We are in the midst of the global pandemic. Though acute respiratory coronavirus (SARS-COV2) that leads to COVID-19 infects people of all ages, severe symptoms and mortality occur disproportionately in older adults. Geroscience interventions that target biological aging could decrease risk across multiple age-related diseases and improve outcomes in response to infectious disease. This offers hope for a new host-directed therapeutic approach that could (i) improve outcomes following exposure or shorten treatment regimens; (ii) reduce the chronic pathology associated with the infectious disease and subsequent comorbidity, frailty, and disability; and (iii) promote development of immunological memory that protects against relapse or improves response to vaccination. We review the possibility of this approach by examining available evidence in metformin: a generic drug with a proven safety record that will be used in a large-scale multicenter clinical trial. Though rigorous translational research and clinical trials are needed to test this empirically, metformin may improve host immune defenses and confer protection against long-term health consequences of infectious disease, age-related chronic diseases, and geriatric syndromes.

我们正处于全球大流行之中。尽管导致 COVID-19 的急性呼吸道冠状病毒 (SARS-COV2) 会感染所有年龄段的人，但严重症状和死亡率在老年人中发生的比例不成比例。针对生物衰老的老年科学干预措施可以降低多种与年龄相关的疾病的风险，并改善传染病的应对结果。这为一种新的针对宿主的治疗方法带来了希望，该方法可以（i）改善暴露后的结果或缩短治疗方案； (ii) 减少与传染病相关的慢性病理以及随后的合并症、虚弱和残疾； (iii) 促进免疫记忆的发展，以防止复发或改善对疫苗接种的反应。我们通过检查二甲双胍的现有证据来审查这种方法的可能性：二甲双胍是一种具有经过验证的安全记录的仿制药，将用于大规模多中心临床试验。尽管需要严格的转化研究和临床试验来验证这一点，但二甲双胍可以改善宿主的免疫防御，并提供针对传染病、与年龄相关的慢性疾病和老年综合症的长期健康后果的保护。