Potential COVID-19 treatment: Effective, cheap, available

Researchers at McMaster University, Toronto, led by Edward Mills, PhD, FRCP, from the Department of Health Research Methods, Evidence & Impact, are reporting in the TOGETHER randomly assigned platform clinical trial that an inexpensive orally administered generic antidepressant, fluvoxamine (Luvox, Abbott), may prevent COVID-19 from becoming life-threatening.

In their as yet unpublished findings, Mills and colleagues evaluated the drug in 3,238 Brazilian patients with COVID-19 symptoms who were at risk of progressing to severe disease.

Patients were randomly given fluvoxamine 100 mg twice daily for 10 days or placebo.

The primary outcomes was emergency room observation for more than 6 hours or hospitalization up to 28 days after randomization; the secondary outcomes were viral clearance at day 7, the time to hospitalization, death, and adverse reactions.

Of the included patients, 739 received fluvoxamine, 733 placebo, and 1,766 other treatments including hydroxychloroquine, lopivinar/ritovinar, metformin, ivermectin, doxazosin, and interferon lambda.

The investigator reported that of those receiving fluvoxamine, the risk of emergency room observation for over 6 hours or hospital admission was lower compared with placebo, i.e., 77 of 739 compared with 108 of 733, respectively.

No significant adverse events were seen compared with placebo on the viral clearance at day 7, mortality, time to death, number of days on ventilation, or other secondary outcomes.

The study found that of all the treatments, fluvoxamine was the only one that positively impacted the COVID-19 patients by preventing progression to severe disease. The cost of the drug is about $4 for the 10-day treatment.

“Treatment with fluvoxamine (100 mg twice daily for 10 days) among high-risk outpatients with early diagnosed COVID-19 reduced the need for extended emergency room observation or hospitalization,” the investigators concluded.