Mechanisms of action of fluvoxamine for COVID-19: a historical review

The ongoing coronavirus disease 2019 (COVID-19) pandemic caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) accelerates the discovery of prophylactic and therapeutic drugs for persons infected with the virus. Drug repurposing for the COVID-19 pandemic has received particular attention. Increasing clinical data suggest that antidepressant use in early-stage subjects with COVID-19 might be associated with a reduced risk of intubation or death. Among the antidepressants, fluvoxamine is the most attractive drug for mild to moderate subjects with COVID-19. In this article, we review the mechanisms of action (i.e., serotonin transporter, sigma-1 receptor, and acid sphingomyelinase) of fluvoxamine for COVID-19. Furthermore, we discuss a possible link between maternal COVID-19 infection and a risk for neuropsychiatric disorders (i.e., autism spectrum disorder and schizophrenia) in offspring.

Automated summary

The ongoing COVID-19 pandemic has sparked interest in drug repurposing, particularly in the use of antidepressants. Clinical data suggest that early-stage COVID-19 patients who take antidepressants may have a lower risk of intubation or death. Fluvoxamine, among antidepressants, is the most attractive drug for mild to moderate COVID-19 cases. Additionally, there may be a possible link between maternal COVID-19 infection and a risk for neuropsychiatric disorders in offspring, such as autism spectrum disorder and schizophrenia.