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Cheap anti-depressant may reduce severe COVID-19, research finds

Trial in Brazil finds 11% of high-risk patients on fluvoxamine needed hospitalization, compared with 16% who were given the placebo; course of the treatment costs just $4

Patients affected by COVID-19 at a field hospital set up at a sports gym, in Santo Andre, Sao Paulo state, Brazil, on March 26, 2021 (Miguel SCHINCARIOL / AFP)
Patients affected by COVID-19 at a field hospital set up at a sports gym, in Santo Andre, Sao Paulo state, Brazil, on March 26, 2021 (Miguel SCHINCARIOL / AFP)

A cheap anti-depressant may reduce the need for hospitalization among high-risk adults with COVID-19, according to research published in The Lancet on Thursday.

The research was part of a study hunting for existing drugs that could be repurposed to treat coronavirus.

A selective serotonin reuptake inhibitor (SSRI) known as fluvoxamine and sold under the brand name Luvox, among others, was given to 1,500 patients in Brazil who were recently infected and assessed to be at risk of becoming seriously ill.

Researchers tested the pill, which is used for depression and obsessive-compulsive disorder, because it was known to reduce inflammation and looked promising in smaller studies.

The drug was chosen with the hope that it could help prevent cytokine storms, the immune reaction that causes major inflammation and is believed to be behind many of the deaths among COVID-19 patients.

Researchers said a 10-day course of fluvoxamine costs approximately $4. By comparison, antibody IV treatments cost about $2,000 and Merck’s experimental antiviral pill for COVID-19 is about $700 per course. Some experts predict various treatments eventually will be used in combination to fight the coronavirus.

People with COVID-19 symptoms wait to be assisted outside a hospital that is at full capacity in Ribeirao Preto, Sao Paulo state, Brazil, May 28, 2021. (Andre Penner/AP)

In the trial, 741 patients were given fluvoxamine while 756 volunteers took the placebo. The average age of participants was 50 and 58% were female.

Of those on the drug, 79 (11%) required emergency hospital treatment, while 119 (16%) of those who took the placebo needed care.

The researchers admitted that the trial had limitations, particularly as it is still unclear who exactly is at greater risk to develop severe illness as a result of coronavirus infection.

“There is no standard of care that exists for early treatment of COVID-19 and various advocacy groups promote different interventions, including some of those evaluated in this and our previous trials,” the researchers wrote.

“Furthermore, there is little understanding of who is at greatest risk of disease progression from this disease as some patients with numerous risk factors do recover quickly whereas some others with less established risk factors might not,” they said.

Researchers also noted that the participants had a higher rate of hospitalization than seen in other similar trials, “thus permitting inferences on treatment effects in this higher-risk population,”

The study also noted that when the trial began, vaccines were not widely available in Brazil but became more widely available as the study progressed, and some participants were vaccinated while others were not.

“Although we modified inclusion criteria and permitted vaccinated patients during the trial, we believe this had minimal effect on the primary outcome as only 86 (6%) of 1497 reported at least one dose of a COVID-19 vaccine at the end of the trial,” the researchers said.

The larger project looked at eight existing drugs to see if they could work against the pandemic virus. The project is still testing a hepatitis drug, but all the others —  including metformin, hydroxychloroquine and ivermectin — haven’t panned out.

Agencies contributed to this report.

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