Speaker
Jamie I. Forrest PhD, MPH
Scientific Director, Health Equity & Resilience Observatory (HERO)
Faculty of Applied Science
University of British Columbia
Keywords
Long COVID, Fluvoxamine, Metformin, Fatigue, Brazil .
Key Points
- Globally, millions are affected by the symptoms of Long COVID including fatigue. Multifactorial mechanisms complicate therapeutic development of pharmacological interventions.
- REVIVE-TOGETHER is a 22 site study conducted in Brazil from October 2023 to February 2025 investigating fluvoxamine and metformin for the treatment of Long COVID.
- Patients taking fluvoxamine showed a statistically significant reduction in fatigue severity scale and sustained benefits across all endpoints. Metformin results were not statistically significant.
- The study explored whether reduced fatigue seen on fluvoxamine is simply due to the drug’s antidepressant effect. The REVIVE-TOGETHER data suggest that the effect is not explained solely by antidepressant activity.
Discussion Themes
Trial procedures differ in Brazil compared with typical trial procedures in North America. Recruitment was handled through Brazil’s public health authority groups. This decentralized system allowed for recruitment of more patients than would have been possible via the typical recruitment methods in North America.
The REVIVE-TOGETHER trial used a previously reported measure of fatigue reduction to determine what was considered a clinically meaningful reduction in fatigue.
Read more about the REVIVE-TOGETHER trial.