FRIDAY, April 3, 2026 (HealthDay News) -- For patients with postacute sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), fluvoxamine seems effective for reducing fatigue and improving quality of life (QoL), according to a study published online March 31 in the Annals of Internal Medicine.
Gilmar Reis, M.D., Ph.D., from McMaster University in Hamilton, Ontario, Canada, and colleagues examined the efficacy of fluvoxamine and metformin for long COVID fatigue in a randomized adaptive trial. A total of 399 adults with fatigue persisting 90 or more days after confirmed SARS-CoV-2 infection were enrolled and randomly assigned to 60 days of fluvoxamine (100 mg twice daily), metformin (750 mg twice daily), or matching placebo.
The researchers found that compared with placebo, there was a significant reduction in fatigue with fluvoxamine at day 60 as assessed by the Fatigue Severity Scale score (mean difference, -0.43), with a sustained effect at day 90 (mean difference, -0.58). Improvement was also seen in QoL scores with high posterior probability for fluvoxamine. No significant benefit was seen with metformin. Adverse events occurred less often with fluvoxamine versus metformin or placebo (20.0 versus 28.8 and 29.7 percent, respectively). Across all groups, grade 3 and higher adverse events were rare.
"This trial gives clinicians their first strong evidence for a medication that helps reduce long COVID fatigue," corresponding author Jamie Forrest, Ph.D., from the University of British Columbia in Vancouver, Canada, said in a statement. "Patients want something they can try today – and this finding brings us closer to that reality."
One author disclosed ties to the biopharmaceutical industry.