COVID-19Infectious DiseasesPreventive Medicine


According to a play written in the 16th century, “curiosity killed the cat;” or so they say! Mr. Tom stuck his nose in someone else’s business and thus, did not live to enjoy his eight other lives. Scientists are a curious lot, too, but their purpose is to find something that will improve the “business” they’ve nosed into. 

Such is the case with the “business” of COVID-19. The effects of this virus completely ruined the lives of many people for most of 2020, all of 2021, and continued its reign of misery the first 3-4 months of 2022. Scientists have worked hard to prevent the disease with a vaccine, reduce its severity and progression with hydroxychloroquine and ivermectin, and treat the disease, with remdesivir, monoclonal antibodies, and dexamethasone. I would have to say none of these treatments (other than monoclonal antibodies) has had overwhelming success.

Curiosity then intervened. Researchers began wondering if there were drugs that would prevent COVID -19 from getting worse. Could they find a drug, or combination of drugs, if given soon enough, could keep patients from dying, being hospitalized, having a low blood oxygen, or even going to the ER? They tried three drugs that had been around for years on the off chance they might find an effective combination. The three drugs are 

          Metformin — the diabetes drug

          Ivermectin — the horse de-wormer

          Fluvoxamine — an anti-depressant called Luvox

I don’t know how they chose these drugs, but they were given to 1431 patients who were either within 3 days of testing positive for COVID or within 7 days, or less, of becoming symptomatic. The mean age was 46 years, 56% were women, and 52% had been vaccinated for COVID-19. There were 6 trial groups. Patients received one of the following combinations:

          Metformin and Fluvoxamine

          Metformin and Ivermectin

          Metformin and Placebo 

          Fluvoxamine and Placebo

          Ivermectin and Placebo

          Placebo and Placebo

The end points (significant events—death, hospitalization, ER visit, or low blood oxygen) occurred in 25.5% of patients.

“None of the three drugs was effective at preventing the composite primary  end point compared to identically matched placebo.” ie. THEY DIDN’T WORK!

“Metformin may prevent ER visits, hospitalizations, or death,” but the researchers weren’t totally certain and felt further study was warranted.

Dr. G’s Opinion: It seems more effort has been spent discrediting treatments for COVID-19 that don’t work than finding treatments that do. I had not considered fluvoxamine as a possibility. Ivermectin is one of those treatments tried by celebrities who are later vilified for taking it. Patients already on metformin for diabetes seemed to have less severe cases of COVID-19, so it may have some value. Instead, why don’t we use those research dollars and time to find something that has a real chance of working?

Reference: Clinical Trials Update: “Repurposed Drugs Failed to Prevent Severe COVID-19” JAMA 2022 September 27;328(12):1171.

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