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21 fluvoxamine COVID-19 controlled studies, 10 RCTs
48% improvement
for early treatment, RR
0.52
[0.27-0.99]
0
0.25
0.5
0.75
1
1.25
1.5
1.75
2+
STOP COVID
Lenze (DB RCT)
93%
0.07 [0.01-0.52]
1,200mg
progression
0/80
6/72
Improvement, RR [CI]
Dose (4d)
Treatment
Control
STOP COVID
Lenze (DB RCT)
82%
0.18 [0.05-0.65]
1,200mg
hosp.
1/80
5/72
Seftel (QR)
72%
0.28 [0.01-6.68]
500mg
death
0/77
1/48
Seftel (QR)
84%
0.16 [0.01-3.29]
500mg
death/ICU
0/77
2/48
Seftel (QR)
94%
0.06 [0.01-0.37]
500mg
hosp.
0/77
6/48
Seftel (QR)
99%
0.01 [0.00-0.21]
500mg
no recov.
0/77
29/48
STOP COVID 2
Reiersen (DB RCT)
-201%
3.01 [0.12-73.6]
800mg
oxygen
1/272
0/275
STOP COVID 2
Reiersen (DB RCT)
33%
0.67 [0.24-1.87]
800mg
oxygen
6/272
9/275
STOP COVID 2
Reiersen (DB RCT)
38%
0.62 [0.16-2.46]
800mg
oxygen
3/164
6/205
STOP COVID 2
Reiersen (DB RCT)
9%
0.91 [0.38-2.20]
800mg
hosp.
9/272
10/275
STOP COVID 2
Reiersen (DB RCT)
12%
0.88 [0.42-1.81]
800mg
progression
13/272
15/275
Seo (SB RCT)
0%
1.00 [0.15-6.57]
800mg
progression
2/26
2/26
Seo (SB RCT)
34%
0.66 [0.06-6.73]
800mg
progression
1/19
2/25
Seo (SB RCT)
13%
0.87 [0.71-1.06]
800mg
progression
26 (n)
26 (n)
COVID-OUT
Bramante (DB RCT)
-11%
1.11 [0.33-3.61]
400mg
death/hosp.
6/329
5/324
OT1
COVID-OUT
Bramante (DB RCT)
-16%
1.16 [0.58-2.25]
400mg
progression
18/329
15/324
OT1
COVID-OUT
Bramante (DB RCT)
2%
0.98 [0.29-3.37]
400mg
hosp.
5/329
5/324
OT1
COVID-OUT
Bramante (DB RCT)
2%
0.98 [0.29-3.37]
400mg
hosp.
5/329
5/324
OT1
COVID-OUT
Bramante (DB RCT)
5%
0.95 [0.72-1.25]
400mg
progression
79/329
80/321
OT1
Pineda
94%
0.06 [0.01-0.52]
800mg
death
1/594
4/63
Pineda
73%
0.27 [0.14-0.54]
800mg
oxygen
15/594
13/63
Pineda
51%
0.49 [0.26-0.95]
800mg
hosp.
23/594
11/63
Pineda
-71%
1.71 [0.94-3.14]
800mg
hosp. time
23 (n)
11 (n)
Farahani (DB RCT)
51%
0.49 [0.24-1.02]
400mg
PASC
42 (n)
43 (n)
LONG COVID
Farahani (DB RCT)
44%
0.56 [0.23-1.37]
400mg
PASC
6/42
11/43
LONG COVID
Farahani (DB RCT)
62%
0.38 [0.11-1.35]
400mg
PASC
3/42
8/43
LONG COVID
Farahani (DB RCT)
52%
0.48 [0.25-0.95]
400mg
PASC
9/42
19/43
LONG COVID
Farahani (DB RCT)
49%
0.51 [0.14-1.91]
400mg
PASC
3/42
6/43
LONG COVID
Farahani (DB RCT)
59%
0.41 [0.08-2.00]
400mg
PASC
2/42
5/43
LONG COVID
Farahani (DB RCT)
-17%
1.17 [0.47-2.94]
400mg
PASC
8/42
7/43
LONG COVID
Farahani (DB RCT)
8%
0.92 [0.42-2.04]
400mg
PASC
9/42
10/43
LONG COVID
Farahani (DB RCT)
74%
0.26 [0.03-2.20]
400mg
PASC
1/42
4/43
LONG COVID
Farahani (DB RCT)
85%
0.15 [0.02-1.14]
400mg
PASC
1/42
7/43
LONG COVID
Farahani (DB RCT)
37%
0.63 [0.29-1.36]
400mg
PASC
8/42
13/43
LONG COVID
Farahani (DB RCT)
27%
0.73 [0.25-2.12]
400mg
PASC
5/42
7/43
LONG COVID
Farahani (DB RCT)
6%
0.94 [0.75-1.17]
400mg
PASC
32/42
35/43
LONG COVID
TOGETHER
Reis (DB RCT)
-200%
3.00 [0.12-73.5]
800mg
death
1/738
0/738
CT2
TOGETHER
Reis (DB RCT)
12%
0.88 [0.32-2.40]
800mg
hosp.
