Early Fluvoxamine Reduces the Risk for Clinical Deterioration in Symptomatic Outpatients with COVID-19: A Real-World, Retrospective, before-after Analysis
Aristotelis Tsiakalos, Panayiotis D Ziakas, Eleni Polyzou, Georgios Schinas, Karolina Akinosoglou
doi:10.3390/microorganisms11082073
Fluvoxamine, a selective serotonin reuptake inhibitor with anti-inflammatory properties, has gained attention as a repurposed drug to treat COVID-19. We aimed to explore the potential benefit of fluvoxamine on outpatients with early SARS-CoV-2 infection. We performed a retrospective study of fluvoxamine adult outpatients with symptomatic COVID-19 disease of early onset (<5 days), in the context of an infectious diseases private practice, between September-December 2021, in Greece. Patients with disease duration ≥5 days, dyspnea and/or hypoxemia with oxygen saturation <94% in room air and pregnancy were excluded from the analysis. In total, 103 patients, 54 males/49 females with a median age of 47 years (39-56), were included in this study. Patient characteristics were balanced before and after the introduction of fluvoxamine. Two patients in the fluvoxamine arm (3.8%; 95% CI 0.4-13) had clinical deterioration compared to 8 patients in the standard of care group (16%; 95% CI 7.2-29.1, p < 0.04). After controlling for age, sex, body mass index > 30 and vaccination status, fluvoxamine was independently associated with a lower risk of clinical deterioration (adj. OR 0.12; 95% CI 0.02-0.70, p < 0.02). Adding on fluvoxamine to treatment for early symptomatic COVID-19 patients may protect them from clinical deterioration and hospitalization, and it is an appealing low-cost, low-toxicity option in the community setting and warrants further investigation.
Author Contributions: A.T. and P.D.Z. conceived the idea, A.T. and P.D.Z. collected and analyzed data, A.T., P.D.Z., K.A., E.P. and G.S. wrote the manuscript, K.A. and P.D.Z. critically corrected the manuscript, A.T. oversaw the study. All authors have read and agreed to the published version of the manuscript. Funding: This research received no external funding.
Conflicts of Interest: The authors declare no conflict of interest.
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'abstract': '<jats:p>Fluvoxamine, a selective serotonin reuptake inhibitor with anti-inflammatory '
'properties, has gained attention as a repurposed drug to treat COVID-19. We aimed to explore '
'the potential benefit of fluvoxamine on outpatients with early SARS-CoV-2 infection. We '
'performed a retrospective study of fluvoxamine adult outpatients with symptomatic COVID-19 '
'disease of early onset (<5 days), in the context of an infectious diseases private '
'practice, between September–December 2021, in Greece. Patients with disease duration ≥5 days, '
'dyspnea and/or hypoxemia with oxygen saturation <94% in room air and pregnancy were '
'excluded from the analysis. In total, 103 patients, 54 males/49 females with a median age of '
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'and after the introduction of fluvoxamine. Two patients in the fluvoxamine arm (3.8%; 95% CI '
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'95% CI 7.2–29.1, p < 0.04). After controlling for age, sex, body mass index > 30 and '
'vaccination status, fluvoxamine was independently associated with a lower risk of clinical '
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