Metformin and its analogues as a therapeutic tool for COVID-19: a
narrative review.
Abstract
The new coronavirus (Sars-Cov-2) appeared in China in late 2019 and with
it an intense search for effective pharmacological tools in the
treatment of COVID-19. This virus can cause from mild symptoms, such as
dry cough, fever and tiredness, to more severe symptoms, such as
respiratory failure and systemic shock. Part of this problem is due to
the increase in the neutrophil/lymphocyte ratio and serum levels of
several inflammatory cytokines and chemokines. Other blood markers also
deflagrate the inflammatory condition, among them C-reactive protein,
ferritin and D dimers. Additionally, the history of chronic and/or acute
hyperglycemia is an independent predictor for morbidity and mortality in
patients with severe acute respiratory syndrome. In this pandemic
scenario, numerous new and other drugs already available on the market
have become therapeutic tools. Biguanide class drugs, classically used
in the treatment of type 2 diabetes mellitus, received great notoriety
for potentially useful systemic effects in the clinic, in cardiovascular
level and against cancer. Some of their properties may be useful in the
fight against Sars-Cov-2, such as the reduction of mRNA expression
levels of inflammatory cytokines, chemokines and by the attenuation of
NF-κB activation. These actions reduce the inflammatory response in the
individual and the damage from a severe inflammatory response. Given the
morbidity and mortality, partly attributed to the cardiovascular damage
of the COVID-19, the objective of this work was to review the systemic
effects of biguanides, as well as their therapeutic potential as an
adjuvant.