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In the endosome it blocks entry of viral RNA (19) by not allowing the endosome pH to acidify, thereby preventing the acidic-pH-dependent conformational change required by the coronavirus spike protein to fuse with the endosome membrane (25, 26))

This may be attributed to the role of metformin in reducing the production of sFlt-1 and soluble endoglin by endothelial cells, trophoblasts, and syncytiotrophoblasts, and modulating anti-angiogenic factors at the mitochondrial level (Romero et al., 2017)