According to National Institutes of Health (NIH, 2021) fluvoxamine is a selective serotonin reuptake inhibitor (SSRI). It is approved by the FDA for the treatment of obsessive-compulsive disorder. It is also used in depression and other conditions.

Studies have shown that fluvoxamine binds to the sigma-1 receptor in immune cells, resulting in reduced production of inflammatory cytokines. It also reduces the expression of inflammatory genes in an invitro study of human endothelial cells and macrophages. Therefore, fluvoxamine acts as an anti-inflammatory, and may be helpful in treating covid patients who are struggling with inflammation, degenerating into their lungs.

Sigma-1 agonism has been shown to inhibit SARS-CoV-2 replication and to modulate the inflammatory response to sepsis(The medical letter, 2021). It could theoretically prevent development of life-threatening cytokine storm and acute respiratory distress syndrome in COVID-19. Fluvoxamine has shown to prevent clinical deterioration (such as shortness of breath and hypoxemia) in patients who tested positive for COVID-19 (The medical letter, 2021).

According to the article from K. Hashimoto (NIH ,2021) the sigma-1 receptor in the endoplasmic reticulum plays an important role in SARS-CoV-2 replication in cells. Knockout and knockdown of SIGMAR1 (sigma-1 receptor, encoded by SIGMAR1) caused robust reductions in SARS-CoV-2 replication, which indicates that the sigma-1 receptor is a key therapeutic target for SARS-CoV-2 replication.

Reference list:

NIH (National institue of health). 2021. https://www.covid19treatmentguidelines.nih.gov/therapies/immunomodulators/fluvoxamine/ Date of access: 13 Oct. 2021

NIH (National institue of health). 2021. https://pubmed.ncbi.nlm.nih.gov/33403480/ Date of access: 13 Oct. 2021

Medical letter. 2021.https://secure.medicalletter.org/sites/default/files/freedocs/w1623d.pdf Date op access: 13 Oct. 2021