Update on COVID-19 strains epidemic in America and Metformin for COVID-19 treatment and Long COVID prevention

On June 10, 2023 Assoc. Prof. Dr. Thira Worathanarat or “Doctor Thira“Faculty of Medicine Chulalongkorn University Facebook post about the issue “COVID-19“Indicates that update knowledge of COVID-19

COVID-19 strains epidemic in America

Data from the US CDC up to 10 June 2023 assessed that Omicron subspecies XBB.1.5 Still occupying the proportion of the main epidemic at 39.9%, with a continuous downward trend.

while the subspecies XBB.1.16 increased to 18.2%, with a tendency to continue to increase as well

The next one is XBB.1.9.1 at 12.5%.

followed by XBB.1.16.1 and XBB.1.9.2, which were found in the same proportion of 8.4%.

and XBB.2.3, another variant under Monitoring (VUM) that the World Health Organization monitors, was also found at 6%.

the above characteristics Suffice it to point out the trend of species change in America. That should be more similar to Australasia in the coming quarters.

Some scientists, such as Weiland JP, have estimated that this could result in more hospitalizations in the US as well, with increases in 1.16.x, 1.9.x, 2.3.

Metformin for COVID-19 Treatment and Long COVID Prevention

According to research published in the New England Journal of Medicine last year, it reduced the risk of getting sick to the emergency department. hospital stay and death was approximately 42% (confidence range from 6%-65%).

Most recently, research published in The Lancet Infectious Diseases two days ago. Metformin was also studied and found to reduce the viral load in the blood. And most importantly, it can reduce the risk of Long COVID by about 40% by the incidence rate.Long COVID problem At 300 days after infection It was 10.4% in the drug-free group, while 6.3% in the drug-treated group.

If you calculate the Number needed to treat, it will be about 25, meaning that if you use the drug for 25 people, it will reduce the risk of Long COVID for 1 person.

The research above was studied in a population aged 30-85 years who were obese. or overweight Having a body mass index (BMI) of 25 or higher

The dose used is Metformin (500 mg) 1 tablet on the first day, then increased to 1 tablet twice a day. From day 2-5, continue with 1 morning pill and 2 evening pills for 14 days. The drug should be started within 3 days after the onset of illness.

However, the limitation of the above study results is It cannot be used for other populations under 30 years of age, including people with normal body weight. or have a body mass index less than 25

Metformin is now of interest to medical professionals around the world. Because there is standard research data that proves the properties step by step and the price is cheap, although the mechanism explaining the properties is still unclear. But laboratory data suggests that the drug inhibits the replication of the disease virus.COVID-19 which suggests that this mechanism may play a role in reducing the risk of severe illness and reducing the risk of Long COVID

refer

1. Randomized Trial of Metformin, Ivermectin, and Fluvoxamine for Covid-19. NEJM. 18 August 2022.

2. Outpatient treatment of COVID-19 and incidence of post-COVID-19 condition over 10 months (COVID-OUT): a multicentre, randomised, quadruple-blind, parallel-group, phase 3 trial. The Lancet Infectious Diseases. 8 June 2023.

3. Covid-19: Metformin reduces the risk of developing long term symptoms by 40%, study finds. BMJ. 8 June 2023.