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Short-term metformin course proves ineffective for Long COVID symptoms in new study

A team of scientists from South Korea, led by Lim et al., recently conducted a randomized, double-blind study utilizing a placebo control. Their objective was to evaluate whether ursodeoxycholic acid (UDCA) or metformin could effectively manage symptoms associated with Long COVID.

Participants were assigned to one of three groups based on a 1:1:1 ratio for a duration of 14 days. During this period, subjects received either a double placebo, a daily intake of 900 mg of UDCA, or oral metformin that was uptitrated to a level of 1500 mg/d.

Upon conclusion of the trial, the findings indicated that neither therapeutic option offered any improvement when compared against the placebo.

The investigation into metformin was especially compelling due to prior evidence. Two earlier clinical trials had established that administering the drug during the acute phase of infection successfully lowered the odds of developing Long COVID. This discrepancy leads to the question: why is metformin effective as a preventative measure but unsuccessful as a treatment for established LC?

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Recent findings indicate that a two-week regimen of metformin does not alleviate symptoms associated with Long COVID.

A research team based in South Korea undertook a randomized, double-blind, and placebo-controlled clinical trial to assess whether ursodeoxycholic acid (UDCA) or metformin could serve as effective treatments for Long COVID.

The study divided participants into three distinct groups using a 1:1:1 ratio. Over a duration of 14 days, individuals were administered either a double placebo, UDCA at a dose of 900 mg once daily, or oral metformin uptitrated to 1500 mg/d.

The final analysis determined that neither pharmaceutical option offered any benefit when compared to the placebo.

Investigating metformin was considered a priority because two previous clinical trials had established that taking the drug during an acute infection reduced the risk of developing Long COVID.

This leads us to ask why metformin appears successful in preventing the condition but fails to treat established cases of LC.

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Update regarding the Long COVID Labs Patient Grant Fund

We wish to inform the community that limited financial resources remain available through our Patient Grant Fund. These funds are designed to assist patients who require support to access necessary care. If financial constraints are preventing you from pursuing a specific treatment for Long COVID, our program aims to bridge that gap.

To apply, please request that your physician submit an application using the following URL:

https://t.co/RC1IFmOiSl

Our funding efforts are primarily concentrated on therapies that address root causes related to SARS-CoV-2 persistence, including immunomodulators, monoclonals, and antivirals.

One specific option we regard as potentially beneficial is the thymosin alpha 1 peptide. While this treatment has not yet been formally studied, our research indicates it may possess antiviral properties that could assist individuals in clearing SARS-CoV-2.

We encourage you to make contact today if you are interested in exploring thymosin alpha 1 or other anti-SARS-CoV-2 therapies. You may reach us by sending a direct message on this platform or by emailing support@longcovidlabs.org

Recent findings have illuminated a compelling link between gut imbalance, known as intestinal dysbiosis, and neurological manifestations in LC cases. The data is quite remarkable. 🦠🧠

For some time, observers have noted that certain patients with Long COVID experience significant recovery leaps when using therapies focused on the microbiome. This latest research offers a plausible scientific rationale for those observations.

A team of Canadian researchers has established that this condition is linked to a distinct microbiome pattern that encourages neuroinflammation. To reach this conclusion, the investigators first mapped the gut characteristics of patients suffering from neurological issues. Subsequently, they obtained stool samples from these individuals and introduced them into mice that were bred to be germ-free.

Following this transplantation, the animals began to suffer from compromised intestinal barriers and displayed symptoms of neuroinflammation.

To determine the cause, the scientists investigated the specific function of gut bacterial extracellular vesicles, known as GBEV. These elements serve as signaling molecules that bacteria in the digestive tract release to interact with peers and modulate their host environment.

Upon analyzing the blood of the mice after the transplant, the team discovered that these circulating GBEVs were the primary agents driving the observed biological alterations.

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New study shows relationship between intestinal dysbiosis and neurological symptoms in LC 🦠🧠

This is pretty impressive!

