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Antidepressant use and risk of intubation or death in hospitalized patients with COVID-19: A retrospective cohort study of clinical effectiveness. | LitMetric

Antidepressant use and risk of intubation or death in hospitalized patients with COVID-19: A retrospective cohort study of clinical effectiveness.

Front Psychiatry

Psychiatric Epidemiology Research Program and Biological Psychiatry Laboratory, McLean Hospital, Belmont, MA, United States.

Published: September 2022

AI Article Synopsis

  • - Initial trials of the antidepressant fluvoxamine showed potential for treating mild to moderate COVID-19 in outpatients, but later studies had less optimistic results.
  • - A 2021 study suggested that serotonergic antidepressants might reduce the risk of intubation or death in hospitalized COVID-19 patients, leading to further research on this treatment.
  • - In a new study involving 500 hospitalized patients, no significant differences were found in outcomes between those taking antidepressants and those who were not, revealing inconsistent evidence about the effectiveness of these drugs in COVID-19 treatment.

Article Abstract

Initial controlled trials of the serotonergic antidepressant fluvoxamine showed promise for treatment of mild to moderate COVID-19 in outpatients, although more recent outpatient data have been less encouraging. Turning to studies of hospitalized patients, a retrospective cohort study by Hoertel and associates in 2021 found a markedly reduced risk of intubation or death among patients hospitalized with COVID-19 who were receiving serotonergic antidepressants at the time of admission vs. those not receiving antidepressants. In an attempt to replicate these latter findings, we performed a similarly designed study of 500 individuals hospitalized with COVID-19 in a large academic hospital system who were taking a serotonergic antidepressant at the time of admission compared with two groups ( = 573 and = 593) not receiving an antidepressant. In analyses controlling for demographic and clinical variables, we found no significant difference in effect between the antidepressant group and either of the two comparison groups [hazard ratios (95% CI) for intubation or death 1.1 (0.83-1.5) and 1.1 (0.86-1.5); and for death alone 1.3 (0.93-1.8) and 1.1 (0.85-1.7)]. Examining the results of our study, along with those of Hoertel et al. and three additional retrospective cohort studies in inpatients published in the interim, the data permit only very limited conclusions, with the findings on the effect of serotonergic antidepressants ranging from a strongly protective effect to no effect. Although there are numerous threats to validity that might account for this wide range of findings, we could not identify any principal factor or set of factors that could clearly explain the differences.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9520125PMC
http://dx.doi.org/10.3389/fpsyt.2022.951065DOI Listing

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