Metformin and Covid-19: Focused Review of Mechanisms and Current Literature Suggesting Benefit

Sherehan Ibrahim, Jamie R. Lowe, Carolyn T. Bramante, Surbhi Shah, Nichole R. Klatt, Nancy Sherwood, Louis Aronne, Michael Puskarich, Leonardo Tamariz, Ana Palacio, Eric Bomberg, Michael Usher, Samantha King, Brad Benson, Deneen Vojta, Chris Tignanelli, Nicholas Ingraham

Research output: Contribution to journalReview articlepeer-review

29 Scopus citations


Metformin is the first-line medication for type 2 diabetes, but it also has a long history of improved outcomes in infectious diseases, such as influenza, hepatitis C, and in-vitro assays of zika. In the current Covid-19 pandemic, which has rapidly spread throughout the world, 4 observational studies have been published showing reduced mortality among individuals with home metformin use. There are several potential overlapping mechanisms by which metformin may reduce mortality from Covid-19. Metformin’s past anti-infectious benefits have been both against the infectious agent directly, as well as by improving the underlying health of the human host. It is unknown if the lower mortality suggested by observational studies in patients infected with Covid-19 who are on home metformin is due to direct activity against the virus itself, improved host substrate, or both.

Original languageEnglish (US)
Article number587801
JournalFrontiers in Endocrinology
StatePublished - Jul 22 2021

Bibliographical note

Funding Information:
1. This research was supported by the Agency for Healthcare Research and Quality (AHRQ) and Patient-Centered Outcomes Research Institute (PCORI), grant K12HS026379 (CJT).

Publisher Copyright:
© Copyright © 2021 Ibrahim, Lowe, Bramante, Shah, Klatt, Sherwood, Aronne, Puskarich, Tamariz, Palacio, Bomberg, Usher, King, Benson, Vojta, Tignanelli and Ingraham.


  • COVID-19
  • mechanisms of action
  • metformin
  • microbiome
  • obesity

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review


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