Generic placeholder image

Current Psychopharmacology

Editor-in-Chief

ISSN (Print): 2211-5560
ISSN (Online): 2211-5579

Research Article

The Impact of SSRI Use on the Clinical Outcome and Prognosis of COVID-19 Patients: A Single-Center Prospective Study

Author(s): Mitra Safa, Seyed Ali Ziaee, Afshin Moniri, Fatemeh Ghassem Boroujerdi*, Farzaneh Haji Zadeh, Amirali Soheili, Siamak Afaghi, Fatemeh Sadat Rahimi and Bamdad Mirab Zadeh Ardekani

Volume 11, Issue 2, 2022

Published on: 07 November, 2022

Article ID: e271022210420 Pages: 7

DOI: 10.2174/2211556011666221027124605

Price: $65

Abstract

Background: Recent studies have found a link between the usage of selective serotonin reuptake inhibitors (SSRIs) and a lower mortality rate in COVID-19 cases.

Objective: The goal of the current research was to evaluate the effectiveness of SSRI drugs in improving COVID-19 patients.

Methods: This prospective case-control study compared SSRI-treated patients with matched control patients not treated with SSRIs at the Masih Daneshvari Hospital on a population of 350 patients diagnosed with COVID-19 from March 15th, 2021, to March 16th, 2022.

Results: ICU admission rates were significantly more in the control group than in the case group (44.8% vs. 25.9%; p-value=0.0002; Odds Ratio (OR)= 2.32). Intubation was reported for more cases in the control group than the case group (26.7% vs. 11.4%; p-value=0.0002; OR=2.84). The mortality rate was found to be significantly more in the control group than in the case group (23.0% vs. 10.8%; p-value=0.0002; OR=2.46). Furthermore, the subgroup analyses on fluvoxamine and sertraline showed that hospitalization period, ICU admission rates, and intubation were all reported to be significantly lower in each case subgroup than the control group.

Conclusion: Our assessments underlined the potential efficacy of SSRIs in improving COVID-19 patients’ prognosis since the use of SSRIs was shown to be associated with shorter hospital stay and ICU stay, lower ICU admission rates and intubation rates, and ultimately decreased mortality rates.

