirus SARS-CoV-2 has become a serious challenge for medicine and science. Analysis of the molecular mechanisms associated with the clinical manifestations and severity of COVID-19 has identified several key points of immune dysregulation observed in SARS-CoV-2 infection. For diabetic patients, factors including higher binding affinity and virus penetration, decreased virus clearance and decreased T cell function, increased susceptibility to hyperinflammation, and cytokine storm may make these patients susceptible to a more severe course of COVID-19 disease. Metabolic changes induced by diabetes, especially hyperglycemia, can directly affect the immunometabolism of lymphocytes in part by affecting the activity of the mTOR protein kinase signaling pathway. High mTOR activity can enhance the progression of diabetes due to the activation of effector proinflammatory subpopulations of lymphocytes and, conversely, low activity promotes the differentiation of T-regulatory cells. Interestingly, metformin, an extensively used antidiabetic drug, inhibits mTOR by affecting the activity of AMPK. Therefore, activation of AMPK and/or inhibition of the mTOR-mediated signaling pathway may be an important new target for drug therapy in COVID-19 cases mostly by reducing the level of pro-inflammatory signaling and cytokine storm. These suggestions have been partially confirmed by several retrospective analyzes of patients with diabetes mellitus hospitalized for severe COVID-19.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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 OpenQuestion graph.