Overview
- Peer-reviewed results, published Tuesday in Annals of Internal Medicine, show fluvoxamine reduced self-reported fatigue and modestly improved quality of life through 90 days for adults with long COVID.
- The REVIVE-TOGETHER study used a Bayesian adaptive design and randomized 399 adults at 22 outpatient sites in Brazil between October 2023 and February 2025 to fluvoxamine, metformin, or placebo for 60 days.
- Fluvoxamine achieved high posterior probabilities of superiority to placebo on the Fatigue Severity Scale at day 60 and day 90, indicating a credible treatment effect on a common and disabling symptom.
- Metformin did not provide a meaningful benefit for established long COVID fatigue in this trial, contrasting with its earlier signal as a preventive when given during acute infection.
- Safety was similar across groups, and researchers and outside experts urged replication because the Brazil-only sample and reliance on self-reported fatigue scores limit how broadly the results can be applied.