Efficacy and safety of selective serotonin reuptake inhibitors in COVID-19 management: A systematic review and meta-analysis

Lastly, we found that fluvoxamine was not associated with reduced hospitalization once we excluded one study with a high risk of bias rating. This was likely due to loss of precision from a reduced sample size given the small number of studies and patients included in this review. The incorporation of larger, betterdesigned RCTs in future meta-analyses can help confirm our findings relating to hospitalization. CONCLUSION This systematic review and meta-analysis of 6 RCTs and 5 observational studies found that fluvoxamine may reduce mortality and hospitalization based on moderate quality of evidence. Medium J o u r n a l P r e -p r o o f CONFLICT OF INTEREST The authors declare no conflicts of interest. J o u r n a l P r e -p r o o f GRADE Working Group quality of evidence rating [28] High quality: We are very confident that the true effect lies close to that of the estimate of the effect Moderate quality: We are moderately confident in the effect estimate; the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different Low quality: Our confidence in the effect estimate is limited; the true effect may be substantially different from the estimate of the effect Very low quality: We have very little confidence in the effect estimate; the true effect is likely to be substantially different from the estimate of effect a The risk in the intervention group (and its 95% CI) is based on the assumed risk in..