[1]
Hoertel N. Sánchez-Rico M, Vernet R, et al. Association between antidepressant use and reduced risk of intubation or death in hospitalized patients with COVID-19: Results from an observational study. Mol Psychiatry 2021; 26(9): 5199-212.
[http://dx.doi.org/10.1038/s41380-021-01021-4] [PMID: 33536545]
[2]
Stebbing J, Phelan A, Griffin I, et al. COVID-19: combining antiviral and anti-inflammatory treatments. Lancet Infect Dis 2020; 20(4): 400-2.
[http://dx.doi.org/10.1016/S1473-3099(20)30132-8] [PMID: 32113509]
[3]
Liu Y, Yan LM, Wan L, et al. Viral dynamics in mild and severe cases of COVID-19. Lancet Infect Dis 2020; 20(6): 656-7.
[http://dx.doi.org/10.1016/S1473-3099(20)30232-2] [PMID: 32199493]
[4]
Hojyo S, Uchida M, Tanaka K, et al. How COVID-19 induces cytokine storm with high mortality. Inflamm Regen 2020; 40(1): 37.
[http://dx.doi.org/10.1186/s41232-020-00146-3] [PMID: 33014208]
[5]
Wang L, Wang R, Liu L, Qiao D, Baldwin DS, Hou R. Effects of SSRIs on peripheral inflammatory markers in patients with major depressive disorder: A systematic review and meta-analysis. Brain Behav Immun 2019; 79: 24-38.
[http://dx.doi.org/10.1016/j.bbi.2019.02.021] [PMID: 30797959]
[6]
Amini K, Sahebnasagh A, Mojtahedzadeh M. Possible role of selective serotonin reuptake inhibitors (SSRIs) in clinical outcome of COVID-19 patients. Front Emerg Med 2021; 5(4)1404166
[7]
Hannestad J, DellaGioia N, Bloch M. The effect of antidepressant medication treatment on serum levels of inflammatory cytokines: a meta-analysis. Neuropsychopharmacology 2011; 36(12): 2452-9.
[http://dx.doi.org/10.1038/npp.2011.132] [PMID: 21796103]
[8]
Gulbins E, Palmada M, Reichel M, et al. Acid sphingomyelinase–ceramide system mediates effects of antidepressant drugs. Nat Med 2013; 19(7): 934-8.
[http://dx.doi.org/10.1038/nm.3214] [PMID: 23770692]
[9]
Carpinteiro A, Edwards MJ, Hoffmann M, et al. Pharmacological inhibition of acid sphingomyelinase prevents uptake of SARS-CoV-2 by epithelial cells. Cell Rep Med 2020; 1(8)100142
[http://dx.doi.org/10.1016/j.xcrm.2020.100142] [PMID: 33163980]
[10]
Lenze EJ, Mattar C, Zorumski CF, et al. Fluvoxamine vs placebo and clinical deterioration in outpatients with symptomatic COVID-19. JAMA 2020; 324(22): 2292-300.
[http://dx.doi.org/10.1001/jama.2020.22760] [PMID: 33180097]
[11]
Sukhatme VP, Reiersen AM, Vayttaden SJ, Sukhatme VV. Fluvoxamine: A review of its mechanism of action and its role in COVID-19. Front Pharmacol 2021; 12652688
[http://dx.doi.org/10.3389/fphar.2021.652688] [PMID: 33959018]
[12]
Oskotsky T. Marić I, Tang A, et al. Mortality risk among patients with COVID-19 prescribed selective serotonin reuptake inhibitor antidepressants. JAMA Netw Open 2021; 4(11)e2133090
[http://dx.doi.org/10.1001/jamanetworkopen.2021.33090] [PMID: 34779847]
[13]
Calusic M, Robert M, Lea L, et al. Safety and efficacy of fluvoxamine in COVID-19 ICU patients: An open label, prospective cohort trial with matched controls. Br J Clin Pharmacol 2021; 88(5): 2065-73.
[PMID: 34719789]
[14]
Reis G, Eduardo AS, Daniela CMS, et al. Effect of early treatment with fluvoxamine on risk of emergency care and hospitalisation among patients with COVID-19: the TOGETHER randomised, platform clinical trial. Lancet Glob Health 2021; 10(1): E42-51.
[PMID: 34717820]
[15]
Hashimoto Y, Suzuki T, Hashimoto K. Mechanisms of action of fluvoxamine for COVID-19: A historical review. Mol Psychiatry 2022; 27(4): 1898-907.
[http://dx.doi.org/10.1038/s41380-021-01432-3] [PMID: 34997196]
[16]
Eyre H, Lavretsky H, Kartika J, Qassim A, Baune B. Modulatory effects of antidepressant classes on the innate and adaptive immune system in depression. Pharmacopsychiatry 2016; 49(3): 85-96.
[http://dx.doi.org/10.1055/s-0042-103159] [PMID: 26951496]
[17]
Leonard BE. SSRI differntiation: Pharmacology and pharmacokinetics. Hum Psychopharmacol 1995; 10 (Suppl. 3): S149-58.
[http://dx.doi.org/10.1002/hup.470100903] [PMID: 29569414]
[18]
Ishima T, Fujita Y, Hashimoto K. Interaction of new antidepressants with sigma-1 receptor chaperones and their potentiation of neurite outgrowth in PC12 cells. Eur J Pharmacol 2014; 727: 167-73.
[http://dx.doi.org/10.1016/j.ejphar.2014.01.064] [PMID: 24508523]
[19]
Rosen DA, Seki SM. Fernández-Castañeda A, et al. Modulation of the sigma-1 receptor–IRE1 pathway is beneficial in preclinical models of inflammation and sepsis. Sci Transl Med 2019; 11(478)eaau5266
[http://dx.doi.org/10.1126/scitranslmed.aau5266] [PMID: 30728287]
[20]
Schlienger RG, Meier CR. Effect of selective serotonin reuptake inhibitors on platelet activation: Can they prevent acute myocardial infarction? Am J Cardiovasc Drugs 2003; 3(3): 149-62.
[http://dx.doi.org/10.2165/00129784-200303030-00001] [PMID: 14727927]
[21]
Wilson DR, Warise L. Cytokines and their role in depression. Perspect Psychiatr Care 2008; 44(4): 285-9.
[http://dx.doi.org/10.1111/j.1744-6163.2008.00188.x] [PMID: 18826467]
[22]
Hannestad J, DellaGioia N, Ortiz N, Pittman B, Bhagwagar Z. Citalopram reduces endotoxin-induced fatigue. Brain Behav Immun 2011; 25(2): 256-9.
[http://dx.doi.org/10.1016/j.bbi.2010.10.013] [PMID: 20955776]
[23]
Sukoff Rizzo SJ, Neal SJ, Hughes ZA, et al. Evidence for sustained elevation of IL-6 in the CNS as a key contributor of depressive-like phenotypes. Transl Psychiatry 2012; 2(12)e199
[http://dx.doi.org/10.1038/tp.2012.120] [PMID: 23212583]
[24]
Perna G, Cogo R, Bellodi L. Selective serotonin re-uptake inhibitors beyond psychiatry: Are they useful in the treatment of severe, chronic, obstructive pulmonary disease? Depress Anxiety 2004; 20(4): 203-4.
[http://dx.doi.org/10.1002/da.20041] [PMID: 15643645]
[25]
Roumestan C, Michel A, Bichon F, et al. Anti-inflammatory properties of desipramine and fluoxetine. Respir Res 2007; 8(1): 35.
[http://dx.doi.org/10.1186/1465-9921-8-35] [PMID: 17477857]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy