Another, somewhat unexpected at least to me, approach for making it less likely that COVID-19 becomes serious, has been discovered according to this report from UPI:
The antidepressant drug fluvoxamine — best known by the brand name Luvox — may help prevent serious illness in COVID-19 patients who aren’t yet hospitalized, a new study finds.
The study included 152 patients infected with mild-to-moderate COVID-19. Of those, 80 took fluvoxamine and 72 took a placebo for 15 days.
By the end of that time, none of the patients who took the drug had seen their infection progress to serious illness, compared with six (8.3%) of the patients who took the placebo, according to researchers at Washington University School of Medicine in St. Louis.
“The patients who took fluvoxamine did not develop serious breathing difficulties or require hospitalization for problems with lung function,” said first author Dr. Eric Lenze, professor of psychiatry.
They have a potential explanation for its effectiveness:
Fluvoxamine — widely used to treat depression, obsessive-compulsive disorder and social anxiety disorder — is a type of drug called a selective serotonin-reuptake inhibitor (SSRI). This class of drugs also includes medicines such as Prozac, Zoloft and Celexa.
But unlike other SSRIs, fluvoxamine has a strong interaction with a protein called the sigma-1 receptor, which helps regulate the body’s inflammatory response.
“There are several ways this drug might work to help COVID-19 patients, but we think it most likely may be interacting with the sigma-1 receptor to reduce the production of inflammatory molecules,” explained study senior author Dr. Angela Reiersen, associate professor of psychiatry.
“Past research has demonstrated that fluvoxamine can reduce inflammation in animal models of sepsis, and it may be doing something similar in our patients,” she said in the release.
By reducing inflammation, fluvoxamine may prevent a hyperactive immune response in COVID-19 patients. That, in turn, may decrease their risk of serious illness and death, Reiersen said.
You might see how that underscores some suggestions I’ve made.
I find no evidence of drug company involvement in the study which may provide some increased credibility for it.
If this study proves out in the larger follow-up study, it might provide another arrow in the quiver of treatments for COVID-19.
That would be wonderful, especially since these are cheap generics.
Also teases me because I went through three weeks of bad symptoms in April, but my high risk wife didn’t get sick. She’s been on citalopram for years.
Ran across this new paper today which provides more support for aerosols as a spreading means for Covid:
https://www.nature.com/articles/s41598-020-76442-2
Not good with winter just about upon us and more people spending all day indoors.
The caveats to your study (Andy) are that the Ct values were at the edge of maximum and it is surprising that it was not influenced by the use of Hi Flow O2. Still, I think that we have enough evidence to support that aerosol spread is a factor. Just not sure how much.
If this is just another generic anti-inflammatory effect I would not expect much. Study too small to be useful at this point. Follow up would be good of course but low expectations.
Of note on the home front, I now have 5 staff who have had family exposures. During the lockdowns and the COvid surge in March-April we had none. Our people have been pretty neurotic about this but I think people are wearing out, plus kids going back to school has been a factor. In the Spring we got swamped with cases heading over from NYC and NJ. This time we have cases coming from our rural areas to the north and west. We talked today with the big system to our north and they are rapidly filling beds. They are filling ICU beds at a slower rate than we did in the spring but faster than our network is now. We figure they are 1-2 weeks ahead of us.
College kids coming home soon. Respiratory virus season just really starting. Good thing we are better at treating this now or nationally we are probably looking at about 3000 deaths a day now, way ahead of the spring numbers. I believe it was Trump who predicted this would all disappear on 11/3, right after the election, but it sure doesnt look that way. I now know of at least 3 nurses who have decided to leave their jobs and are thinking of leaving the profession. Covid pts take so much effort. The whole thing takes so much effort. We are now short on tests again. With the surge in COvid and testing there are not enough tests. We are now routinely finding out pts have Covid a few days after we care for them.
We are using universal precautions, but it does get to you after a while. I had a hell day with lots of trauma the other day while trying to balance a bunch of meetings and other stuff. When I found out 2 days later one of the pts from that bad day had tested positive I started second guessing whether or not I had done everything right while rushing from place to place.
Then you get to go home and get emails from the parts of the family about how it is all a hoax.
Steve
What health care workers are going through is a particularly private hell through deliberate isolation of wards and patients. Hard to even get media in there to share that.
https://www.worldometers.info/
is showing a steep rise in cases and a moderate rise in deaths so obviously treatment is getting better.
What I see here in town is 100% mask compliance but cases are doubling nearly every day so I believe there’s a night life I don’t see.
Stores are beginning to ration again which shows total lockdowns are impossible.