COVID-19 mortality among selective serotonin reuptake inhibitor users—results from a nationwide cohort

Stauning, Marius Ahm; Gur, Dvir; Torp‐Pedersen, Christian; Tingleff, Jens

doi:10.1016/j.cmi.2023.04.028

Cited by 7 publications

(3 citation statements)

References 28 publications

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“…However, fluvoxamine stood out as the most probable and investigated member of the class (Hashimoto, 2021; Oskotsky et al, 2021; Vatvani et al, 2023; Visos-Varela et al, 2023). There are conflicting results regarding its use and clinical outcomes in observational studies in various clinical settings (Osores et al, 2023; Stauning et al, 2023; Visos-Varela et al, 2023; Wang et al, 2023). Furthermore, several RCTs carried out in outpatient setting measured mortality as an outcome, yet only one study reported clinical events.…”

Section: Discussionmentioning

confidence: 99%

Specific adverse outcomes associated with selective serotonin reuptake inhibitors use in COVID-19 patients might be potentiated by remdesivir use

Papic,

Bistrovic,

Krecak

et al. 2024

J Psychopharmacol

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Background: Due to non-consistent reports in the literature, there are uncertainties about the potential benefits and harms of selective serotonin reuptake inhibitors (SSRIs) in patients with Coronavirus disease 2019 (COVID-19). Aim: To investigate associations of SSRIs with clinical characteristics and unwanted outcomes among real-life severe and critical COVID-19 patients and their relationship with remdesivir (RDV) use. Methods: This retrospective cohort study evaluated a total of 1558 COVID-19 patients of the white race treated in a tertiary center institution, among them 779 patients treated with RDV and 779 1:1 case-matched patients. Results: A total of 78 (5%) patients were exposed to SSRIs during hospitalization, similarly distributed among patients treated with RDV and matched patients (5.1 and 4.9%). No significant associations of SSRI use with age, sex, comorbidity burden, and COVID-19 severity were present in either of the two cohorts ( p < 0.05 for all analyses). In multivariate analyses adjusted for clinically meaningful variables, SSRI use was significantly associated with higher mortality among RDV (adjusted odds ratio (aOR) 2.0, p = 0.049) and matched patients (aOR 2.22, p = 0.044) and with higher risk for mechanical-ventilation (aOR 2.57, p = 0.006), venous-thromboembolism (aOR 3.69, p = 0.007), and bacteremia (aOR 2.22, p = 0.049) among RDV treated patients. Conclusions: Adverse outcomes associated with SSRI use in COVID-19 patients might be potentiated by RDV use, and clinically significant interactions between these two drug classes might exist. Although our findings raise important considerations for clinical practice, they are limited by retrospective nature of the study, lack of ethnic diversity, and the potential for unmeasured confounding factors. Future studies exploring underlying biological mechanisms are needed.

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Section: Discussionmentioning

confidence: 99%

Specific adverse outcomes associated with selective serotonin reuptake inhibitors use in COVID-19 patients might be potentiated by remdesivir use

Papic,

Bistrovic,

Krecak

et al. 2024

J Psychopharmacol

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“… [46] , [47] , [48] Similarly, several, [49] , [45] though not all [50] , [51] , [52] prospective, randomized, controlled investigations into the potential therapeutic effects of fluvoxamine in outpatients with acute COVID-19, have suggested evidence of benefit. A number of other investigators have been interested in the evaluating whether SSRIs prevent COVID-19, exert a treatment effect in acute infection or lower early mortality after acute COVID-19 [53] , [54] , [55] , [56] , [57] , and a recent uncontrolled study including 95 patients with PASC treated with SSRI therapy has been published [58] , but to our knowledge, ours is the first study to suggest a diminished risk of the development of Long COVID in patients receiving SSRIs at baseline (i.e., prior to SARS-CoV-2 infection). Although an immunological basis for this observation has been postulated, we acknowledge the possibility that the findings in the current study may reflect non-immunological effects of SSRIs.…”

Section: Discussionmentioning

confidence: 99%

Assessing the effect of selective serotonin reuptake inhibitors in the prevention of post-acute sequelae of COVID-19

Sidky,

Hansen,

Girvin

et al. 2024

Computational and Structural Biotechnology Journal

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“…Other studies have highlighted conflicting results, especially for certain drugs such as tricyclic antidepressants and antipsychotics (Clelland et al, 2021;Min et al, 2022). Additionally, a recent retrospective study (Stauning et al, 2023), based on a notably extensive but internally diverse sample of SARS-CoV-2 positive patients, has revealed a higher risk of mortality in SSRI treated individuals compared to non-SSRI-treated individuals.…”

Section: Introductionmentioning

confidence: 99%

SSRIs in the course of COVID‐19 pneumonia: Evidence of effectiveness of antidepressants on acute inflammation. A retrospective study

Fei,

Bozza,

Melani

et al. 2023

Human Psychopharmacology

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IntroductionRelationships between inflammation and mood have been observed in terms of pro‐inflammatory effects induced by depressive conditions and, in parallel, by an antidepressant‐induced favorable effect on the recovery of inflammatory states. Selective serotonin reuptake inhibitor (SSRI) drugs were hypothesized to improve the prognosis of COVID‐19 pneumonia, a typical acute inflammation, in terms of decreased mortality rate and pro‐inflammatory cytokine serum levels.MethodsThe medical records of COVID‐19 pneumonia inpatients at Careggi University Hospital (Florence) were analyzed for prognosis and Interleukin 6 (IL‐6) after admission for over a period of 22 months. Medical records of patients treated at admission and not discontinued until discharge with an SSRI or with vortioxetine were identified. Two groups, one treated with antidepressants, the other not treated, were evaluated according to the mentioned parameters. Multiple linear regression and logistic regression were performed.ResultsThe entire sample composed of 1236 records (recovered patients 77.1%, deceased patients 22.9%). The treated group (n = 107) had a better prognosis than the untreated group in spite of age and comorbidity both being greater than in the untreated group. Correspondingly, IL‐6 levels in the treated group were significantly lower (p < 0.01) than the levels in the untreated group, in every comparison.ConclusionsOutcomes of this study support the hypothesis of the favorable influence of some antidepressants on the prognosis of COVID‐19, possibly mediated by IL‐6 modulation. Reduction in acute inflammation induced by the action of antidepressants was confirmed.

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COVID-19 mortality among selective serotonin reuptake inhibitor users—results from a nationwide cohort

Cited by 7 publications

References 28 publications

Specific adverse outcomes associated with selective serotonin reuptake inhibitors use in COVID-19 patients might be potentiated by remdesivir use

Specific adverse outcomes associated with selective serotonin reuptake inhibitors use in COVID-19 patients might be potentiated by remdesivir use

Assessing the effect of selective serotonin reuptake inhibitors in the prevention of post-acute sequelae of COVID-19

SSRIs in the course of COVID‐19 pneumonia: Evidence of effectiveness of antidepressants on acute inflammation. A retrospective study

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