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Potential therapeutic role of fluvoxamine in COVID-19: A systematic review
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  • Francisco Cardoso,
  • Ricardo Moreira,
  • Luís Rocha,
  • Maria Coelho
Francisco Cardoso
Universidade do Porto Faculdade de Medicina

Corresponding Author:[email protected]

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Ricardo Moreira
Centro Hospitalar de São João EPE
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Luís Rocha
Universidade do Porto Faculdade de Medicina
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Maria Coelho
Universidade do Porto Faculdade de Medicina
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Fluvoxamine is a selective-serotonin reuptake inhibitor (SSRI), well-tolerated and widely available, usually used in the management of mental-health conditions. Fluvoxamine is also a sigma-1 agonist with high affinity to this receptor and this pharmacodynamical effect has been being portrayed as the main explanation in emerging evidence about the potential of using fluvoxamine in COVID-19 patients. This systematic review was conducted according to the PRISMA guidelines. The search was run in MEDLINE, Web of Science, and CENTRAL from the Cochrane databases. The study protocol was registered in PROSPERO (CRD42022302025). Our aim was to assess the present evidence for therapeutic role of fluvoxamine in COVID-19 patients, the review included studies which evaluate the effect of fluvoxamine in COVID-19 patients. The main outcomes evaluated in the review were: mortality, need for hospitalization (outpatients) and clinical deterioration. The quality control of the selected articles was made using Cochrane’s Risk of Bias tool for the randomized controlled trials (RCTs) and the ROBINS-I criteria for non-randomized studies. A total of 4 studies were included in the final qualitative analysis of the review, 2 of which were RCTs, and the others were open-label prospective cohorts. 3 studies assessed outpatient population and 1 evaluated ICU population. Overall, the 4 studies included a total of 1864 participants. In conclusion, 3 studies with outpatients showed that fluvoxamine treatment can prevent clinical deterioration, hospitalisation, or proxy-hospitalisation. The only study with patients hospitalized in the ICU also demonstrated a therapeutic benefit reducing overall mortality.
23 Mar 2022Submitted to British Journal of Clinical Pharmacology
24 Mar 2022Submission Checks Completed
24 Mar 2022Assigned to Editor
08 Apr 2022Reviewer(s) Assigned
25 Apr 2022Review(s) Completed, Editorial Evaluation Pending
29 May 2022Editorial Decision: Revise Major
28 Jul 20221st Revision Received
29 Jul 2022Submission Checks Completed
29 Jul 2022Assigned to Editor
29 Jul 2022Review(s) Completed, Editorial Evaluation Pending
09 Aug 2022Editorial Decision: Revise Major