Metformin use and decreased risk of severe COVID-19 outcomes in a real-world case-control study

Metformin use has been associated with a lower risk of severe COVID-19 outcomes. The aim of our study was thus to evaluate the effect of metformin use via a population-based study. We conducted a case-control study with real-world data, analysing: (i) risk of hospitalisation, with cases being subjects admitted to hospital with a PCR+ test and controls without a PCR+; (ii) risk of disease progression, including all subjects with a PCR+ test, with cases being hospitalised and controls non-hospitalised subjects; and (iii) risk of susceptibility among subjects with a PCR+ test versus those without a PCR+. Adjusted odds ratios (aOR) and their 95% confidence intervals (95%CIs) were calculated. Our study covered 81,348 subjects. Of these, 29,568 had a PCR+ test, 2753 of whom were admitted to hospital. According to our results, prior metformin use reduces the risk of hospitalisation (aOR 0.70; 95%CI 0.51–0.97) and progression of COVID-19 (aOR 0.66; 95%CI 0.45–0.98) among metformin users when compared with those not taking antidiabetic medication. There were no differences in risk of susceptibility to the SARS-CoV-2 virus (aOR 0.97; 95%CI 0.81–1.16). The results of this large-scale real-world study suggest that by reducing the risk of progression, metformin could provide an appropriate treatment option for combating the advance of COVID-19 to severe outcomes.

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Journal
Scientific Reports
Published
2026-09-11
DOI
https://doi.org/10.1038/s41598-026-68017-4
Primary Topic
Metabolism, Diabetes, and Cancer
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article
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article

Metformin use and decreased risk of severe COVID-19 outcomes in a real-world case-control study

Margarita Taracido, Narmeen Mallah, Adolfo Figueiras, Martina Lema-Oreiro et al.
Scientific Reports
Metabolism, Diabetes, and Cancer
article

Metformin use and decreased risk of severe COVID-19 outcomes in a real-world case-control study

Margarita Taracido, Narmeen Mallah, Adolfo Figueiras, Martina Lema-Oreiro, Eduardo Carracedo‐Martínez, Manuel Portela‐Romero, Almudena Rodríguez-Fernández, Rosa María García-Álvarez, Ángel Salgado‐Barreira, Maruxa Zapata‐Cachafeiro, Ángela Prieto-Campo, María Piñeiro‐Lamas, María Teresa Herdeiro, Irene Visos‐Varela, Samuel Pintos‐Rodríguez, Marc Sáez, Almudena Rodríguez-Fernández, Francisco J. González‐Barcala, Rosendo Bugarín-González, Maria Piñeiro-Lamas
article en

Abstract

Metformin use has been associated with a lower risk of severe COVID-19 outcomes. The aim of our study was thus to evaluate the effect of metformin use via a population-based study. We conducted a case-control study with real-world data, analysing: (i) risk of hospitalisation, with cases being subjects admitted to hospital with a PCR+ test and controls without a PCR+; (ii) risk of disease progression, including all subjects with a PCR+ test, with cases being hospitalised and controls non-hospitalised subjects; and (iii) risk of susceptibility among subjects with a PCR+ test versus those without a PCR+. Adjusted odds ratios (aOR) and their 95% confidence intervals (95%CIs) were calculated. Our study covered 81,348 subjects. Of these, 29,568 had a PCR+ test, 2753 of whom were admitted to hospital. According to our results, prior metformin use reduces the risk of hospitalisation (aOR 0.70; 95%CI 0.51–0.97) and progression of COVID-19 (aOR 0.66; 95%CI 0.45–0.98) among metformin users when compared with those not taking antidiabetic medication. There were no differences in risk of susceptibility to the SARS-CoV-2 virus (aOR 0.97; 95%CI 0.81–1.16). The results of this large-scale real-world study suggest that by reducing the risk of progression, metformin could provide an appropriate treatment option for combating the advance of COVID-19 to severe outcomes.

Scientific Reports
Universidade de Santiago de Compostela (ES), Instituto de Investigación Sanitaria de Santiago (ES), Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (ES), Servicio Gallego de Salud (ES), University of Aveiro (PT)
Instituto de Salud Carlos III
Good health and well-being
Openalex Percentile: Top 18%
Metabolism, Diabetes, and Cancer
DOIOpen Access PDFOpenAlex
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