DeCure's autonomous AMR AI scientist is researching a drug-repurposing hypothesis for long COVID-19 — screening already-approved drugs against its 33-gene Open Targets disease module to publish open-access research. Research is fast; the path to publication is funded in milestone stages.
Disease moduleLong COVID-19 maps to a 33-gene Open Targets module — the target space DeCure's AI scientist screens approved drugs against.
DeCure.ai methodSignature reversal (LINCS) plus network proximity (STRING) rank already-approved drugs likely to perturb this module — the same engine that produces DeCure.ai's repurposing hypotheses.
Repurposing thesisScreening approved medicines against this disease module, then publishing the evidence for the strongest candidate. Known pharmacology and human exposure data make the first question sharper — they do not establish safety or efficacy in a new indication.
Research record
01
ResearchComing soon
Candidate research + dossier — target rationale, drug-repurposing thesis and evidence pack.proof: Published dossier + on-chain hash
02
ValidationComing soon
In-vitro biological validation at a contract research org (CRO).proof: CRO contract + in-vitro report
03
Peer review & paperComing soon
Peer-reviewed paper published open-access (preprint + journal).proof: DOI + open-access link + on-chain hash
Current lead
approvedMetforminApproved drug
Structures already discussed alongside long covid-19 in the retrieved literature, rendered from public PubChem SMILES. Which drugs appear here reflects the evidence found, not a ranked prediction.
Molecular view
Crystal structure of human CYP3A4 — Metformin has a real, experimentally solved structure in complex with this target (PDB 5G5J, 2.6 Å). This is the drug's own deposited structure, not a prediction, and confirms it is a structurally characterised molecule rather than an untested guess.
Loading structure…
helix sheet mf8drag to rotate · scroll to zoom
RCSB Protein Data Bank · entry 5G5J · 2.6 Å · ligand Metformin (MF8). Experimental structure, not a prediction.
What the evidence adds up to
A 2023 retrospective study of 571 type 2 diabetes patients among 4330 confirmed COVID-19 cases in Wuhan found that the 241 who received metformin had lower in-hospital mortality and less need for invasive mechanical ventilation. In the multivariate model, metformin use was linked to a decreased risk of death (HR 0.376, 95% CI 0.154–0.922, P = 0.033). A 2022 review of retrospective analyses noted that most studies reported improved clinical outcomes—reduced admission to intensive care and reduced mortality—among type 2 diabetes patients treated with metformin at the time of hospitalisation for COVID-19. The same review cautioned that reports of increased acidosis and lactic acidosis in patients with more severe COVID-19 mean metformin should be withdrawn in those with hypoxaemia or acute renal disease.
A 2020 computational study using molecular docking found that chloroquine phosphate and other repurposed antiviral drugs attached to the SARS-CoV-2 protease enzyme in silico, and proposed these drugs as candidates after further testing. A 2021 editorial described the lack of effective treatment for COVID-19 at the start of the pandemic and the major health and socio-economic consequences that followed, but provided no new data.
A 2006 study of 48 myasthenia gravis patients who received tacrolimus and prednisone after thymectomy reported complete stable remission in 33.4% of patients overall and in 47% of non-thymoma patients, with a median follow-up of 24.4 months. This study is not about COVID-19 or long COVID.
No abstract in this set reports any trial or observational data on drug treatment specifically for long COVID. The metformin data come from acute COVID-19 hospitalisations in patients with type 2 diabetes, not from patients with persistent post-COVID symptoms. There are no randomised controlled trials of metformin for long COVID, no data on symptom duration, fatigue, cognitive impairment, or post-exertional malaise, and no information on patient stratification by sex, prior severity, or vaccination status. Funding for such trials and prospective designs that measure long COVID outcomes are missing.
Evidence
Retrieved by DeepSearch across 234,678,978 indexed works and resolved on OpenAlex — ranked by citations, including the results that did not work.