7/738
8/738
CT2
TOGETHER
Reis (DB RCT)
50%
0.50 [0.25-0.92]
800mg
progression
13/738
27/738
CT2
EFFaCo
Siripongbo.. (RCT)
-2%
1.02 [0.26-4.00]
400mg
oxygen
4/162
4/165
EFFaCo
Siripongbo.. (RCT)
-22%
1.22 [0.38-3.93]
400mg
hosp.
6/162
5/165
Tsiakalos
67%
0.33 [0.01-7.84]
800mg
ICU
0/53
1/50
Tsiakalos
84%
0.16 [0.02-1.26]
800mg
hosp.
1/53
6/50
Tsiakalos
86%
0.14 [0.02-0.74]
800mg
progression
2/53
8/50
Fluvoxa
Siripongboonsitti
59%
0.41 [0.02-9.98]
400mg
death
0/234
1/518
Fluvoxa
Siripongboonsitti
-48%
1.48 [0.25-8.77]
400mg
ventilation
2/234
3/518
Fluvoxa
Siripongboonsitti
26%
0.74 [0.15-3.63]
400mg
ICU
2/234
6/518
Fluvoxa
Siripongboonsitti
-67%
1.67 [1.10-2.54]
400mg
oxygen
34/234
45/518
Fluvoxa
Siripongboonsitti
42%
0.58 [0.32-1.05]
400mg
progression
13/217
49/475
Fluvoxa
Siripongboonsitti
35%
0.65 [0.43-0.99]
400mg
progression
23/166
88/413
Fluvoxa
Siripongboonsitti
33%
0.67 [0.51-0.89]
400mg
progression
51/217
132/377
Fluvoxa
Siripongboonsitti
-48%
1.48 [0.25-8.77]
400mg
progression
2/234
3/518
Fluvoxa
Siripongboonsitti
34%
0.66 [0.59-0.75]
400mg
no recov.
234 (n)
518 (n)
Fluvoxa
Siripongboonsitti
-8%
1.08 [1.00-1.17]
400mg
no recov.
234 (n)
518 (n)
Fluvoxa
Siripongboonsitti
-3%
1.03 [0.95-1.12]
400mg
no recov.
234 (n)
518 (n)
Fluvoxa
Siripongboonsitti
-4%
1.04 [0.91-1.19]
400mg
viral+
130/210
218/365
Wannigama (RCT)
98%
0.02 [0.00-0.34]
500mg
ventilation
0/162
32/336
Wannigama (RCT)
98%
0.02 [0.00-0.40]
500mg
ventilation
0/162
27/336
Wannigama (RCT)
97%
0.03 [0.00-0.56]
500mg
ventilation
0/162
19/336
Wannigama (RCT)
89%
0.11 [0.06-0.21]
500mg
oxygen
9/162
171/336
Wannigama (RCT)
100%
0.00 [0.00-0.07]
500mg
oxygen
0/162
150/336
Wannigama (RCT)
99%
0.01 [0.00-0.09]
500mg
oxygen
0/162
117/336
Wannigama (RCT)
94%
0.06 [0.03-0.11]
500mg
hosp.
9/162
321/336
Wannigama (RCT)
98%
0.02 [0.00-0.40]
500mg
hosp.
0/162
27/336
Wannigama (RCT)
97%
0.03 [0.00-0.56]
500mg
hosp.
