I went back to the original article in The Lancet and that didn’t make much more sense than the summary.
Metformin is a long-acting drug that smooths insulin levels and reduces sugar levels for people with Type-2 diabetes. Diabetes and obesity were two of many factors found to trigger higher levels of acuity with COVID cases, up to death. Of course, there were and continue to be many examples of perfectly healthy individuals with zero “co-morbidity” factors who were also afflicted with acute COVID illness and / or subsequent long-haul COVID. (Remember, many people with now-debilitating long COVID often did not have terribly severe initial infections…)
The study itself didn’t identify a biological theory on why metformin was selected along with ivermectin or fluvoxamine for inclusion in the test. Were they thought to help reduce inflammation as the immune system attempted to fight a novel virus signature not previously seen? Were they thought to minimize damage to other systems while the body rid itself of the core COVID virus, thus reducing long-lasting aftereffects (while being useless after-the-fact)?
The study also only involved patients who a) took the course of drugs DURING their original acute COVID infection (whether hospitalized or at home) and b) were willing to submit to follow-up reviews remotely. The study kicked off in May 2021 and ended January 28, 2022 so patients with variants common outside of that time interval may have issues not reflected in the base of patients who enrolled in the study during that interval.
Consider the variations:
- original “classic COVID” – December 2019
- alpha – December 2020 in Britain
- beta – December 2020 in South Africa
- delta – late 2020 in India – biggest variant until omicron
- omicron – November 2021 in Botswana / South Africa
From a calendar perspective, this study would have likely collected data from “delta” patients. At that point, there were already tens of thousands of patients of prior variants already experiencing long COVID issues.
While existing vaccines (and booster modifications) were effective at combatting these variants, the fact that these variants differed substantially in infection rates and severity of original infection illness suggests each variant was capable of unique damage to infected patients. Extrapolating results from a patient group with delta to the full population of infected patients with five variants seems dubious from a scientific standpoint.
Given such attention getting results for metformin helping to AVOID long COVID, it would be useful to know if any organization is executing a study to administer metformin to EXISTING long COVID patients to see if it helps mitigate / eliminate existing cases. One theory for long COVID is that long COVID patients have trace levels of the virus still in their system which escapes detection of tests but is still enough to trigger continued inappropriate responses from the immune system. If clinicians are just going to throw treatments against a wall in random combinations and measure results to see if something sticks for AVODING long COVID, they might as well try the same for “CURING” it.
Most doctors are still blowing off patients with long haul symptoms as they did with CFE patients. Recent statistics show 107,204,117 unique COVID cases in the US with 1,116,924 deaths. That (cases) - (deaths) delta would be 106,087,193 survivors but the same page shows a figure of 105,349,072 “recovered.” That implies 738,121 people “not recovered,” presumably because of lingering long-haul symptoms.
I think the number is WAY higher than that. Most GPs and most health care plans have zero clue about long COVID or organized programs for people to consult for help. And the range of impacts is so wide that “recovery” is not well defined. If you are bed-ridden, unable to perform physical work for more than five minutes, etc., sure – you have long COVID. What if you have brain fog? Random, uncontrolled racing heart rhythm? Shortness of breath. Chronic pain? Drastically increased allergy sensitivities? Out of 107 million total cases, I would bet there are at least 5 million Americans with long COVID ailments that have impaired their ability to work by between 10 and 30 percent. That might not seem acute but if you have to work on your feet all day, do critical think work as a medical / legal / technical professional, etc., those might as well be career ending impairments.
Early on in the COVID epidemic, I read something (probably in The Atlantic or The New Yorker) from a doctor on the front lines who said the world lost several months by focusing on treating COVID as a RESPIRATORY disease threat when it was apparent from some of the more shocking extended ICU cases that the root problem was inflammatory in nature. Once exposed to the novel virus, the immune system over-reacted and was doing things that impaired organs throughout the body – lungs for sure but heart, kidneys, brain, pancreas, etc. While we have drugs that have effectively halted transmission and infection, the fact that we still don’t understand the biology that COVID exploits to trigger so much damage is discouraging to say the least.