Frontiers in Pharmacology · 2022 · 43 citations · open access
Diabetes, Metformin and the Clinical Course of Covid-19: Outcomes, Mechanisms and Suggestions on the Therapeutic Use of Metformin
AbstractObjectives: Pre-existing or new diabetes confers an adverse prognosis in people with Covid-19. We reviewed the clinical literature on clinical outcomes in metformin-treated subjects presenting with Covid-19. Methods: Structured PubMed search: metformin AND [covid (ti) OR covid-19 (ti) OR covid19 (ti) OR coronavirus (ti) OR SARS-Cov2 (ti)], supplemented with another PubMed search: “diabetes AND [covid OR covid-19 OR covid19 OR coronavirus (i) OR SARS-Cov2 (ti)]” (limited to “Clinical Study”, “Clinical Trial”, “Controlled Clinical Trial”, “Meta-Analysis”, “Observational Study”, “Randomized Controlled Trial”, “Systematic Review”). Results: The effects of metformin on the clinical course of Covid-19 were evaluated in retrospective analyses: most noted improved clinical outcomes amongst type 2 diabetes patients treated with metformin at the time of hospitalisation with Covid-19 infection. These outcomes include reduced admission into intensive care and reduced mortality in subgroups with versus without metformin treatment. Conclusion: The pleiotropic actions of metformin associated with lower background cardiovascular risk may mediate some of these effects, for example reductions of insulin resistance, systemic inflammation and hypercoagulability. Modulation by metformin of the cell-surface ACE2 protein (a key binding target for SARS-CoV 2 spike protein) via the AMP kinase pathway may be involved. While pre-existing metformin treatment offers potentially beneficial effects and can be continued when Covid-19 infection is not severe, reports of increased acidosis and lactic acidosis in patients with more severe Covid-19 disease remind that metformin should be withdrawn in patients with hypoxaemia or acute renal disease. Prospective study of the clinical and metabolic effects of metformin in Covid-19 is warranted.
Cermin Dunia Kedokteran · 2020 · 15 citations · open access
Drug Repurposing Option for COVID-19 with Structural Bioinformatics of Chemical Interactions Approach
AbstractThe SARS-CoV-2 virus is the pathogenic agent that caused the COVID-19 disease. The epicenter of this disease is the city of Wuhan, China. It is already categorized as “pandemic” by WHO, as many countries already affected with the infections, including recently Indonesia. Although the standard RT-PCR and DNA sequencing protocols has already developed for diagnostic, no drugs are available to cure this disease until today. The anti-malaria drug of chloroquine phosphate was repurposed, as well as other anti-viral drugs. In this regard, a structural bioinformatics pipeline was utilized to validate the claim in the computational realm. Within the sphere of the online molecular docking method, it was found that all the tested repurposed drugs attached accordingly with the SARS-CoV-2 protease enzyme that plays a role in viral replication. The repurposed drugs could be proposed as drug candidates for COVID-19, after clinical trials or further laboratory testing. Virus SARS-CoV-2 adalah patogen penyebab penyakit COVID-19. Episentrum penyakit ini adalah kota Wuhan, Tiongkok. WHO mengeluarkan peringatan ‘pandemi’ karena banyak negara sudah terkena infeksi, termasuk Indonesia. Meskipun protokol RT-PCR dan sekuensing DNA standar telah dikembangkan untuk tujuan diagnostik, hingga saat ini tidak ada obat untuk menyembuhkan penyakit ini. Obat anti-malaria chloroquine phosphate dicoba, bersama dengan beberapa obat anti-virus. Alur analisis bioinformatika struktural digunakan untuk validasi di ranah komputasi. Dalam lingkup metode molecular docking secara online, ditemukan bahwa obat tersebut tertambat dengan enzim protease SARS-CoV-2 yang berperan dalam replikasi virus. Obat ini dapat diusulkan sebagai kandidat obat untuk COVID-19, setelah pengujian laboratorium dan uji klinis lebih lanjut.
