In a new study from the Washington University School of Medicine, experts have demonstrated that the antidepressant fluvoxamine prevented COVID-19 infections from becoming severe in some patients and kept them out of the hospital.
The researchers conducted a trial that was designed to compare fluvoxamine with a placebo in 152 adult outpatients infected with COVID-19. Among the participants who received fluvoxamine, none had deteriorated 15 days later. On the other hand, six individuals who received placebo did experience “clinical deterioration” and were hospitalized for up to three weeks. One of the participants in the control group even ended up on a ventilator for 10 days.
The study authors acknowledge that the study size was small, but say the results are statistically significant and that fluvoxamine warrants further study as a COVID-19 treatment. The team plans to launch a larger trial in the next few weeks.
“The patients who took fluvoxamine did not develop serious breathing difficulties or require hospitalization for problems with lung function,” said Dr. Eric J. Lenze.
“Most investigational treatments for COVID-19 have been aimed at the very sickest patients, but it’s also important to find therapies that prevent patients from getting sick enough to require supplemental oxygen or to have to go to the hospital. Our study suggests fluvoxamine may help fill that niche.”
Last year, Dr. Alban Gaultier of UVA discovered that fluvoxamine may block deadly inflammation known as sepsis, which sends the immune system into overdrive. The study revealed that the drug can prevent dangerous “cytokine storms” that are thought to occur in severe cases of COVID-19. This prompted the Washington University team to investigate the potential protective effects of fluvoxamine for patients with COVID-19.
“Because elevated cytokines levels have been associated with COVID-19 severity, testing fluvoxamine in a clinical trial made a lot of sense to us,” said Dr. Gaultier. “We are still unclear about the mode of action of fluvoxamine against SARS-CoV-2, but research is under way to find the answer.”
The experts noted that recent studies have raised questions about whether cytokines are causing COVID-19 infections to become deadly. If not, fluvoxamine may be having beneficial effects by some other mechanism that is not yet understood, said the researchers.
“There are several ways this drug might work to help COVID-19 patients, but we think it most likely may be interacting with the sigma-1 receptor to reduce the production of inflammatory molecules,” explained Dr. Angela M Reiersen. “Past research has demonstrated that fluvoxamine can reduce inflammation in animal models of sepsis, and it may be doing something similar in our patients.”
The researchers emphasized that their research had several limitations, which means that the results should not be treated as a measure of fluvoxamine’s effectiveness against COVID-19. Even still, the findings are encouraging.
“If a larger clinical trial (phase III) confirms the results, fluvoxamine would be a perfect treatment for COVID patients newly diagnosed,” said Dr. Gaultier. “Fluvoxamine is not an experimental drug, it is cheap and safe and could be available as a first line of defense to unburden the hospitals that are overwhelmed by the COVID health crisis.”
The study is published in the Journal of the American Medical Association.