Institute of Epidemiology & Health Care


Metformin use in COVID-19 Patients with Diabetes


Metformin is a widely used drug in the management of diabetes, with millions taking it worldwide. Metformin has been shown to have anti-inflammatory effects and can reduce the expression of pro-inflammatory cytokines and chemokines, inhibit or reduce the activities of immune cells such as monocytes and neutrophils. Research has also suggested that metformin, through its activation of adenosine monophosphate-activated protein kinase (AMPK), may cause conformational changes in the ACE2 receptor, which may prevent SARS-CoV-2 entry. The focus of the project is to examine the role of a relatively novel potentially protective factor (metformin use) and the risk of serious illness among older COVID-19 patients with diabetes. Metformin is a relatively inexpensive, safe and widely available drug. Although the proposed research is observational, it provides extensive baseline information on comorbidities.  The UK Biobank and ELSA COVID19 sub-study will represent the main sources of investigation.  If it is found that there is a strong association indicating COVID-19 patients with diabetes who use Metformin have better outcomes, even when baseline differences between users and non-users with diabetes are taken into account, it would generate a great deal of clinical interest. This is a collaborative project between University College London (UCL) and University of Toronto that will expand an existing research collaboration focused on factors associated with negative sequelae of COVID-19 in frail older adults. The current project aims the following:

  1.  To investigate the associations between Metformin use in COVID-19 patients with diabetes and several health outcomes
  2.  To widen the focus of collaborative research to investigate the impact of metformin use on COVID-19 outcomes;
  3.  To fund an international workshop titled ‘COVID-19 Patients with Diabetes’ in London, in October 2021. This workshop aims to enhance the network capacity and collaborations between faculty and students from UCL and University of Toronto.

Principal Investigator (UCL): Dr Dorina Cadar

Principal Investigator (University of Toronto): Prof Esme Fuller-Thompson 

Co-Investigators: Professor Andrew Steptoe (UCL), Professor Lisa McCarthy (University of Toronto), Professor Riyaz Patel (UCL)

Contact: Dr Dorina Cadar at d.cadar@ucl.ac.uk