Illustration showing long COVID patients revitalized by fluvoxamine treatment in a clinical trial, with scientists and physician highlighting study results.
Illustration showing long COVID patients revitalized by fluvoxamine treatment in a clinical trial, with scientists and physician highlighting study results.
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Fluvoxamine eases severe fatigue in long COVID patients

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A study shows the antidepressant fluvoxamine reduces severe fatigue in long COVID patients. In a randomized trial of 399 adults, it was compared with metformin and placebo. Physician Judith Bruchfeld describes the findings as interesting.

A new study, reported by Dagens Medicin, examined treatments for severe fatigue in adults with long COVID – fatigue that does not improve with rest. 399 patients were randomized to receive fluvoxamine, the type 2 diabetes drug metformin, or placebo.

Fluvoxamine, used for depression, effectively reduced fatigue. Metformin and placebo showed no comparable effect in the study.

"These are interesting data from a well-conducted study. Fluvoxamine is a well-known drug with relatively few side effects and something that can be tested clinically on selected patients," says Judith Bruchfeld, senior physician in infectious medicine at Karolinska University Hospital who researches long COVID, to the newspaper.

The drug is sold in Sweden as Fevarin but is not subsidized.

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Reactions on X to the fluvoxamine long COVID fatigue study are cautiously optimistic, with medical professionals and patients noting its RCT design and significant fatigue reduction versus placebo. Skeptics highlight the modest clinical effect size and lack of mechanistic data. Metformin showed no benefit, and some raised concerns about SSRI side effects.

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Realistic depiction of a long COVID patient experiencing fatigue and breathing difficulties, overlaid with highlighted CD14+ monocytes (LC-Mo state) and inflammatory markers from recent immune study.
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Study links a distinct CD14+ monocyte state to fatigue and breathing symptoms in long COVID

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Researchers analyzing immune cells from people with long COVID have identified a distinct molecular state in CD14+ monocytes—labeled “LC-Mo”—that was more prevalent among patients whose initial COVID-19 illness was mild to moderate and that tracked with reported fatigue and respiratory symptoms, along with higher levels of inflammatory signaling molecules in blood plasma.

A randomized, placebo-controlled trial led by Australia’s Garvan Institute of Medical Research found that metformin, a long-used and low-cost drug for type 2 diabetes, did not improve clamp-measured insulin resistance in adults with type 1 diabetes but was associated with roughly 12% lower insulin requirements while blood sugar measures remained broadly unchanged.

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Germany's Gemeinsamer Bundesausschuss (G-BA) decided on Thursday to allow health insurers to cover four drugs that alleviate certain Long Covid symptoms. Previously, patients had to pay for these off-label uses themselves. The ruling eases access for the country's 74 million statutory insurees.

A repurposed breast cancer drug called MDL-001 has shown promise in lab and animal studies against a range of viruses, including flu, covid-19, RSV and norovirus. Developed by California-based Model Medicines using AI, the pill targets a conserved enzyme domain in viruses. A clinical trial is planned for early next year.

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A study involving 73 people with mild cognitive impairment or early dementia found that tailored treatment plans targeting nutritional deficiencies, infections and other factors led to significant cognitive improvements after nine months. Participants in the intervention group saw their overall cognitive scores rise by 13.7 points, while the control group declined by 4.5 points. The approach combines medical interventions with lifestyle changes like diet, exercise and cognitive training.

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