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Ongoing use of SSRIs and the hospital course of COVID-19 patients: a retrospective outcome analysis

Rauchman et al., medRxiv, doi:10.1101/2021.10.25.21265218
Oct 2021  
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0 0.5 1 1.5 2+ Mortality 2% Improvement Relative Risk Fluvoxamine for COVID-19  Rauchman et al.  Prophylaxis Is prophylaxis with fluvoxamine beneficial for COVID-19? Retrospective study in the USA No significant difference in mortality c19early.org Rauchman et al., medRxiv, October 2021 Favors fluvoxamine Favors control
26th treatment shown to reduce risk in November 2021
 
*, now known with p = 0.00014 from 21 studies, recognized in 3 countries.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
4,200+ studies for 70+ treatments. c19early.org
Retrospective 9,043 COVID-19+ patients in the USA, 832 with existing SSRI use, showing no significant difference in mortality. None of the patients were on fluvoxamine. Authors note that specific SSRIs such as fluvoxamine may be effective, and that fluvoxamine is a sigma-1 receptor (S1R) agonist and has the strongest binding affinity to S1R of all SSRIs.
risk of death, 2.0% lower, OR 0.98, p = 0.83, RR approximated with OR.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Rauchman et al., 26 Oct 2021, retrospective, USA, preprint, 6 authors.
This PaperFluvoxamineAll
Ongoing use of SSRIs and the hospital course of COVID-19 patients: a retrospective outcome analysis
Steven H Rauchman, Sherri G Mendelson, Courtney Rauchman, Lora J Kasselman, Aaron Pinkhasov, Allison B Reiss
doi:10.1101/2021.10.25.21265218
Background: The SARS-CoV2 virus continues to have devastating consequences worldwide. Though vaccinations have helped to reduce the impact of the virus, new strains still pose a threat to unvaccinated, and to a lesser extent vaccinated, individuals. Therefore, it is imperative to identify treatments that can prevent the development of severe COVID-19. Recently, acute use of SSRI antidepressants in COVID+ patients has been shown to reduce the severity of symptoms compared to placebo. Since SSRIs are a widely used anti-depressant, the aim of this study was to determine if COVID+ patients already on SSRI treatment upon admission to the hospital had reduced mortality compared to COVID+ patients not on chronic SSRI treatment. Methods: A retrospective observational study design was used. Electronic medical records of 9,043 patients with a laboratory-confirmed diagnosis of Covid-19 from 03/2020 to 03/2021from six hospitals were queried for demographic and clinical information. Using R, a logistic regression model was run with mortality as the outcome and SSRI status as the exposure. An adjusted logistic regression model was run to account for age category, gender, and race. All tests were considered significant at p of 0.05 or less. Results: In this sample, no patients admitted on SSRIs had them discontinued. This is consistent with current recommendations. There was no significant difference in the odds of dying between COVID+ patients on chronic SSRIs vs COVID+ patients not taking SSRIs, after controlling for age category, gender, and race. The odds of COVID+ patients on SSRIs dying was 0.98 (95%CI: 0.81, 1.18) compared to COVID+ patients not on SSRIs (p=0.83). Conclusion: In times of pandemics due to novel infectious agents it is difficult, but critical to evaluate safety and efficacy of drugs that might be repurposed for treatment. This large sample size of 9,043 patients suggests that there will be no significant benefit to use of SSRIs to .
Competing interests The authors declare that they have no competing interests.
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