Gynecology & Obstetrics
Open Access

Abstract

Use of metformin for COVID-19 treatment in pregnant individuals

Sarah L. Fenno1*, Jennifer L. Thompson2, Carolyn T. Bramante1,3, Jacinda M. Nicklas4

Pregnant individuals have been excluded from participation in the randomized trials currently in the guidelines for outpatient COVID-19 treatment during pregnancy. However, there has been a randomized trial of outpatient COVID-19 treatment that found metformin to be effective in preventing hospitalizations and death in pregnant individuals. COVIDOUT was a phase 3, quadruple-blinded, placebo-controlled randomized clinical trial assessing the outpatient treatment of COVID-19 with three medications. Because the trial published the results of all three medications in the same paper, this striking result in pregnant individuals was only visible in the supplementary appendix and has therefore understandably been missed by committees writing guidelines for outpatient COVID-19 treatment. According to guideline recommendation rating schemes, metformin meets AI criteria for being added to outpatient treatment guidelines for COVID-19. Metformin is safe for use during pregnancy and lactation, inexpensive, widely available, and should be added to outpatient COVID-19 treatment guidelines during pregnancy.

Published Date: 2024-12-05; Received Date: 2024-11-16