Metformin may lower risk of long COVID or death by 53% when prescribed early

A new study published in the Annals of Internal Medicine reveals that half of long COVID patients show improvement within three years of their initial infection. However, the likelihood of recovery varies significantly based on the patient's symptoms. Researchers tracked over 1,000 patients with long COVID, discovering that those whose primary symptoms were changes in their sense of taste or smell had the best outcomes three years after their first positive test.

In contrast, less than 20% of patients with a multisystem presentation, which affects their heart, nervous system, and gastrointestinal tract, showed improvement over the same period.

The study's findings suggest that long COVID may share similarities with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), both of which often arise after an infection and impact multiple bodily systems. This comparison could inform future clinical trials for treatments aimed at long COVID patients, as experts emphasize that different subtypes of the condition may require distinct therapeutic approaches.

The research, conducted as part of the long-term RECOVER Adult Study funded by the National Institutes of Health, involved patients who scored more than 10 points on a 30-point symptom scale, known as the 2024 LC Research Index. Out of nearly 1,020 participants, 36% experienced improvement two years after their COVID-19 infection, and this figure increased to 50% after three years.

Some patients, however, still had their LCRI scores at zero after three years, indicating complete symptom resolution. It's important to note that the study did not track potential relapses among patients who initially showed improvement.

The study also identified that men and women had similar improvement rates, while younger adults under 46 were more likely to recover than older participants. Those affected by the Omicron variant of SARS-CoV-2, which became the dominant strain in 2021, were more likely to improve than those infected with earlier strains. Dr. Carmen Scheibenbogen, an immunologist at Charité University Medicine Berlin, noted that patients in the multisystem subgroup, which had the lowest improvement rate of 19%, might be experiencing a condition similar to ME/CFS, suggesting that these individuals could benefit from treatments aimed at ME/CFS.

The study underscores the need for targeted clinical trials to develop effective treatments for long COVID, considering the diverse symptom profiles and underlying mechanisms of the condition.