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

Vanderbilt Institute for Clinical and Translational Research (VICTR) -Identifying correlates of functional immunity in SARS-CoV-2 convalescent plasmaUL1TR002243 · NCATS · VANDERBILT UNIVERSITY MEDICAL CENTER · PI Paul A. Harris, Wesley H Self · 2017 to 2026
$130.7M
UCLA Clinical Translational Science InstituteUL1TR001881 · NCATS · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI ARLEEN F. BROWN, ARASH NAEIM · 2016 to 2026
$118.1M
Clinical and Translational Science InstituteUL1TR001872 · NCATS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI COLLARD, HAROLD R, JACOBY, VANESSA · 2016 to 2025
$112.1M
Project-005UL1TR001445 · NCATS · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI BREDELLA, MIRIAM ANTOINETTE, HOCHMAN, JUDITH S · 2015 to 2025
$103.5M
Yale Clinical and Translational Science Award (U Component)UL1TR001863 · NCATS · YALE UNIVERSITY · PI John H. Krystal, LUCILA OHNO-MACHADO · 2016 to 2026
$102.9M
Phenotypic Diversity in COVID-19UL1TR001878 · NCATS · UNIVERSITY OF PENNSYLVANIA · PI FITZGERALD, GARRET A · 2016 to 2025
$102.4M
Transform Dissemination and Implementation Science in CTSA ProgramsUL1TR002319 · NCATS · UNIVERSITY OF WASHINGTON · PI John K. Amory · 2017 to 2026
$100.0M
Clinical and Translational Science AwardUL1TR001873 · NCATS · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI REILLY, MUREDACH P · 2016 to 2025
$99.0M
WU INSTITUTE OF CLINICAL AND TRANSLATIONAL SCIENCESUL1TR002345 · NCATS · WASHINGTON UNIVERSITY · PI William G. Powderly · 2017 to 2026
$97.8M
The Harvard Clinical and Translational Science CenterUL1TR002541 · NCATS · HARVARD MEDICAL SCHOOL · PI NADLER, LEE MARSHALL · 2018 to 2022
$93.0M
Implementing a Maternal health and PRegnancy Outcomes Vision for Everyone (IMPROVE)UL1TR002378 · NCATS · EMORY UNIVERSITY · PI Andres J Garcia, Elizabeth O. Ofili · 2017 to 2026
$92.1M
UC San Diego Clinical and Translational Research InstituteUL1TR001442 · NCATS · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI FIRESTEIN, GARY S, HOGARTH, MICHAEL · 2015 to 2024
$88.3M
Bill & Melinda Gates Foundation INV-018455NCATS NIH HHS U24 TR002306NCATS NIH HHS UL1 TR001409NCATS NIH HHS UL1 TR001412NCATS NIH HHS UL1 TR001414NCATS NIH HHS UL1 TR001420NCATS NIH HHS UL1 TR001422NCATS NIH HHS UL1 TR001425NCATS NIH HHS UL1 TR001427NCATS NIH HHS UL1 TR001430NCATS NIH HHS UL1 TR001433NCATS NIH HHS UL1 TR001436NCATS NIH HHS UL1 TR001439NCATS NIH HHS UL1 TR001442NCATS NIH HHS UL1 TR001445NCATS NIH HHS UL1 TR001449NCATS NIH HHS UL1 TR001450NCATS NIH HHS UL1 TR001453NCATS NIH HHS UL1 TR001855NCATS NIH HHS UL1 TR001860NCATS NIH HHS UL1 TR001863NCATS NIH HHS UL1 TR001866NCATS NIH HHS UL1 TR001872NCATS NIH HHS UL1 TR001873NCATS NIH HHS UL1 TR001876NCATS NIH HHS UL1 TR001878NCATS NIH HHS UL1 TR001881NCATS NIH HHS UL1 TR001998NCATS NIH HHS UL1 TR002001NCATS NIH HHS UL1 TR002003NCATS NIH HHS UL1 TR002014NCATS NIH HHS UL1 TR002240NCATS NIH HHS UL1 TR002243NCATS NIH HHS UL1 TR002319NCATS NIH HHS UL1 TR002345NCATS NIH HHS UL1 TR002366NCATS NIH HHS UL1 TR002369NCATS NIH HHS UL1 TR002373NCATS NIH HHS UL1 TR002377NCATS NIH HHS UL1 TR002378NCATS NIH HHS UL1 TR002384NCATS NIH HHS UL1 TR002389NCATS NIH HHS UL1 TR002489NCATS NIH HHS UL1 TR002494NCATS NIH HHS UL1 TR002529NCATS NIH HHS UL1 TR002535NCATS NIH HHS UL1 TR002537NCATS NIH HHS UL1 TR002538NCATS NIH HHS UL1 TR002541NCATS NIH HHS UL1 TR002544NCATS NIH HHS UL1 TR002550NCATS NIH HHS UL1 TR002553NCATS NIH HHS UL1 TR002556NCATS NIH HHS UL1 TR002645NCATS NIH HHS UL1 TR002649NCATS NIH HHS UL1 TR002733NCATS NIH HHS UL1 TR002736NCATS NIH HHS UL1 TR003015NCATS NIH HHS UL1 TR003017NCATS NIH HHS UL1 TR003096NCATS NIH HHS UL1 TR003098NCATS NIH HHS UL1 TR003107NCATS NIH HHS UL1 TR003142NCATS NIH HHS UL1 TR003167NIAID NIH HHS K01 AI182501NIDDK NIH HHS R01 DK130351NIGMS NIH HHS U54 GM104938NIGMS NIH HHS U54 GM104940NIGMS NIH HHS U54 GM104941NIGMS NIH HHS U54 GM104942NIGMS NIH HHS U54 GM115371NIGMS NIH HHS U54 GM115428NIGMS NIH HHS U54 GM115458NIGMS NIH HHS U54 GM115516NIGMS NIH HHS U54 GM115677
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

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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 OpenQuestion graph.