Association between antidepressant use and ED or hospital visits in outpatients with SARS-CoV-2

{ 'indexed': {'date-parts': [[2022, 8, 22]], 'date-time': '2022-08-22T15:43:28Z', 'timestamp': 1661183008128}, 'reference-count': 64, 'publisher': 'Springer Science and Business Media LLC', 'issue': '1', 'license': [ { 'start': { 'date-parts': [[2022, 8, 22]], 'date-time': '2022-08-22T00:00:00Z', 'timestamp': 1661126400000}, 'content-version': 'tdm', 'delay-in-days': 0, 'URL': 'https://creativecommons.org/licenses/by/4.0'}, { 'start': { 'date-parts': [[2022, 8, 22]], 'date-time': '2022-08-22T00:00:00Z', 'timestamp': 1661126400000}, 'content-version': 'vor', 'delay-in-days': 0, 'URL': 'https://creativecommons.org/licenses/by/4.0'}], 'funder': [ { 'DOI': '10.13039/100005831', 'name': 'Foundation for Anesthesia Education and Research', 'doi-asserted-by': 'publisher', 'award': ['MRTG08152020FRITZ']}, { 'DOI': '10.13039/100006108', 'name': 'U.S. Department of Health & Human Services | NIH | National Center for Advancing ' 'Translational Sciences', 'doi-asserted-by': 'publisher', 'award': ['UL1TR002345', 'UL1TR002345']}, { 'name': 'U.S. Department of Health & Human Services | NIH | National Center for Advancing ' 'Translational Sciences'}], 'content-domain': {'domain': ['link.springer.com'], 'crossmark-restriction': False}, 'abstract': '<jats:title>Abstract</jats:title><jats:p>Antidepressants have previously been associated with ' 'better outcomes in patients hospitalized with COVID-19, but their effect on clinical ' 'deterioration among ambulatory patients has not been fully explored. The objective of this ' 'study was to assess whether antidepressant exposure was associated with reduced emergency ' 'department (ED) or hospital visits among ambulatory patients with SARS-CoV-2 infection. This ' 'retrospective cohort study included adult patients (<jats:italic>N</jats:italic>\u2009=\u2009' '25 034) with a positive SARS-CoV-2 test performed in a non-hospital setting. Logistic ' 'regression analyses tested associations between home use of antidepressant medications and a ' 'composite outcome of ED visitation or hospital admission within 30 days. Secondary exposures ' 'included individual antidepressants and antidepressants with functional inhibition of acid ' 'sphingomyelinase (FIASMA) activity. Patients with antidepressant exposure were less likely to ' 'experience the primary composite outcome compared to patients without antidepressant exposure ' '(adjusted odds ratio [aOR] 0.89, 95% CI 0.79–0.99, <jats:italic>p</jats:italic>\u2009=\u2009' '0.04). This association was only observed with daily doses of at least 20\u2009mg ' 'fluoxetine-equivalent (aOR 0.87, 95% CI 0.77–0.99, <jats:italic>p</jats:italic>\u2009=\u2009' '0.04), but not with daily doses lower than 20\u2009mg fluoxetine-equivalent (aOR 0.94, 95% CI ' '0.80–1.11, <jats:italic>p</jats:italic>\u2009=\u20090.48). In exploratory secondary analyses, ' 'the outcome incidence was also reduced with exposure to selective serotonin reuptake ' 'inhibitors (aOR 0.87, 95% CI 0.75–0.99, <jats:italic>p</jats:italic>\u2009=\u20090.04), ' 'bupropion (aOR 0.70, 95% CI 0.55–0.90, <jats:italic>p</jats:italic>\u2009=\u20090.005), and ' 'FIASMA antidepressant drugs (aOR 0.87, 95% CI 0.77–0.99, <jats:italic>p</jats:italic>\u2009' '=\u20090.03). Antidepressant exposure was associated with a reduced incidence of emergency ' 'department visitation or hospital admission among SARS-CoV-2 positive patients, in a ' 'dose-dependent manner. These data support the FIASMA model of antidepressants’ effects ' 'against COVID-19.</jats:p>', 'DOI': '10.1038/s41398-022-02109-3', 'type': 'journal-article', 'created': {'date-parts': [[2022, 8, 22]], 'date-time': '2022-08-22T14:04:27Z', 'timestamp': 1661177067000}, 'update-policy': 'http://dx.doi.org/10.1007/springer_crossmark_policy', 'source': 'Crossref', 'is-referenced-by-count': 0, 'title': 'Association between antidepressant use and ED or hospital visits in outpatients with SARS-CoV-2', 'prefix': '10.1038', 'volume': '12', 'author': [ { 'ORCID': 'http://orcid.org/0000-0002-7239-8877', 'authenticated-orcid': False, 'given': 'Bradley A.', 'family': 'Fritz', 'sequence': 'first', 'affiliation': []}, {'given': 'Nicolas', 'family': 'Hoertel', 'sequence': 'additional', 'affiliation': []}, {'given': 'Eric J.', 'family': 'Lenze', 'sequence': 'additional', 'affiliation': []}, {'given': 'Farid', 'family': 'Jalali', 'sequence': 'additional', 'affiliation': []}, { 'ORCID': 'http://orcid.org/0000-0003-3203-4590', 'authenticated-orcid': False, 'given': 'Angela M.', 'family': 'Reiersen', 'sequence': 'additional', 'affiliation': []}], 'member': '297', 'published-online': {'date-parts': [[2022, 8, 22]]}, 'reference': [ { 'key': '2109_CR1', 'doi-asserted-by': 'publisher', 'first-page': '1417', 'DOI': '10.1038/s41591-020-1001-6', 'volume': '26', 'author': 'N Hoertel', 'year': '2020', 'unstructured': 'Hoertel N, Blachier M, Blanco C, Olfson M, Massetti M, Rico MS, et al. 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