0/162
19/336
Wannigama (RCT)
40%
0.60 [0.53-0.68]
500mg
PASC
97/162
336/336
TOGETHER
Reis (DB RCT)
30%
0.70 [0.37-1.26]
800mg
death
17/741
25/756
TOGETHER
Reis (DB RCT)
91%
0.09 [0.01-0.47]
800mg
death
1/548
12/618
TOGETHER
Reis (DB RCT)
22%
0.78 [0.46-1.28]
800mg
ventilation
26/741
34/756
TOGETHER
Reis (DB RCT)
22%
0.78 [0.61-1.03]
800mg
hosp.
75/741
97/756
TOGETHER
Reis (DB RCT)
32%
0.68 [0.52-0.88]
800mg
hosp./ER
79/741
119/756
TOGETHER
Reis (DB RCT)
31%
0.69 [0.53-0.90]
800mg
hosp./ER
78/740
115/752
TOGETHER
Reis (DB RCT)
66%
0.34 [0.21-0.54]
800mg
hosp./ER
541 (n)
609 (n)
TOGETHER
Reis (DB RCT)
-49%
1.49 [0.94-2.38]
800mg
viral+
167/207
163/221
Calusic (ICU)
42%
0.58 [0.36-0.94]
1,200mg
death
30/51
39/51
ICU patients
Kirenga
68%
0.32 [0.19-0.53]
800mg
death
29/94
126/222
Kirenga
53%
0.47 [0.23-0.97]
800mg
recovery
94 (n)
222 (n)
ACTIV-6
Stewart (DB RCT)
31%
0.69 [0.27-1.21]
700mg
progression
14/589
21/586
ACTIV-6
Stewart (DB RCT)
34%
0.66 [0.23-1.16]
700mg
clin. ord.
589 (n)
586 (n)
ACTIV-6
Stewart (DB RCT)
-15%
1.15 [0.51-1.83]
700mg
clin. ord.
589 (n)
586 (n)
ACTIV-6
Stewart (DB RCT)
6%
0.94 [0.29-1.74]
700mg
clin. ord.
589 (n)
586 (n)
ACTIV-6
Stewart (DB RCT)
-1%
1.01 [0.92-1.12]
700mg
no recov.
589 (n)
586 (n)
ACTIV-6
Stewart (DB RCT)
49%
0.51 [0.05-5.64]
700mg
hosp.
1/589
2/586
Oskotsky (PSM)
-58%
1.58 [0.42-5.93]
n/a
death
2/11
19/165
Oskotsky (PSM)
26%
0.74 [0.55-0.99]
n/a
death
48/481
956/7,215
Fritz
19%
0.81 [0.26-2.22]
n/a
hosp./ER
4/17
1,896/20,457
Fritz
12%
0.88 [0.79-0.99]
n/a
hosp./ER
707/3,414
1,896/20,457
Fritz
12%
0.88 [0.77-0.99]
n/a
hosp./ER
559/2,744
1,896/20,457
Fritz
10%
0.90 [0.81-0.99]
n/a
hosp./ER
971/4,577
1,896/20,457
Diaz (PSM)
28%
0.72 [0.63-0.81]
n/a
cases
4,558 (n)
4,558 (n)
Trkulja (PSM)
27%
0.73 [0.35-1.55]
n/a
death
Trkulja (PSM)
-37%
1.37 [0.56-3.33]
n/a
hosp.
Visos-Varela
-103%
2.03 [0.24-17.4]
n/a
death
case control
Visos-Varela
-395%
4.95 [0.34-71.4]
n/a
ICU
case control
Visos-Varela
40%
0.60 [0.19-1.92]
n/a
hosp.
case control
Visos-Varela
32%
0.68 [0.18-2.50]
n/a
progression
case control
Visos-Varela
12%
0.88 [0.54-1.43]
n/a
cases
case control
Fluvoxamine COVID-19 outcomes
c19 early .org
December 2024
1 OT: comparison with other treatment 2 CT: study uses combined treatment
Favors fluvoxamine
Favors control
Figure S2. Comparison of results for RCTs versus observational studies.
For COVID-19 treatments, there is no significant difference between the results of RCTs and observational studies. Observational studies do not systematically over or underestimate efficacy. For high-cost treatments, there is a non-significant trend towards RCTs showing greater efficacy.
Please send us corrections, updates, or comments.
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means should be used based on risk/benefit analysis.
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of risks and benefits based on your medical history and situation.
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