Expert Opinion and review article of fluvoxamine’s role in treating COVID-19.

Key Messages

This Expert Opinion article reviews drugs which have the potential to reduce hospitalization and death from COVID-19.

Clinical studies on the use of fluvoxamine to treat COVID-19 are reviewed. These studies show promising results that suggest fluvoxamine may prevent hospitalization, reduce the need for ventilation, and lower death rates. Furthermore, it appears that fluvoxamine may even prevent long-term COVID-19 symptoms.

Fluvoxamine may reduce COVID-19 mortality in different ways, including reducing the levels of anxiety and depression that are associated with a COVID-19 diagnosis.

The ability of fluvoxamine to activate the Sigma-1 receptor, and induce “autophagy”, which is the body’s way of cleaning out damaged cells, may be responsible for its anti-COVID-19 effects.

Expert Opinion on Therapeutic Targets

Publication Date: July 15, 2021
Peer Reviewed: Yes
Publication Type: Review/Commentary/Letter
DOI: https://www.doi.org/10.1080/14728222.2021.1952987

Drugs that offer the potential to reduce hospitalization and mortality from SARS-CoV-2 infection: The possible role of the sigma-1 receptor and autophagy

James Michael Brimson, Mani Iyer Prasanth, Dicson Sheeja Malar, Sirikalaya Brimson, Premrutai Thitilertdecha, Tewin Tencomnao

Abstract

Introduction: Despite the availability of new vaccines for SARS-CoV-2, there has been slow uptake and problems with supply in some parts of the world. Hence, there is still a necessity for drugs that can prevent hospitalization of patients and reduce the strain on health care systems. Drugs with sigma affinity potentially provide protection against the most severe symptoms of SARS-COV-2 and could prevent mortality via interactions with the sigma-1 receptor.

Areas covered: This review examines the role of the sigma-1 receptor and autophagy in SARS-CoV-2 infections and how they may be linked. The authors reveal how sigma ligands may reduce the symptoms, complications, and deaths resulting from SARS-CoV-2 and offer insights on those patient cohorts that may benefit most from these drugs.

Expert opinion: Drugs with sigma affinity potentially offer protection against the most severe symptoms of SARS-CoV-2 via interactions with the sigma-1 receptor. Agonists of the sigma-1 receptor may provide protection of the mitochondria, activate mitophagy to remove damaged and leaking mitochondria, prevent ER stress, manage calcium ion transport, and induce autophagy to prevent cell death in response to infection.