Share this page!

Enter URL or ID to Unroll

You can paste full URL like: https://x.com/threadreaderapp/status/1644127596119195649
or just the ID like: 1644127596119195649

How to get URL link on X (Twitter) App

  1. On the Twitter thread, click on or icon on the bottom
  2. Click again on or Share Via icon
  3. Click on Copy Link to Tweet
  4. Paste it above and click "Unroll Thread"!
  5. More info at Twitter Help
Noha Aboelata, MD Profile picture
@NohaAboelataMD
Mar 10 • 8 tweets • 4 min read • Read on X
Metformin & Covid. Metformin is widely used, accessible/cheap, and has been around for decades, so we'd love if it could help in our ongoing struggles with covid. So far it looks promising to prevent long covid, and those already on it should continue it during acute c19 infxn.🧵
In the COVID-OUT trial (multicenter randomized quadruple-blind parallel-group phase 3 trial), in 30-85yo's w/"overweight or obesity," Metformin cut the risk of long Covid by ~41%. And when started within 3 days of Covid symptoms, it reduced the incidence of long COVID by ~63%!
Can this be generalized to those not 30-85 or those without "overweight or obesity?" More study is needed, but for those who do fit the criteria, it is certainly compelling.

*Metformin, Ivermectin, or fluvoxamine did not reduce severe acute C19 outcomes. thelancet.com/journals/lanin…
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 Carolyn T Bramante, MD Prof John B Buse, PhD David M Liebovitz, MD Jacinda M Nicklas, MD Michael A Puskarich, MD Ken Cohen, MD et al. Published:June 08, 2023 DOI:https://doi.org/10.1016/S1473-3099(23)00299-2
Next, this RCT pre-print shows that Metformin reduced SARS-CoV-2 viral load 3.6-fold! This could explain why Metformin is effective in LC. Or it could be because of Metformin’s known ability to reduce inflammation. Or something else. More study is needed. medrxiv.org/content/10.110…
Metformin reduces SARS-CoV-2 in a Phase 3 Randomized Placebo Controlled Clinical Trial
If you're interested in participating in such research, the ACTIV-6 study is actively enrolling folks 30+ yo who tested positive for covid less than 10 days ago and have at least 2 symptoms. No guarantee you won't get placebo, but something to consider!
activ6study.org
Interested in participating in ACTIV6? We need to know a few things about you before we begin This study is looking for people who are: -are 30 years old or older -Tested positive for COVID-19 less than 10 days ago and -have at least 2 symptoms of COVID-19
And if you're already on Metformin for diabetes or otherwise, it should be continued during acute infection, even if you're hospitalized. (Expert opinion via NIH guidelines, which will be sunsetted in August, so download them if you need them).
covid19treatmentguidelines.nih.gov/therapies/misc…
Recommendations There is insufficient evidence for the COVID-19 Treatment Guidelines Panel (the Panel) to recommend either for or against the use of metformin for the treatment of COVID-19 in nonhospitalized patients. The Panel recommends against the use of metformin for the treatment of COVID-19 in hospitalized patients, except in a clinical trial. Patients with COVID-19 who are receiving metformin for an underlying condition should continue this therapy as directed by their health care provider (AIII).
Especially for those 30-85 yo who are "overweight or obese" by BMI, it might be worth sharing the COVID-OUT trial with your physician as the Metformin results are compelling.

I talked all of this through starting at ~20 min mark in this recent briefing.❤️
I'd like to see more study on this to know if the findings can be reproduced. Til then, many doctors won't be comfortable prescribing it because even though it's pretty safe & well known, all medications have potential side effects/adverse reactions & Metformin is no exception.

• • •

Missing some Tweet in this thread? You can try to force a refresh
　

Keep Current with Noha Aboelata, MD

Noha Aboelata, MD Profile picture

Stay in touch and get notified when new unrolls are available from this author!

Read all threads

This Thread may be Removed Anytime!

PDF

Twitter may remove this content at anytime! Save it as PDF for later use!

Try unrolling a thread yourself!

how to unroll video
  1. Follow @ThreadReaderApp to mention us!

  2. From a Twitter thread mention us with a keyword "unroll"
@threadreaderapp unroll

Practice here first or read more on our help page!

