Against cytokine storm: Antidepressant mitigates the course of Covid-19

US NEWS

Usually the drug fluvoxamine is used to treat anxiety and obsessive-compulsive disorder, among other things. However, US researchers have now given Covid 19 sufferers to prevent the condition from getting worse. The results are encouraging.

A so-called cytokine storm is one of the major complications of Covid 19 disease. This derails the reaction of the immune system and leads to severe inflammatory reactions in the lungs or other organs. In a study, an antidepressant has now proven to be effective as a preventive measure against this excessive cytokine production.

For their investigation, a team led by Eric Lenze from Washington University School of Medicine recorded patients from April 10 to August 5 in the greater St. Louis area of ​​the US state of Missouri. 152 patients with confirmed corona infection took part in the study, who already suffered from mild symptoms of Covid-19, but in whom the oxygen saturation had not yet dropped to a value of 96 to 98 percent.

Participants received either 100 milligrams of the antidepressant fluvoxamine or a placebo up to three times a day. The goal was to nip a cytokine storm in the bud. Fluvoxamine, which is often used as a serotonin reuptake inhibitor for the treatment of obsessive-compulsive disorder (OCD), social anxiety disorder and depression, appeared to be suitable. Because it strengthens the effect of the sigma-1 receptor in the cells. It is involved in the regulation of the cellular stress response. This so far little researched defense mechanism of cells is considered to trigger a cytokine storm. In a study carried out on mice last year, fluvoxamine had stopped the stress response and thus protected the mice from fatal sepsis.

Prevent serious illness

In the new study, which was published in the US-Ärzteblatt, the researchers wanted to find out whether this result can be transferred to humans. Since the participants were in quarantine at home, the new study was carried out “contactless”. The development of the disease was followed through electronic medical records, emails, and telephone contacts. The medication, heart rate and blood pressure monitors and clinical thermometers were sent to the participants by messenger.

After 15 days, none of the 80 patients who received the drug showed any serious clinical deterioration. At the same time, six of the 72 placebo patients (8.3 percent) became seriously ill, and four had to be hospitalized.

“The patients who took fluvoxamine did not develop serious breathing difficulties or had to be hospitalized for problems with their lung function,” said the study’s lead author, Lenze, in a statement from the Washington University School of Medicine. He pointed out that many researchers are working on drugs that are supposed to help the most seriously ill patients. “But it’s also important to find therapies to prevent patients from getting so sick that they need supplemental oxygen or hospitalization. Our study suggests that fluvoxamine can help fill this niche.” The results are now to be checked in a nationwide larger study.

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