> Among 1900 recruited, a total of 995 participants completed the trial. No participants had clinical deterioration by day 9, 14, or 28 days among those treated with fluvoxamine plus bromhexine (0%), fluvoxamine plus cyproheptadine (0%), or niclosamide plus bromhexine (0%). Nine participants (5.6%) in the fluvoxamine arm had clinical deterioration by day 28, requiring low-flow oxygen. In contrast, most standard care arm participants had clinical deterioration by 9, 14, and 28 days.
> No deaths occurred in any study group. Compared to standard care, participants treated with the combination agents had significantly decreased viral loads as early as day 3 of treatment (p < 0.0001), decreased levels of serum cytokines interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and interleukin-1 beta (IL-1β) as early as day 5 of treatment, and interleukin-8 (IL-8) by day 7 of treatment (p < 0.0001) and lower incidence of post-acute sequelae of COVID-19 (PASC) symptoms (p < 0.0001).
> Early treatment with these combinations among outpatients diagnosed with COVID-19 was associated with lower likelihood of clinical deterioration, and with significant and rapid reduction in the viral load and serum cytokines, and with lower burden of PASC symptoms. When started very soon after symptom onset, these repurposed drugs have high potential to prevent clinical deterioration and death in vaccinated and unvaccinated COVID-19 patients.
@trendless there are a number of red flags in this paper that make me suspect it is unreliable. The first is that 100 % of standard treatment patients had PASC — even in the worst case scenarios in other studies (long ICU stays, etc.) the high end would be ~70%, and 10-30% is more typically reported.
@trendless the other thing that jumped right out to me is that this study was done when COVID strains were quite serious, and people requiring non-invasive positive pressure ventilation or mechanical ventilation tended to have dismal outcomes, yet there were zero deaths in the study group. Possible, but odd.
@trendless I think the idea is intriguing, but this paper is from data from 2 years ago, with stunning results, yet is published in a journal that is for more rapidly emerging therapies and progressing studies. Why not publish in the actual Lancet, or JAMA? I am concerned this is a goose chase with bad data.
@trendless there are good data showing lower long-COVID rates with metformin use, Paxlovid, and vaccination, so there are good options out there that need to be used more often and need to be more available to people.
@mcnado I suggest reading threads by the various authors, several of whom I've got years of history with and have come to trust over the course of the pandemic thus far. If there turn out to be issues with the study that peer review didn't catch, I've no doubt they'll address it.
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