In December 2019 a series of viral pneumonia cases were reported in the city of Wuhan, China and a new subtype of coronavirus has been identified as the causative agent of this condition. On February 11, 2000 the disease has been characterized as COVID-19 and on March 11 the WHO declared a state of worldwide pandemic. On January 25, 2021 there are 98,794,942 cases and 2,124,193 documented deaths (global case-fatality ratio of 2.15%). To date, no early treatment has been identified as effective in combating this disease which has been identified as with high morbidity and mortality. Epidemiological data suggest that despite development of vaccines we will have hundreds od thousands of cases in the next two years.

Thus, we propose the repositioning of three drugs which experimentally have shown anti-inflammatory activity against SARS-CoV2 and some clinical evidence derived from observational studies on reducing complications if used early on the disease, before inflammatory cascade is fully activated.

Patients will be randomly allocated to one of four treatment arms in a 1:1:1:1 ratio:

1. Fluvoxamine
2. Metformin
3. Ivermectin
4. Placebo. We will use a centralized random allocation schedule, generated by computer and implemented using an online remote access system. Randomization will be stratified by participating basic health unit.

Inclusion Criteria:

1. Patients over 18 years old with the ability to provide free and informed consent
2. Acute Flu-Like symptoms < 07 days.
3. All patient need to have at lease ONE enhancement factor:
   1. Age > 50 years;
   2. Diabetes mellitus requiring oral medication or insulin
   3. Systemic arterial hypertension requiring at least 01 oral medication for BP control;
   4. Known cardiovascular diseases (heart failure, congenital heart disease, valvar heart valve disease, coronary artery disease, cardiomyopathies)
   5. Symptomatic lung disease (emphysema, chronic bronchitis)
   6. Symptomatic asthma patients requiring chronic use of agents for control of symptoms.
   7. Smoking
   8. Obesity, defined as BMI> 30 kg / m2 body weight
   9. Transplanted patients
   10. SARS-CoV2 vaccinated patients
   11. Patient with stage IV chronic kidney disease or on dialysis.
   12. Immunosuppressed patients / using corticosteroid therapy (equivalent to at least 10 mg of prednisone per day) and / or immunosuppressive therapy)
   13. Patients with a history of cancer in the last 05 years or undergoing treatment of a current cancer
4. Patient with positive rapid test for SARS-CoV2 antigen performed on occasion of the screening or patient with a positive SARS-CoV2 diagnostic test within 07 days of the onset of symptoms.
5. Willingness to use the proposed investigative treatment and follow the protocol-related procedures foreseen in the research

Exclusion Criteria:

1. Negative SARS-CoV2 test.
2. Flu-like symptom onset 08 days or more.
3. Patients with COVID-19 and hospitalization referral
4. Patients with acute respiratory conditions due to other causes;
5. Dyspnea secondary to other acute and chronic respiratory causes or infections (eg: Decompensated COPD, acute bronchitis, pneumonia, primary pulmonary arterial hypertension)
6. Acute flu condition presenting at least ONE of the criteria below:
   1. Respiratory Rate> 28 / min;
   2. SaO2 <90% or <93% in nasal oxygen therapy at 10 l / min;
   3. PaO2 / FIO2 <300 mmHg
7. Patients using serotonin reception inhibitors (Donepezil, Sertraline)
8. Use of the following medications in the last 14 days:
   1. Monoamine Oxide Inhibitors (MAOIs): Phenelzine, Tranylcypromine, Selegiline, Isocarboxazide, moclobemide;
   2. Use of iodinated contrasts during start of treatment through D14;
   3. Use of antiretroviral agents
9. Patients with severe psychiatric disorders or major uncontrolled depression or controlled with any of the prohibited drugs (see above);
10. Pregnant or breastfeeding patients;
11. History of severe ventricular cardiac arrhythmia (ventricular tachycardia, patients with ventricular fibrillation recovered) or Long QT Syndrome;
12. History of diabetic ketoacidosis or clinical condition that maintains persistent acidosis
13. Surgical procedure or use of contrast designed to occur during treatment or up to 04 days after the last dose of the study medication;
14. Current daily and / or uncontrolled alcoholism;
15. History of seizures in the last month or uncontrolled medical condition;
16. Clinical history of Liver Cirrhosis or Child-Pugh C classification;
17. Patients with known severe degenerative neurological diseases and / or diseases serious mental disorders;
18. Inability of the patient or representative to give consent or adhere to the procedures proposed in the protocol;
19. Known hypersensitivity and / or intolerance to Fluvoxamine, Ivermectin or Metformin;
20. Inability to take oral medications;