Aims Fluvoxamine, a selective serotonin reuptake inhibitor (SSRI) and sigma‐1 receptor agonist, has so far shown promise in the prevention of COVID‐19 progression as an early treatment option in three trials. The aim of this study was to evaluate the safety and efficacy of fluvoxamine in COVID‐19 patients if administered later in the course of the disease. Methods The study was designed as an open‐label, prospective cohort trial with matched controls. In April and May 2021, 51 ICU COVID‐19 patients hospitalised in the University Hospital Dubrava and University Hospital Centre Zagreb, Croatia, were treated with fluvoxamine 100 mg three times daily for 15 days in addition to standard therapy and they were prospectively matched for age, gender, vaccination against COVID‐19, disease severity and comorbidities with 51 ICU controls. Results No statistically significant differences between groups were observed regarding the number of days on ventilator support, duration of ICU or total hospital stay. However, overall mortality was lower in the fluvoxamine group, 58.8% ( n = 30/51), than in the control group, 76.5% ( n = 39/51), HR 0.58, 95% CI (0.36–0.94, P = .027). Conclusion Fluvoxamine treatment in addition to the standard therapy in hospitalised ICU COVID‐19 patients could have a positive impact on patient survival. Further studies on the effects of fluvoxamine in COVID‐19 patients are urgently required.

IntroductionA worldwide vaccination campaign is underway to bring an end to the SARS-CoV-2 pandemic; however, its success relies heavily on the actual willingness of individuals to get vaccinated. Social media platforms such as Twitter may prove to be a valuable source of information on the attitudes and sentiment towards SARS-CoV-2 vaccination that can be tracked almost instantaneously.Materials and methodsThe Twitter academic Application Programming Interface was used to retrieve all English-language tweets mentioning AstraZeneca/Oxford, Pfizer/BioNTech and Moderna vaccines in 4 months from 1 December 2020 to 31 March 2021. Sentiment analysis was performed using the AFINN lexicon to calculate the daily average sentiment of tweets which was evaluated longitudinally and comparatively for each vaccine throughout the 4 months.ResultsA total of 701 891 tweets have been retrieved and included in the daily sentiment analysis. The sentiment regarding Pfizer and Moderna vaccines appeared positive and stable throughout the 4 months, with no significant differences in sentiment between the months. In contrast, the sentiment regarding the AstraZeneca/Oxford vaccine seems to be decreasing over time, with a significant decrease when comparing December with March (p<0.0000000001, mean difference=−0.746, 95% CI=−0.915 to −0.577).ConclusionLexicon-based Twitter sentiment analysis is a valuable and easily implemented tool to track the sentiment regarding SARS-CoV-2 vaccines. It is worrisome that the sentiment regarding the AstraZeneca/Oxford vaccine appears to be turning negative over time, as this may boost hesitancy rates towards this specific SARS-CoV-2 vaccine.

IntroductionSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel coronavirus that appeared in Wuhan, China in January 2020 and caused a global pandemic drastically changing everyday life. Currently, there are vaccine candidates in clinical trials and development, so it is only a matter of time before one is authorised for human use.Materials and methodsWe collected public opinion survey results about attitudes towards SARS-CoV-2 vaccination conducted in 2020 in 26 European countries.ResultsThe pooled surveys were conducted on a total of 24 970 participants; on average only 58% (n=14 365/24 970) of responders across Europe were willing to get a SARS-CoV-2 vaccine once it becomes available, 16% (n=3998/24 970) were neutral, and 26% (n=6607/24 970) were not planning to vaccinate against SARS-CoV-2. Such a low vaccination response could make it exceedingly difficult to reach the herd immunity threshold for SARS-CoV-2 through vaccination.ConclusionIt is very important to start conducting educational public health activities on the topic of vaccination as soon as possible, before a vaccine becomes available, in order to improve attitudes towards SARS-CoV-2 vaccination. Only by educating the general public about the benefits, safety and efficacy of vaccines can we hope to avoid the unnecessary prolongation of the COVID-19 pandemic.

Intravenous immunoglobulin (IVIg) therapy has been suggested as a potential treatment option for hospitalised COVID‐19 patients. The aim of this systematic review and meta‐analysis was to investigate the potential impact of IVIg on mortality and length of hospitalisation in adult COVID‐19 patients. PubMed, Scopus, Web of Science and medRxiv were searched in the week of 20.12.2021 for English language, prospective trials, and retrospective studies with control groups, reporting on the use of intravenous immunoglobulin therapy in adult hospitalised COVID‐19 patients. Exclusion criteria were: studies evaluating the use of IVIg in paediatric COVID‐19 cases, trials using convalescent anti‐SARS‐CoV‐2 plasma or immunoglobulins derived from convalescent anti‐SARS‐CoV‐2 plasma. A random effects meta‐analysis with subgroup analyses regarding study design and patient disease severity according to WHO criteria was also performed. A total of 13 studies were included, of which 6 were prospective, on a total of 2313 (IVIg = 1104, control = 1209) patient outcomes. Meta‐analysis results indicated that IVIg therapy had no statistically significant effect on mortality (RR 0.91 [0.59; 1.39], p = 0.65, I 2 = 69% [46%; 83%]) or length of hospital stay (MD 0.51 [−2.80; 3.81], p = 0.76, I 2 = 96% [94%; 98%]). Subgroup analyses indicated no statistically significant impact on either outcome, but prospective studies' results suggested that IVIg may increase the length of hospitalisation in the severe COVID‐19 patient group (MD 2.66 [1.43; 3.90], p < 0.01, I 2 = 0% [0%; >90%]). The results of this meta‐analysis do not support use of IVIg in hospitalised adult COVID‐19 patients.

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