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Metformin and UDCA Fail to Help Long COVID Recovery

•Posted inInternal Medicine

Doctors continue to seek an effective Long COVID treatment to manage the persistent symptoms after a SARS-CoV-2 infection. A recent randomized clinical trial explored the potential of metformin and ursodeoxycholic acid (UDCA). However, the findings suggest these medications do not provide the hoped-for relief for patients with Postacute Sequelae of SARS-CoV-2 (PASC). Therefore, the medical community must look elsewhere for definitive solutions.

Current Evidence on Long COVID treatment

The study enrolled 396 adults with significant PASC symptoms in South Korea. Researchers randomly assigned participants to receive either metformin, UDCA, or a double placebo. Each group took the intervention for 14 days. Unfortunately, the results showed no significant difference in recovery rates between the groups. Therefore, clinicians should exercise caution when prescribing these agents for PASC. Furthermore, the safety profile remained consistent with previous data, but efficacy was lacking. Consequently, the search for a definitive therapeutic intervention continues. Doctors must focus on symptom management and supportive care in the interim. Additionally, multi-disciplinary rehabilitation remains a cornerstone of care for these patients.

Frequently Asked Questions

Q1: Did metformin reduce PASC symptoms in the trial?

No, metformin did not show superior recovery rates compared to the placebo group in this clinical study.

Q2: Was UDCA effective for patients with high PASC index scores?

UDCA failed to improve recovery scores significantly during the 14-day treatment period for adults with PASC.

References

  1. Lim SY et al. Neither Metformin nor Ursodeoxycholic Acid Effectively Treats Postacute Sequelae of COVID-19 : A Randomized Clinical Trial. Ann Intern Med. 2026 Mar 03. doi: 10.7326/ANNALS-25-04883. PMID: 41771135.
  2. World Health Organization. Post COVID-19 condition (Long COVID). 2024. Available from: https://www.who.int/news-room/fact-sheets/detail/post-covid-19-condition.
  3. Ministry of Health and Family Welfare, Government of India. National Comprehensive Guidelines for Management of Post-COVID Sequelae. 2025.