Over the years, we have seen some Long COVID patients report dramatic improvements with microbiome-based interventions. This study provides a possible explanation as to why.

Here, Canadian researchers demonstrated that Long COVID is associated with a microbiome signature that promotes neuroinflammation.

First, they identified the microbiome profile of LC patients with neurological symptoms.

They then recreated this microbiome profile and transplanted these specific gut microbiota into germ-free mice.

👉After receiving the transplants, the mice developed intestinal barrier disruption and neuroinflammatory symptoms.

Why did this happen?

Specifically, the researchers examined the role of gut bacterial extracellular vesicles (GBEV). These are signalling molecules released by gut bacteria in order to communicate with other and influence their host environment.

Researchers measured these GBEV's in the bloodstream of the mice, post-transplant - and found that the circulating GBEV's are responsible for many of the biological changes observed.

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A recent report by Jason Gale for Bloomberg offers a significant, albeit distressing, perspective on the neurological aftermath of the virus. It is uncommon to find mainstream news outlets covering the pandemic with such gravity in 2026. The piece highlights a condition known as Ondine's curse, a phenomenon where Long COVID patients report that their brains fail to handle respiration automatically, forcing them to breathe consciously. Dr. Avi Nath at the NIH acknowledges this issue as stemming from neurological damage.

Gale details various complications, specifically injury to the brain areas that regulate breathing, drawing on interviews with Dr. Nath and Dr. Tim Henrich, a leading researcher at UCSF. Despite the heavy nature of the reading, there is a silver lining. The article notes that a trial regarding IVIG led by Dr. Nath is expected to wrap up later this year. This treatment offers a potential path forward, as it may help alleviate symptoms by soothing an overactive immune system. While the insights are sobering, it is excellent to see the subject treated with the appropriate level of seriousness.

Featured recently in @bmj_latest Neurology, a team of Australian researchers has developed a unique, non-invasive protocol designed to identify small-fiber neuropathy (SFN) in patients suffering from Long COVID. The authors observed that earlier studies using skin biopsies for diagnosis established a high prevalence of SFN, with one particular study citing a rate of 50%.

Since the biopsy process is invasive, this group aimed to assess more accessible testing options. They formulated a protocol utilizing non-invasive small fibre electrodiagnostic testing, a process where electrodes are applied to the skin to gauge nerve function.

The assessment focused on four key areas: sympathetic skin responses, the cutaneous silent period, quantitative thermal thresholds, and electrochemical skin conductance. These results were then compared against the detection rates of more conventional methods.

Out of the 9 patients included in the study, 3 were found to have SFN. While it is challenging to apply findings from a small cohort of 9 people to the general population, this ratio aligns somewhat with previous data suggesting a 50% diagnosis rate.

The team is encouraged by the outcome, noting that their method successfully detected demonstrable abnormalities in the subgroup of 3 patients. As they move forward, the researchers hope to refine this non-invasive protocol as a research tool, which could significantly improve accessibility for patients seeking diagnosis and treatment for SFN. 🙏

It is highly encouraging to see Long COVID featured across multiple major news platforms throughout this week. The Boston Globe recently highlighted the journey of Samantha Crausman, a severe LC patient currently in her late 20s.

Her narrative is one that many of us recognize all too well. She remains bedbound and must significantly restrict her usage of both physical and cognitive energy. Her relatives take extraordinary measures to safeguard her against reinfection, to the extent that the photographer for the story was only permitted to take pictures from outside her home.

The piece concludes with insights from her father, Rob Crausman, who is a doctor. He draws a comparison to his time as an intern during the bleak early phases of the AIDS epidemic. He shares that a friend diagnosed with HIV back then was expected to pass away, yet that friend lived a happy life and is still doing wonderful things to this day.

