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Annals of Internal Medicine · 2026

The Effect of Fluvoxamine and Metformin for Fatigue in Patients With Long COVID

G Reis, EASM Silva, DCM Silva, L Thabane, ... JI Forrest, ...

  • COVID-19
  • Fluvoxamine
  • Metformin
  • Long COVID

Abstract

Randomized, placebo-controlled adaptive trial of 399 adults with fatigue persisting 90 or more days after confirmed SARS-CoV-2 infection. Fluvoxamine reduced fatigue versus placebo at day 60, with a sustained effect at day 90; metformin showed no significant benefit.

DOI: 10.7326/ANNALS-25-03959