The real-world effectiveness of fluvoxamine therapy in mild to moderate COVID-19 patients; A historical cohort study (Fluvoxa Trial)

Background: Fluvoxamine (FVX) has been proposed as a potential treatment for severe COVID-19 by the σ-1 receptor agonist, which can reduce cytokine production. However, the efficacy of FVX remains controversial. Methods: A historical retrospective cohort study was conducted in mild to moderate COVID...

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Main Authors: Taweegrit Siripongboonsitti, Kriangkrai Tawinprai, Paruspak Payoong, Nithi Mahanonda
Format: Article
Language:English
Published: Elsevier 2023-12-01
Series:Journal of Infection and Public Health
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S1876034123003374
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author Taweegrit Siripongboonsitti
Kriangkrai Tawinprai
Paruspak Payoong
Nithi Mahanonda
author_facet Taweegrit Siripongboonsitti
Kriangkrai Tawinprai
Paruspak Payoong
Nithi Mahanonda
author_sort Taweegrit Siripongboonsitti
collection DOAJ
description Background: Fluvoxamine (FVX) has been proposed as a potential treatment for severe COVID-19 by the σ-1 receptor agonist, which can reduce cytokine production. However, the efficacy of FVX remains controversial. Methods: A historical retrospective cohort study was conducted in mild to moderate COVID-19 patients, 2:1 ratio of standard of care (SOC) and FVX treatments to assess the effectiveness of FVX in preventing deterioration by the fifth day of treatment. Results: Of 752 eligible patients, 234 received FVX while 518 received SOC, and there was no significant difference in the effectiveness of FVX and SOC in preventing clinical deterioration. On the fifth day after treatment, 86.1 % of patients in the FVX-treated group did not experience clinical deterioration compared to 78.7 % in the SOC group. Notably, the FVX group had higher rates of pneumonia development and hospitalization, requiring more oxygen supplementation while showing less reduction in viral shedding than the SOC group. However, no difference in mechanical ventilation use, ICU admission, and survival was observed. Conclusion: Fluvoxamine treatment is failed to demonstrate effectiveness in preventing deterioration in mild to moderate COVID-19 and may lead to a higher incidence of pneumonia, hospitalization, and oxygen supplementation, necessitating careful consideration before prescribing the drug for COVID-19.
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spelling doaj.art-c4d20189180446a394ad9b6d69381a212023-11-17T05:25:46ZengElsevierJournal of Infection and Public Health1876-03412023-12-01161220102016The real-world effectiveness of fluvoxamine therapy in mild to moderate COVID-19 patients; A historical cohort study (Fluvoxa Trial)Taweegrit Siripongboonsitti0Kriangkrai Tawinprai1Paruspak Payoong2Nithi Mahanonda3Division of Infectious Diseases, Department of Medicine, Chulabhorn Hospital, Chulabhorn Royal Academy, Bangkok, Thailand; Princess Srisavangavadhana College of Medicine, Chulabhorn Royal Academy, Bangkok, Thailand; Corresponding author at: Division of Infectious Diseases, Department of Medicine, Chulabhorn Hospital, Chulabhorn Royal Academy, Bangkok, Thailand.Division of Infectious Diseases, Department of Medicine, Chulabhorn Hospital, Chulabhorn Royal Academy, Bangkok, Thailand; Princess Srisavangavadhana College of Medicine, Chulabhorn Royal Academy, Bangkok, ThailandDivision of Infectious Diseases, Department of Medicine, Chulabhorn Hospital, Chulabhorn Royal Academy, Bangkok, ThailandChulabhorn Royal Academy, Bangkok, ThailandBackground: Fluvoxamine (FVX) has been proposed as a potential treatment for severe COVID-19 by the σ-1 receptor agonist, which can reduce cytokine production. However, the efficacy of FVX remains controversial. Methods: A historical retrospective cohort study was conducted in mild to moderate COVID-19 patients, 2:1 ratio of standard of care (SOC) and FVX treatments to assess the effectiveness of FVX in preventing deterioration by the fifth day of treatment. Results: Of 752 eligible patients, 234 received FVX while 518 received SOC, and there was no significant difference in the effectiveness of FVX and SOC in preventing clinical deterioration. On the fifth day after treatment, 86.1 % of patients in the FVX-treated group did not experience clinical deterioration compared to 78.7 % in the SOC group. Notably, the FVX group had higher rates of pneumonia development and hospitalization, requiring more oxygen supplementation while showing less reduction in viral shedding than the SOC group. However, no difference in mechanical ventilation use, ICU admission, and survival was observed. Conclusion: Fluvoxamine treatment is failed to demonstrate effectiveness in preventing deterioration in mild to moderate COVID-19 and may lead to a higher incidence of pneumonia, hospitalization, and oxygen supplementation, necessitating careful consideration before prescribing the drug for COVID-19.http://www.sciencedirect.com/science/article/pii/S1876034123003374FluvoxamineFavipiravirCOVID-19SARS-CoV-2SSRI
spellingShingle Taweegrit Siripongboonsitti
Kriangkrai Tawinprai
Paruspak Payoong
Nithi Mahanonda
The real-world effectiveness of fluvoxamine therapy in mild to moderate COVID-19 patients; A historical cohort study (Fluvoxa Trial)
Journal of Infection and Public Health
Fluvoxamine
Favipiravir
COVID-19
SARS-CoV-2
SSRI
title The real-world effectiveness of fluvoxamine therapy in mild to moderate COVID-19 patients; A historical cohort study (Fluvoxa Trial)
title_full The real-world effectiveness of fluvoxamine therapy in mild to moderate COVID-19 patients; A historical cohort study (Fluvoxa Trial)
title_fullStr The real-world effectiveness of fluvoxamine therapy in mild to moderate COVID-19 patients; A historical cohort study (Fluvoxa Trial)
title_full_unstemmed The real-world effectiveness of fluvoxamine therapy in mild to moderate COVID-19 patients; A historical cohort study (Fluvoxa Trial)
title_short The real-world effectiveness of fluvoxamine therapy in mild to moderate COVID-19 patients; A historical cohort study (Fluvoxa Trial)
title_sort real world effectiveness of fluvoxamine therapy in mild to moderate covid 19 patients a historical cohort study fluvoxa trial
topic Fluvoxamine
Favipiravir
COVID-19
SARS-CoV-2
SSRI
url http://www.sciencedirect.com/science/article/pii/S1876034123003374
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