In a moving piece for @guardian, Savannah Brooks writes, "Long Covid is still here. I know - my life came to a stop because of it." Her story offers a significant look at the personal toll of Long COVID. 💔

It leads one to wonder about the volume of individuals globally facing similar struggles, regardless of whether they identify the virus as the cause.

In the article, Brooks cites @mtosterholm, an expert in infectious diseases, who inquires:

“How much of [long Covid] has actually disappeared due to recovery? How much of it has disappeared because people just stopped talking about it, tried to move on with their lives?

And then how many don’t even recognize what they have? How many people are living a compromised life, but they don’t recognize why?”

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Dalam diskusi terbaru yang ditampilkan di @guardian, @mtosterholm mengeksplorasi pertanyaan penting mengenai visibilitas Covid panjang. Ia mempertimbangkan apakah kondisi ini benar-benar memudar karena pemulihan pasien, atau jika itu hanya tampak demikian karena masyarakat telah berhenti membahasnya dalam upaya untuk maju. Selain itu, ia menunjukkan bahwa banyak orang mungkin bahkan tidak mengenali gejala mereka dengan benar, yang mengarah pada situasi di mana individu menjalani kehidupan yang terkompromikan tanpa memahami alasan sebenarnya di balik perjuangan mereka.

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Why does Long COVID brain fog seem to affect more patients in the US? (Hint: it’s not what it seems!) 🧠

A recent Northwestern University study surveyed 3,100 long COVID patients from around the world. 🌍

They interviewed patients from:

-Chicago US
-Medellín, Colombia
-Lagos, Nigeria
-Jaipur, India

Surprisingly, they found that patients in the US reported symptoms such as brain fog and mental health effects at much higher rates than patients in the other cities.

86% of non-hospitalized patients in the U.S. reported brain fog. By contrast, brain fog was reported by:

-63% of patients in Nigeria
-62% in Colombia
-and just 15% in India.

When it comes to anxiety or depression, the difference was even more clear:

Nearly 75% of non-hospitalized patients in the U.S. reported depression or anxiety.

By contrast, these symptoms were reported by:

-40% of Colombian patients
-Fewer than 20% of Nigerian and Indian patients

Researchers suspect these differences are not biological. Rather, they believe cultural differences affect who is likely to feel comfortable reporting mental health symptoms to researchers.

In the US, while things are far from perfect, there is more acceptance around mental health. By contrast, patients in other parts of the world are more likely to experience stigma, meaning they’re less likely to feel comfortable disclosing mental health symptoms to researchers.

These cultural nuances are very important for doctors, researchers, and organizations to keep in mind.

We know there are millions of Long COVID patients all over the world in need of proper diagnostics and treatment - and there are likely significant numbers of patients who are not comfortable speaking up about all of the symptoms they’re experiencing.

We can help by continuing to raise awareness about Long COVID, so that doctors internationally are aware of these symptoms and can be on the lookout for patients who need help.

Papers like this one are very important to raise awareness of the scope of the problem. Thank you to Jimenez et al. for this important work!

Here is a fantastic article highlighting the University of California San Francisco. It explores how the research team is applying decades of knowledge gained from HIV studies to the battle against Long COVID. UCSF: Solving Long COVID: How Decades of HIV Research Paved the Way 🙏 👇

Temuan terbaru menunjukkan bahwa mengidentifikasi cedera paru-paru yang berkepanjangan setelah infeksi COVID-19 dapat dicapai melalui skrining darah yang sederhana. 🩸

Penyelidikan yang dilakukan di Inggris mengungkapkan bahwa individu yang menderita ketidaknormalan paru-paru yang berkepanjangan beberapa bulan setelah dirawat di rumah sakit menunjukkan konsentrasi yang meningkat dari dua penanda biologis tertentu. 🧬

Penanda pertama, MMP-7, berperan dalam dekomposisi jaringan saat tubuh berusaha memperbaiki dan membentuk ulang dirinya sendiri. Yang kedua, KL-6, menandakan peradangan atau kerusakan di dalam paru-paru, dengan jumlah yang lebih tinggi biasanya diamati pada mereka yang didiagnosis dengan berbagai bentuk penyakit paru interstisial.