Current Medical Research and Opinion · 2006 · 12 citations
Experience with starting tacrolimus postoperatively after transsternal extended thymectomy in patients with myasthenia gravis
AbstractBACKGROUND: Thymectomy is a standard treatment of myasthenia gravis (MG). Immunomodulating agents are frequently given during the post-thymectomy latency period until complete remission is fully consolidated, but serious side effects is a relevant clinical problem for patients on long-term immunomodulating treatment. OBJECTIVE: To assess the effectiveness of starting tacrolimus in the immediate postoperative period in MG patients undergoing transsternal extended thymectomy, with complete stable remission (CSR) as the primary outcome of the study. METHODS: Forty-eight MG patients received tacrolimus, 0.1 mg/kg per day b.i.d. (started 24 h after thymectomy) and prednisone 1.5 mg/kg/day. Histologically, 34 patients had hyperplasia, 20 thymic involution, and 14 thymoma. Of the 48 patients, 40 completed 1 year of tacrolimus therapy, 38 completed 2 years, 27 completed 3 years, 21 completed 4 years, and 9 more than 5 years. Mean dose of tacrolimus was 4.9 mg/day (range 2-8 mg/day) with a mean plasma drug concentration of 7.6 ng/mL (range 7-9 ng/mL). Prednisone could be withdrawn after the first year in 93.7% of patients and at 2 years in 100%. RESULTS: The mean follow-up was 24.4 months, SD 17.3 (range 6-60 months). Improvement of muscular strength and decrease of anti-AChR antibodies were statistically significant (p < 0.001) shortly after operation. CSR was obtained in 33.4% of patients, pharmacological remission in 62.6%; 4% of patients had minimal symptoms. None of the patients with thymoma achieved CSR. The estimated median follow-up to obtain a CSR was 37.9 months (95% confidence interval [CI] 26.4-49.5 months). The overall crude CSR rate was 33.4%, with 47% for non-thymoma patients. The probability to achieve CSR at 3 years was 67% for the non-thymomatous group. CONCLUSIONS: Long-term immune-directed treatment with tacrolimus to improve the effectiveness of thymectomy in MG is feasible and was associated with a high rate of CSR in patients without thymoma.
Frontiers in Pharmacology · 2021 · 5 citations · open access
Editorial: Drug Repurposing for COVID-19 Therapy
AbstractThe rapid emergence in December 2019 of cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in China rapidly expanded to multiple countries leading to a pandemic situation in March 2020 and dramatic changes worldwide. COVID-19 immediately had major health consequences due to its severity, mainly in the population at risk, and to the lack of effective treatment to ameliorate the prognosis of the disease. Indeed, SARS-CoV-2 infection causes respiratory symptoms that range from mild forms to more serious ones, causing pneumonia, and multi-organ damage. Moreover, the sudden appearance and rapid propagation of COVID-19 produced an unexpected socio-economic crisis and major efforts have been devoted by multiple professionals to try to minimize the burden generated by this disease.
Diabetes Metabolic Syndrome and Obesity · 2023 · 4 citations · open access
Effects of Metformin on COVID-19 Patients with Type 2 Diabetes: A Retrospective Study
AbstractPurpose: The pandemic of coronavirus disease 2019 (COVID-19) has highlighted the intricate relationship between underlying conditions and death. We designed this study to determine whether metformin therapy for type 2 diabetes mellitus (T2D) is associated with low in-hospital mortality in patients hospitalized for COVID-19. Materials and Methods: This was a retrospective study including patients with COVID-19 and T2D in Wuhan, from February 4th to April 11th, 2020. Patients were divided into two groups according to metformin exposure. The hazard ratio (HR) of COVID-19-related mortality and invasive mechanical ventilation was estimated using Cox regression. Results: There were 571 T2D patients among the 4330 confirmed COVID-19 patients. Of those patients, 241 received metformin therapy. The in-hospital mortality and invasive mechanical ventilation of metformin group was lower than non-metformin group. In the multivariate model, metformin use was linked to a decreased in-hospital mortality and invasive mechanical ventilation when compared with that of the control group (HR: 0.376 [95% CI 0.154-0.922]; P = 0.033). Conclusion: Our study indicated that metformin therapy was associated with decreased death risk in COVID-19 patients with T2D.
Disease module: DeepOracle (Open Targets). Structures: RDKit from PubChem SMILES. Literature: retrieved by DeepSearch across 234,678,978 indexed works (targeted per-candidate search), resolved on OpenAlex.
DeCure is a research and publication project, not medical advice and not a treatment. "DeCure for X" describes a research goal, not a claim that a cure exists. Backing a cure is a contribution to fund the research — it is not an investment, and confers no yield, royalty, equity or IP ownership. Papers are published open-access by the DeCure.ai DAO.
