Elnaz Shaseb
1,2 
, Saba Ghaffary
2,3* , Alireza Garjani
2, Elnaz Zoghi
4, Nasrin Maleki Dizaji
2, Somaieh Soltani
2, Parvin Sarbakhsh
5, Mohammad Hossein Somi
6, Parya Valizadeh
7, Ali Taghizadieh
8, Masood Faghihdinevari
6, Mojtaba Varshochi
9, Behrooz Naghily
9, Zhinous Bayatmakoo
9, Parviz Saleh
9, Sepehr Taghizadeh
9, Mehdi Haghdoost
9, Hamid Owaysi
9, Fatemeh Ravanbakhsh Ghavghani
9, Mohammad Kazem Tarzamni
10, Rojin Moradi
10, Fateme Javan Ali Azar
11, Saeid Shabestari Khiabani
1, Ardavan Ghazanchaei
12, Sana Hamedani
2, Shahabeddin Hatefi
21 Department of Pharmacotherapy, Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
2 Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran.
3 Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
4 Faculty of Pharmacy, Tehran University of Medical Sciences, Tabriz, Iran.
5 Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
6 Liver and Gastrointestinal Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
7 School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
8 Tuberculosis and Lung Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
9 Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
10 Department of Radiology, Medical Radiation Sciences Research Group, Imam Reza Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.
11 Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
12 Imam Reza Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.
Abstract
Purpose: The aim of the study is to evaluate the effect of metformin in complication improvement of hospitalized patients with COVID-19.
Methods: This was a randomized clinical trial that involved 189 patients with confirmed COVID-19 infection. Patients in the intervention group received metformin-500 mg twice daily. Patients who received metformin before admission were excluded from the control group. Patients who were discharged before taking at least 2000 mg of metformin were excluded from the study. Primary outcomes were vital signs, need for ICU admission, need for intubation, and mortality.
Results: Data showed that patients with diabetes with previous metformin in their regimen had lower percentages of ICU admission and death in comparison with patients without diabetes (11.3% vs. 26.1% (P=0.014) and 4.9% vs. 23.9% (P≤0.001), respectively). Admission time characteristics were the same for both groups except for diabetes and hyperlipidemia, which were significantly different between the two groups. Observations of naproxen consumption on endpoints, duration of hospitalization, and the levels of spO2 did not show any significant differences between the intervention and the control group. The adjusted OR for intubation in the intervention group versus the control group was 0.21 [95% CI, 0.04-0.99 (P=0.047)].
Conclusion: In this trial, metformin consumption had no effect on mortality and ICU admission rates in non-diabetic patients. However, metformin improved COVID-19 complications in diabetic patients who had been receiving metformin prior to COVID-19 infection, and it significantly lowered the intubation rates.