Trial finds first effective treatment
Researchers at McMaster University, in collaboration with institutions in Brazil and the United States, have identified one of the first medications proven to reduce fatigue in people with long COVID. Fluvoxamine, sold under the brand name Luvox and commonly used as an antidepressant, showed consistent and meaningful benefits in a randomized, placebo-controlled trial published in the Annals of Internal Medicine.
The REVIVE-TOGETHER trial enrolled 399 adults in Brazil who had experienced fatigue for at least 90 days after a confirmed SARS-CoV-2 infection. Participants received fluvoxamine, metformin, or a placebo for 60 days. Fluvoxamine significantly improved fatigue scores and overall quality of life, with evidence suggesting a 99% probability the drug outperformed placebo. Metformin showed no benefit for established long COVID fatigue.
Hope for 65 million patients
Long COVID affects an estimated 65 million people worldwide, with fatigue as its most common and debilitating symptom. Until now, most medical guidelines have offered only supportive care. "This is an important step forward for patients who have been desperate for evidence-based options," said Edward Mills, the trial's senior author. Because fluvoxamine is already widely available and well understood, it has clear potential for immediate clinical use.
Trial design innovation
The study used a Bayesian adaptive design that allowed researchers to stop treatment arms early when results became clear. This approach accelerates evidence generation while maintaining scientific rigor. The research was funded by The Latona Foundation.