Sukhatme Vikas P, Reiersen Angela M, Vayttaden Sharat J, Sukhatme Vidula V
Department of Medicine and the Morningside Center for Innovative and Affordable Medicine, School of Medicine, Emory University, Atlanta, GA, United States.
Department of Psychiatry, School of Medicine, Washington University in St. Louis, St. Louis, MO, United States.
Front Pharmacol. 2021 Apr 20;12:652688. doi: 10.3389/fphar.2021.652688. eCollection 2021.
Fluvoxamine is a well-tolerated, widely available, inexpensive selective serotonin reuptake inhibitor that has been shown in a small, double-blind, placebo-controlled, randomized study to prevent clinical deterioration of patients with mild coronavirus disease 2019 (COVID-19). Fluvoxamine is also an agonist for the sigma-1 receptor, through which it controls inflammation. We review here a body of literature that shows important mechanisms of action of fluvoxamine and other SSRIs that could play a role in COVID-19 treatment. These effects include: reduction in platelet aggregation, decreased mast cell degranulation, interference with endolysosomal viral trafficking, regulation of inositol-requiring enzyme 1α-driven inflammation and increased melatonin levels, which collectively have a direct antiviral effect, regulate coagulopathy or mitigate cytokine storm, which are known hallmarks of severe COVID-19.
氟伏沙明是一种耐受性良好、广泛可得且价格低廉的选择性5-羟色胺再摄取抑制剂。在一项小型双盲、安慰剂对照、随机研究中，它已被证明可预防轻度2019冠状病毒病（COVID-19）患者的临床病情恶化。氟伏沙明还是σ-1受体的激动剂，通过该受体来控制炎症。我们在此回顾了一系列文献，这些文献展示了氟伏沙明及其他选择性5-羟色胺再摄取抑制剂的重要作用机制，它们可能在COVID-19治疗中发挥作用。这些作用包括：减少血小板聚集、降低肥大细胞脱颗粒、干扰内溶酶体病毒运输、调节肌醇需求酶1α驱动的炎症以及提高褪黑素水平，这些作用共同具有直接抗病毒作用、调节凝血病或减轻细胞因子风暴，而这些都是重症COVID-19的已知特征。
