In a randomized, placebo-controlled adaptive trial of 399 adults with long COVID–related fatigue, fluvoxamine significantly reduced fatigue severity and improved quality of life compared with placebo, with effects sustained through 90 days, whereas metformin showed no meaningful benefit. Fluvoxamine was also associated with a higher likelihood of recovery (FSS <3) and a favorable safety profile, supporting its potential role as a treatment option for long COVID fatigue, though longer-term outcomes and mechanisms remain uncertain.

Source: Annals of Internal Medicine