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Journal Article Epublish 24 citations

PubMed: 36233753 DOI: 10.3390/jcm11195882

Antidepressant Use and Its Association with 28-Day Mortality in Inpatients with SARS-CoV-2: Support for the FIASMA Model against COVID-19.

J Clin Med 11(19)

Authors: Nicolas Hoertel, Marina Sánchez-Rico, Johannes Kornhuber, Erich Gulbins, Angela M Reiersen, Eric J Lenze, Bradley A Fritz, Farid Jalali, Edward J Mills, Céline Cougoule, Alexander Carpinteiro, Christiane Mühle, Katrin Anne Becker, David R Boulware, Carlos Blanco, Jesús M Alvarado, Nathalie Strub-Wourgaft, Cédric Lemogne, Frédéric Limosin, On Behalf Of Ap-Hp/Université Paris Cité/Inserm Covid-Research Collaboration Ap-Hp Covid Cdr Initiative And Entrepôt de Données de Santé Ap-Hp Consortium

Affiliations

  • Institut de Psychiatrie et Neuroscience de Paris, Université Paris Cité, INSERM U1266, F-75014 Paris, France.
  • AP-HP, DMU Psychiatrie et Addictologie, Hôpital Corentin-Celton, Issy-les-Moulineaux, F-92130 Paris, France.
  • Department of Psychobiology and Behavioural Sciences Methods, Faculty of Psychology, Universidad Complutense de Madrid, Pozuelo de Alarcón, 28223 Pozuelo de Alarcón (Madrid), Spain.
  • Department of Psychiatry and Psychotherapy, University Hospital, Friedrich-Alexander-University of Erlangen-Nuremberg (FAU), 91054 Erlangen, Germany.
  • Institute for Molecular Biology, University Hospital Essen, University of Duisburg-Essen, 47057 Essen, Germany.
  • Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110, USA.
  • Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO 63110, USA.
  • Department of Gastroenterology, Saddleback Medical Group, Laguna Hills, CA 92653, USA.
  • Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON L8S 4K1, Canada.
  • Institut de Pharmacologie et de Biologie Structurale (IPBS), Université de Toulouse, F-31400 Toulouse, France.
  • Department of Hematology and Stem Cell Transplantation, University Hospital Essen, University of Duisburg-Essen, 47057 Essen, Germany.
  • Department of Medicine, Division of Infectious Diseases and International Medicine, University of Minnesota, Minneapolis, MN 55455, USA.
  • National Institute on Drug Abuse (NIDA), National Institutes of Health, Bethesda, MD 20852, USA.
  • COVID-19 Response & Pandemic Preparedness, Drugs for Neglected Diseases Initiative (DNDi), 1202 Geneva, Switzerland.
  • Service de Psychiatrie de l'adulte, AP-HP, Hôpital Hôtel-Dieu, DMU Psychiatrie et Addictologie, F-75004 Paris, France.

Abstract

To reduce Coronavirus Disease 2019 (COVID-19)-related mortality and morbidity, widely available oral COVID-19 treatments are urgently needed. Certain antidepressants, such as fluvoxamine or fluoxetine, may be beneficial against COVID-19. We included 388,945 adult inpatients who tested positive for SARS-CoV-2 at 36 AP−HP (Assistance Publique−Hôpitaux de Paris) hospitals from 2 May 2020 to 2 November 2021. We compared the prevalence of antidepressant use at admission in a 1:1 ratio matched analytic sample with and without COVID-19 (N = 82,586), and assessed its association with 28-day all-cause mortality in a 1:1 ratio matched analytic sample of COVID-19 inpatients with and without antidepressant use at admission (N = 1482). Antidepressant use was significantly less prevalent in inpatients with COVID-19 than in a matched control group of inpatients without COVID-19 (1.9% versus 4.8%; Odds Ratio (OR) = 0.38; 95%CI = 0.35−0.41, p < 0.001). Antidepressant use was significantly associated with reduced 28-day mortality among COVID-19 inpatients (12.8% versus 21.2%; OR = 0.55; 95%CI = 0.41−0.72, p < 0.001), particularly at daily doses of at least 40 mg fluoxetine equivalents. Antidepressants with high FIASMA (Functional Inhibitors of Acid Sphingomyelinase) activity seem to drive both associations. These treatments may reduce SARS-CoV-2 infections and COVID-19-related mortality in inpatients, and may be appropriate for prophylaxis and/or COVID-19 therapy for outpatients or inpatients.

MeSH

Mortality, Therapeutics, Antidepressive Agents, Sphingomyelin Phosphodiesterase, Fluvoxamine, Sars Virus, Fluoxetine, Covid-19, Sars-Cov-2

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