More from @NohaAboelataMD

Noha Aboelata, MD Profile picture
Feb 4
It's sad to see so much venom towards scientists, doctors, and covid-careful individuals on this app - one of the reasons so many have left. I left FB because it became a cesspool of disinformation, and I was impressed with the quality info direct from scientists and docs here.🧵
Having a common enemy - a mutating virus infecting, sickening, and killing so many - should have brought us together. And I think it did for a brief moment. Then, it became highly politicized, and bad actors exploited folks' uncertainty, unfamiliarity, and fear.
And yes, there were many policies and interventions that were polarizing. We can Monday morning quarterback it forever, but we'll never all agree on the right balance between individual freedom and collective responsibility. Sadly, we seem further apart on this point than ever.
Read 11 tweets
Noha Aboelata, MD Profile picture
Jan 28
Despite baked-in racial bias, pulse oximeters continue to be relied upon for covid, qualifying for home oxygen, and more. They're used at home, on ambulances, in clinics and hospitals. The FDA is aware but moving slowly, which is why we filed a lawsuit.🧵
nature.com/articles/d4158…
Image
This lawsuit demands pulse ox manufacturers/distributors fix the devices, label them as to their flaws, or stop selling them in California. But even if we're successful, this doesn't extend beyond CA, and the FDA can continue approving faulty devices as they've done for decades.
No doubt, this flaw has resulted in morbidity and mortality, especially at the height of the pandemic when beds and oxygen were not always available. Yet the device continues to be used and can lead to denial of home oxygen among other treatments. We should all be outraged. 3/6
Read 6 tweets
Noha Aboelata, MD Profile picture
Jan 23
Thank you, @DrJudyStone and @Forbes for interviewing me for this fantastic article about California's shocking move, recklessly encouraging contagious people to go unmasked into schools and pubic places - in the middle of winter no less! 🧵1/4
forbes.com/sites/judyston…
Just 1 contagious child can infect many more in 1 day, let alone coming to school contagious many days in a row! The order admits that the contagious period begins 2 days before symptoms start through 10 days after. There's a buried *recommendation* to mask x 10d. Seriously? 2/4
More platitudes about being "in a better place" and having "the tools" mean little when we still have a mutating virus, worrisome impacts of repeat infection, undervaccination and no real treatment for kids. What's it about? Is this really about improving school attendance? 3/4
Read 4 tweets
Noha Aboelata, MD Profile picture
Jan 20
Thanks, @CalMatters, for interviewing me about these wild new "guidelines" encouraging contagious people to get back to school and work, despite our ability to easily test and prevent much unnecessary spread. Promoting reckless disregard for everyone.🧵1/8
calmatters.org/health/2024/01…
“'Instead of staying home for a minimum of five days, individuals may return to work or school when they start to feel better,' state public health officials said in an unsigned statement."

I wouldn't want to sign it either. 2/
The notion that this is reasonable as long as we're careful around vulnerable people is just 🤯. How do you know who's immunocompromised? What about vulnerable household members? This policy will surely level the playing field - we'll all be made vulnerable at this rate. 3/
Read 8 tweets
Noha Aboelata, MD Profile picture
Jan 19
I haven't said anything about this yet - at first, it was because I was speechless. Then I hoped no one would notice. Now that advocates, reporters, concerned parents, and outraged colleagues have reached out, I see that's not going to be the case.🧵1/7
ktla.com/news/californi…
Contagious people are being encouraged to go to work/school. This decision is not evidence-based, and it clearly does not consider the impacts of long covid, the need for people to rest and recover when sick, or the ramifications of increased transmission such as new variants. 2/
The consistent dialing back of precautions every time we think we're in "a better place" is what keeps up from actually getting to a better place. Zero mention of the burden of repeat infection or risk of long covid. I wonder if they listened to Dr. @zalaly's brilliant testimony.
Read 7 tweets
Noha Aboelata, MD Profile picture
Jan 13
WHO is emerging as more reliable and vocal than any US health leadership on the pandemic, despite its lack of complete data or authority to obtain it. A dramatic turn compared to pre-pandemic times. We've heard repeatedly from WHO during this surge. It's crickets from CDC and WH.
"Whether we acknowledge it or not, the world is still in a pandemic, Van Kerkhove said, citing the virus’s lack of a seasonal pattern...and its continued, rapid-pace evolution."

fortune.com/well/2024/01/1…
“Five years, 10 years, 20 years from now, what are we going to see in terms of cardiac impairment, pulmonary impairment, neurologic impairment? It’s year five in the pandemic, but there’s still a lot we don’t know about it.”
Read 5 tweets

Did Thread Reader help you today?

Support us! We are indie developers!

This site is made by just two indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3/month or $30/year) and get exclusive features!

Become Premium

Don't want to be a Premium member but still want to support us?

Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal

Or Donate anonymously using crypto!

Ethereum

0xfe58350B80634f60Fa6Dc149a72b4DFbc17D341E copy

Bitcoin

3ATGMxNzCUFzxpMCHL5sWSt4DVtS8UqXpi copy

Thank you for your support!

Follow Us!

Send Email!

:(