A Review: How Metformin Improves the Prognosis for Coronavirus Disease-19 Patients with Hypertension?

Background: Hypertension is one of the comorbidities for patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.Hypertension has been shown to increase the severity and mortality of the Coronavirus disease-19 (COVID-19) patients.Metformin has various benefits, such as an antiinflammatory and antiviral agent, which can be used in several diseases including cardiovascular disease.Objectives: We were interested in assessing the potential of metformin in improving the prognosis of COVID-19 patients with hypertension.Methods: Our article reviews use a non-systematic review method.Discussion: Metformin could reduce blood pressure by activating AMP-activated protein kinase (AMPK) signaling through various mechanisms, such as vascular, neural, renal, hormonal, immunological, and insulin resistance mechanisms.Metformin could phosphorylate the angiotensin-converting enzyme 2 (ACE2) expression through AMPK signaling to prevent binding between SARS-CoV-2 and the ACE2 receptor.The AMPK signaling pathway in metformin has been proven to suppress cytokine storms in severe COVID-19 patients.Several observational studies have been published showing improvement in the prognosis among COVID-19 patients with metformin use.Conclusion: Metformin can improve the prognosis of COVID-19 with comorbid hypertension.