Ketika indikator-indikator ini tetap tinggi, itu menunjukkan kerusakan yang terus-menerus pada epitel, lapisan luar yang rapuh dari organ pernapasan kita. 🫁

Penemuan pola-pola ini memberikan wawasan penting tentang proses biologis yang mendorong gejala pernapasan yang terus dihadapi oleh beberapa individu setelah Covid-19 akut, dan mungkin menawarkan penjelasan mengenai kasus Long COVID juga. 🔎

Memperoleh pemahaman yang lebih jelas tentang mekanisme ini membawa kita lebih dekat untuk mengembangkan terapi yang efektif! 🙌

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@BBC saat ini sedang menampilkan studi Batu Rosetta mengenai MECFS dan Long COVID, yang telah dibiayai dengan £1,1 juta dari @MEAssociation. 🙏👇

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Membuat berita di bidang Long COVID, peneliti UPenn Yong Chen, PhD, baru-baru ini dianugerahi Penghargaan Forum Penelitian Klinis. Penghargaan ini diberikan untuk makalahnya yang berjudul Long COVID Terkait dengan Reinfection SARS-CoV-2 di Antara Anak-anak dan Remaja di Era Omicron (RECOVER-EHR).

Mengenai pemilihan penerima tahun ini, Forum Penelitian Klinis mencatat bahwa 10 studi pemenang penghargaan ini mencerminkan kemajuan besar yang dihasilkan dari investasi negara dalam penelitian untuk manfaat kesehatan dan kesejahteraan warganya. Sangat menggembirakan untuk menyaksikan makalah tentang Long COVID diakui karena memiliki dampak yang begitu mendalam.

Secara khusus, temuan dari studi ini menantang kesalahpahaman yang sering terjadi bahwa reinfeksi kemungkinan besar bersifat jinak atau lebih ringan. Sebaliknya, penelitian menunjukkan bahwa anak-anak dan remaja menghadapi risiko yang jauh lebih tinggi dari berbagai hasil PASC setelah reinfeksi dengan SARS-CoV-2.

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Ada kemajuan yang cukup signifikan yang muncul di bidang terapeutik COVID-19. Traws Pharma saat ini sedang mengembangkan Ratutrelvir, antivirus anti-SARS-CoV-2 baru yang dimaksudkan untuk berfungsi sebagai pengganti potensial untuk Paxlovid.

Organisasi ini telah berhasil menyelesaikan pendaftaran untuk uji klinis fase 2, dengan data sementara menunjukkan bahwa pengobatan memberikan manfaat. Perkembangan ini sangat menggembirakan bagi pasien yang tidak dapat mentolerir Paxlovid. Berbeda dengan pesaingnya, Ratutrelvir diformulasikan tanpa ritonavir, sehingga menghindari masalah keamanan dan efek samping yang sering terkait dengan senyawa tersebut.

Tautan di berikutnya (1/2)

Australia mengalokasikan $120 juta AUD untuk Dana Masa Depan Penelitian Medis (MRFF), dengan inklusi khusus untuk Long COVID!

Ini adalah kabar yang sangat positif! 🙌🙌🙌

Pemerintah Australia secara resmi telah mengumumkan komitmen pendanaan sebesar $120,1M AUD melalui Dana Masa Depan Penelitian Medis (MRFF). Investasi ini ditujukan untuk mendukung 60 proyek penelitian kesehatan dan medis yang fokus pada kemajuan pencegahan, diagnosis, pengobatan, dan perawatan berbagai penyakit.

Secara signifikan, 13 dari proyek ini didedikasikan secara khusus untuk sekuela pasca-akut COVID-19. Inisiatif ini akan menyelidiki penyebab mendasar, mengembangkan diagnosis yang lebih baik, meningkatkan manajemen gejala, dan meneliti pengobatan yang ditargetkan.

