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0 0.5 1 1.5 2+ PASC, S1R SSRI 26% Improvement Relative Risk PASC, non-S1R SSRI 25% SSRI for COVID-19  Sidky et al.  Prophylaxis Favors SSRI Favors control

Assessing the Effect of Selective Serotonin Reuptake Inhibitors in the Prevention of Post-Acute Sequelae of COVID-19

Sidky et al., medRxiv, doi:10.1101/2022.11.09.22282142
Nov 2022  
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N3C retrospective 17,933 COVID-19 patients in the USA, showing lower risk of PASC for SSRIs with or without S1R agonist activity.
risk of PASC, 26.0% lower, RR 0.74, p < 0.001, treatment 2,021, control 14,584, S1R agonist SSRI.
risk of PASC, 25.0% lower, RR 0.75, p = 0.003, treatment 1,328, control 14,584, non-S1R agonist SSRI.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Sidky et al., 10 Nov 2022, retrospective, multiple countries, preprint, 8 authors, study period 1 October, 2021 - 7 April, 2022.
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This PaperFluvoxamineAll
Assessing the Effect of Selective Serotonin Reuptake Inhibitors in the Prevention of Post-Acute Sequelae of COVID-19
PhD Hythem Sidky, MD David K Sahner, PhD Andrew T Girvin, PhD Nathan Hotaling, Sam G Michael, MD Ken Gersing
Findings: In this retrospective study leveraging real-world clinical data that included 17 933 patients, a 28% reduction in risk of PASC was observed for S1R agonist SSRIs and a 25% reduction in risk of PASC was observed for non-S1R agonist SSRIs, both versus controls, using a computable phenotype to define PASC. Meaning: SSRIs may play a role in managing the long term disease burden of COVID-19. Future prospective studies are warranted to confirm these findings and evaluate potential mechanisms of action.
Authors' contributions Authorship was determined using ICMJE recommendations. The authors hereby declare no conflicting interests pertaining to the material in this manuscript.
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