{"id":14586,"date":"2026-04-15T06:00:00","date_gmt":"2026-04-15T10:00:00","guid":{"rendered":"https:\/\/cov19longhaulfoundation.org\/?p=14586"},"modified":"2026-03-30T13:20:19","modified_gmt":"2026-03-30T17:20:19","slug":"understanding-metformin-use-and-long-covid-and-me-cfs-following-covid-19-infection-insights-from-two-studies","status":"publish","type":"post","link":"https:\/\/cov19longhaulfoundation.org\/?p=14586","title":{"rendered":"Understanding metformin use and Long COVID and ME\/CFS"},"content":{"rendered":"\n

RECOVER researchers shared how the prescription drug metformin may reduce the risk of Long COVID and presented research examining the risk of developing myalgic encephalomyelitis\/chronic fatigue syndrome (ME\/CFS) after a COVID-19 infection.<\/p>\n\n\n\n

A recent RECOVER Research Review (R3) Seminar held May 13 spotlighted research presented by Carolyn Bramante, MD, MPH (University of Minnesota) and Steve Johnson, PhD (University of Minnesota) exploring how metformin, a widely prescribed medication primarily used to manage type 2 diabetes, may help reduce the risk of Long COVID. The seminar also featured a presentation from Suzanne Vernon, PhD (Bateman Horne Center) on research examining the risk of developing myalgic encephalomyelitis\/chronic fatigue syndrome (ME\/CFS) following a COVID-19 infection.<\/p>\n\n\n\n

Drawing from both large-scale electronic health record (EHR) networks and RECOVER\u2019s adult observational study, these studies illustrate critical links among COVID-19, persistent post-viral conditions, and potential prevention strategies involving available pharmaceutical drugs. While metformin\u2019s exact mechanisms are still being explored by researchers, evidence supporting its use during acute COVID-19 infection continues to grow.<\/p>\n\n\n\n

Drs. Bramante<\/a> and Johnson<\/a> led an EHR study analyzing data from the National COVID Cohort Collaborative (N3C) and the National Patient-Centered Clinical Research Network (PCORnet). Their study focused on adults with type 2 diabetes. They compared Long COVID outcomes between individuals already taking metformin and those using other diabetes medications, a type of study design known as \u201cprevalent user, active comparator.\u201d In other words, the researchers aimed to evaluate the association between pre-existing metformin use and the risk of developing Long COVID. Results showed a consistent trend: individuals on metformin were less likely to develop Long COVID compared to those not taking the drug. These findings aligned with earlier clinical trial data, including a randomized controlled study<\/a> conducted by Dr. Bramante and the University of Minnesota\u2019s COVID-OUT Study Team, which reduced Long COVID incidence by 31% through early metformin treatment.<\/p>\n\n\n\n

Dr. Bramante noted that many clinicians remain unaware of metformin\u2019s potential role beyond diabetes management. Although prescribing metformin off-label for COVID-19 prevention is legally permissible, this guidance is not yet reflected in most COVID-19 treatment guidelines\u2014some of which are based on earlier clinical trials with less definitive results.<\/p>\n\n\n\n

Dr. Vernon<\/a> presented research findings<\/a> from the RECOVER adult observational study examining risk of developing ME\/CFS following a COVID-19 infection. ME\/CFS is a chronic, disabling illness that includes symptoms such as severe fatigue; tiredness that gets much worse after physical, mental, or emotional activity; sleep that is not deep or restful; trouble remembering, learning new things, concentrating, or making decisions; and dizziness or other problems resulting from standing upright. Using the 2015 ME\/CFS clinical diagnostic criteria from the National Academy of Medicine (formerly the Institute of Medicine), Dr. Vernon and her team found that:<\/p>\n\n\n\n