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Journal Article Epublish 15 citations

PubMed: 38318198 DOI: 10.1016/j.csbj.2023.12.045

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

Comput Struct Biotechnol J 24:115-125

Authors: Hythem Sidky, Kristen A Hansen, Andrew T Girvin, Nathan Hotaling, Sam G Michael, Ken Gersing, David K Sahner

Affiliations

  • National Center for Advancing Translational Sciences, National Institutes of Health, Bethesda, MD, USA.
  • Axle Research and Technologies, Rockville, MD, USA.
  • Palantir Technologies, Denver, CO, USA.

Abstract

Background

Post-acute sequelae of COVID-19 (PASC) produce significant morbidity, prompting evaluation of interventions that might lower risk. Selective serotonin reuptake inhibitors (SSRIs) potentially could modulate risk of PASC via their central, hypothesized immunomodulatory, and/or antiplatelet properties although clinical trial data are lacking.

Materials and Methods

This retrospective study was conducted leveraging real-world clinical data within the National COVID Cohort Collaborative (N3C) to evaluate whether SSRIs with agonist activity at the sigma-1 receptor (S1R) lower the risk of PASC, since agonism at this receptor may serve as a mechanism by which SSRIs attenuate an inflammatory response. Additionally, determine whether the potential benefit could be traced to S1R agonism. Presumed PASC was defined based on a computable PASC phenotype trained on the U09.9 ICD-10 diagnosis code.

Results

Of the 17,908 patients identified, 1521 were exposed at baseline to a S1R agonist SSRI, 1803 to a non-S1R agonist SSRI, and 14,584 to neither. Using inverse probability weighting and Poisson regression, relative risk (RR) of PASC was assessed.A 29% reduction in the RR of PASC (0.704 [95% CI, 0.58-0.85]; P = 4 ×10) was seen among patients who received an S1R agonist SSRI compared to SSRI unexposed patients and a 21% reduction in the RR of PASC was seen among those receiving an SSRI without S1R agonist activity (0.79 [95% CI, 0.67 - 0.93]; P = 0.005).Thus, SSRIs with and without reported agonist activity at the S1R were associated with a significant decrease in the risk of PASC.

MeSH

Selective Serotonin Reuptake Inhibitors, Covid-19, Serotonin

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