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chuka_lisРетроспективное наблюдательное исследование на выборке в 9 тыс больных ковидом в США, которые, кроме того, постоянно принимали препараты (антидепрессанты, против обсессивно-компульсивного расстроства или панических атак) группы СИОЗС (и не прекращали приема препарата во время ковида, согласно текущим рекоемндациям) показало, что СИОЗС не оказывают какого либо значительного и достоверного влияния на картину болезни и смертность от ковида, как и на заражаемость коронавирусом.
Исходя из полученных данных, осбого смысла прописывать эти антидепрессанты заболевшим с ковидом, для лечения ковида- нет.
The potential value of selective serotonin reuptake inhibitors (SSRIs), typically prescribed for anxiety, depression and obsessive-compulsive disorder (OCD), has been discussed significantly in the scientific literature (7) and lay press (8). Numerous in vitro studies have carefully delineated multiple inflammatory pathways in which SSRIs might be beneficial in reducing inflammation (9-12). The key role of inflammation in the progression, morbidity, and mortality of COVID has been well documented in the medical literature and anti-inflammatory effects of SSRIs may underlie their possible protective role in COVID-19 (7, 13). Early in the pandemic a large French multi-center retrospective study (7) suggested the beneficial role of SSRIs in preventing intubation and death in hospitalized COVID-19 patients. The SSRIs needed to be continued within the first 48 hours of hospital admission. The prior use of these drugs in individuals as outpatients before contracting COVID-19 is not clearly described. There was also a noteworthy exclusion of many patients because of incomplete medical records.
A significant segment of the adult population in the United States (estimated at 10-20%) is already taking SSRIs and the rate of antidepressant use has been increasing in the last decade (18). This supports the need to use available data to determine definitively whether patients who are already taking antidepressants fare better or worse than patients not taking such medications. This is especially crucial in more severe COVID-19 cases requiring hospitalization. Our study indicates that, in a population hospitalized for COVID-19, there is no clinical benefit of SSRIs that were being taken before and during admission. Since use of SSRIs for anxiety, OCD or depression seems unrelated to other comorbidities known to affect COVID morbidity and mortality (hypertension, diabetes, heart disease), direct impact of SSRIs on the risk factors for severe COVID-19 is minimal. There is one important caveat and that is the weight gain that may accompany use of some SSRIs (19)
Recently, acute use of SSRI antidepressants in COVID+ patients has been shown to reduce the severity of symptoms compared to placebo. Since SSRIs are a widely used anti-depressant, the aim of this study was to determine if COVID+ patients already on SSRI treatment upon admission to the hospital had reduced mortality compared to COVID+ patients not on chronic SSRI treatment.
Electronic medical records of 9,043 patients with a laboratory-confirmed diagnosis of Covid-19 from 03/2020 to 03/2021from six hospitals were queried for demographic and clinical information. Using R, a logistic regression model was run with mortality as the outcome and SSRI status as the exposure.
Results: In this sample, no patients admitted on SSRIs had them discontinued. This is consistent with current recommendations. There was no significant difference in the odds of dying between COVID+ patients on chronic SSRIs vs COVID+ patients not taking SSRIs, after controlling for age category, gender, and race.
This large sample size of 9,043 patients suggests that there will be no significant benefit to use of SSRIs to decrease mortality rates for hospitalized patients with Covid-19 who are not currently on SSRI medications. This study shows the utility of large clinical databases in addressing the urgent issue of determining what commonly prescribed drugs might be useful in treating COVID-19.
Исходя из полученных данных, осбого смысла прописывать эти антидепрессанты заболевшим с ковидом, для лечения ковида- нет.
The potential value of selective serotonin reuptake inhibitors (SSRIs), typically prescribed for anxiety, depression and obsessive-compulsive disorder (OCD), has been discussed significantly in the scientific literature (7) and lay press (8). Numerous in vitro studies have carefully delineated multiple inflammatory pathways in which SSRIs might be beneficial in reducing inflammation (9-12). The key role of inflammation in the progression, morbidity, and mortality of COVID has been well documented in the medical literature and anti-inflammatory effects of SSRIs may underlie their possible protective role in COVID-19 (7, 13). Early in the pandemic a large French multi-center retrospective study (7) suggested the beneficial role of SSRIs in preventing intubation and death in hospitalized COVID-19 patients. The SSRIs needed to be continued within the first 48 hours of hospital admission. The prior use of these drugs in individuals as outpatients before contracting COVID-19 is not clearly described. There was also a noteworthy exclusion of many patients because of incomplete medical records.
A significant segment of the adult population in the United States (estimated at 10-20%) is already taking SSRIs and the rate of antidepressant use has been increasing in the last decade (18). This supports the need to use available data to determine definitively whether patients who are already taking antidepressants fare better or worse than patients not taking such medications. This is especially crucial in more severe COVID-19 cases requiring hospitalization. Our study indicates that, in a population hospitalized for COVID-19, there is no clinical benefit of SSRIs that were being taken before and during admission. Since use of SSRIs for anxiety, OCD or depression seems unrelated to other comorbidities known to affect COVID morbidity and mortality (hypertension, diabetes, heart disease), direct impact of SSRIs on the risk factors for severe COVID-19 is minimal. There is one important caveat and that is the weight gain that may accompany use of some SSRIs (19)
Recently, acute use of SSRI antidepressants in COVID+ patients has been shown to reduce the severity of symptoms compared to placebo. Since SSRIs are a widely used anti-depressant, the aim of this study was to determine if COVID+ patients already on SSRI treatment upon admission to the hospital had reduced mortality compared to COVID+ patients not on chronic SSRI treatment.
Electronic medical records of 9,043 patients with a laboratory-confirmed diagnosis of Covid-19 from 03/2020 to 03/2021from six hospitals were queried for demographic and clinical information. Using R, a logistic regression model was run with mortality as the outcome and SSRI status as the exposure.
Results: In this sample, no patients admitted on SSRIs had them discontinued. This is consistent with current recommendations. There was no significant difference in the odds of dying between COVID+ patients on chronic SSRIs vs COVID+ patients not taking SSRIs, after controlling for age category, gender, and race.
This large sample size of 9,043 patients suggests that there will be no significant benefit to use of SSRIs to decrease mortality rates for hospitalized patients with Covid-19 who are not currently on SSRI medications. This study shows the utility of large clinical databases in addressing the urgent issue of determining what commonly prescribed drugs might be useful in treating COVID-19.
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