Selain penelitian terkait COVID, pendanaan ini akan memfasilitasi 27 uji klinis baru untuk menguji pengobatan untuk kanker langka dan penyakit langka, serta 12 proyek penelitian pernapasan yang bertujuan untuk meningkatkan deteksi dan perawatan kondisi pernapasan kronis.

Lebih lanjut, inisiatif ini mengalokasikan sumber daya untuk 8 proyek yang dirancang untuk mengoptimalkan penggunaan data pasien dalam penilaian teknologi kesehatan. Ini memastikan bahwa wawasan pasien secara efektif menginformasikan keputusan sistem kesehatan dan penyampaian perawatan.

Kami selalu bersyukur melihat pemerintah menangani COVID dan Long COVID dengan keseriusan yang diperlukan. Meskipun penelitian masih tertinggal dari tempat yang seharusnya, bukti ilmiah yang terus berkembang jelas menunjukkan bahwa ini adalah krisis yang memerlukan perhatian mendesak.

Sangat menggembirakan melihat Australia membentuk dana ini—kami menantikan untuk melihat apa yang ditemukan oleh proyek-proyek ini!

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Penelitian baru tentang pemulihan neurologis Long COVID 🧠

Sebuah studi recent yang diterbitkan dalam BMC Neurology memantau orang-orang yang hidup dengan neurologis Long COVID menggunakan aplikasi mobile untuk melacak gejala dan pemulihan secara keseluruhan selama 3 bulan—sekitar satu tahun setelah infeksi COVID awal mereka.

Apa yang ditemukan dalam studi ini?
👉 Sekitar 4 dari 10 orang melaporkan perbaikan bertahap seiring waktu.
👉 Pemulihan sering kali non-linier—naik dan turun adalah hal yang umum, bahkan di antara mereka yang membaik.
👉 Kelompok tertentu, termasuk wanita dan orang-orang dengan kehilangan penciuman atau pengecapan yang persisten, kurang mungkin melaporkan perbaikan selama periode studi.
👉 Mereka yang membaik menunjukkan kecenderungan menuju kecepatan berpikir yang lebih baik dan tidur yang lebih baik.
👉 Peserta merasa bahwa aplikasi pelacakan gejala mudah digunakan dan bermanfaat, menunjukkan bahwa alat digital dapat mendukung perawatan dan penelitian Long COVID.

🔍 Mengapa ini penting:
Studi ini menyoroti betapa bervariasinya dan terindividualisasinya pemulihan neurologis Long COVID, dan mengapa pelacakan gejala yang berkelanjutan serta pengalaman yang dilaporkan pasien sangat penting untuk memahami—dan meningkatkan—perawatan.

📄 Baca makalah akses terbuka lengkapnya: 👇

Berikut adalah komentar yang penuh wawasan dari seorang anggota subreddit Long COVID Labs kami! 👇

Kami baru saja mulai mengungkap peran virus dalam biologi kami. Sementara fokus kami adalah pada COVID-19, virus lain seperti Epstein-Barr kemungkinan menjadi akar dari banyak penyakit! 🦠

Meskipun dampak dari penyakit-penyakit ini sangat menghancurkan, kami bersemangat dengan kemungkinan saat sains menemukan cara baru untuk mencegah dan mengobati infeksi ini! 🙏

Saya sangat menghargai rangkuman komprehensif dari dokumen baru oleh pasien LC dan blogger Brandon! ✨

Tema rangkuman minggu ini menyoroti bahwa "penelitian Long COVID mulai menghubungkan titik-titik yang dulu terasa sepenuhnya terpisah."

Sangat luar biasa ketika kita di komunitas Long COVID dapat mempertahankan harapan dan optimisme—pastikan untuk memeriksa ini! Terima kasih, Brandon, untuk tulisan komprehensifnya! 🙏