Potential of Selective Serotonin Reuptake Inhibitors in preventing
clinical deterioration of COVID-19
Abstract
COVID-19 has an unpredictable course with substantial percentage of
infected patients developing clinical deterioration and increasing
health care burden. With no specific treatment or vaccination, the
current search is for drugs that can limit the disease progression.
Recently Fluvoxamine has been reported to have disease modifying effects
in COVID-19. We suggest the hypothesis that short term routine use of
Selective Serotonin Reuptake Inhibitors (SSRIs) can prevent clinical
deterioration of asymptomatic or mild COVID-19 cases by the following
ways: a) anti-inflammatory actions through sigma-1 agonism and reducing
release of pro-inflammatory cytokines, b) anti-coagulant action by
reducing platelet aggregation, c) specific antiviral and antibacterial
effects, d) Immunomodulation through Serotonin pathway and
anti-oxidation. The routine short term use of SSRIs can also alleviate
the psychological impact of the disease. We hope our hypothesis will
encourage future clinical trials to validate the routine use of SSRIs
against COVID-19.