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0 0.5 1 1.5 2+ Mortality 27% Improvement Relative Risk Hospitalization -37% Fluvoxamine for COVID-19  Trkulja et al.  Prophylaxis Is prophylaxis with fluvoxamine beneficial for COVID-19? PSM retrospective 32,085 patients in Croatia Lower mortality (p=0.41) and higher hospitalization (p=0.5), not sig. Trkulja et al., European J. Clinical P.., Nov 2022 Favors fluvoxamine Favors control

Outpatients prescribed with fluvoxamine around the time of COVID-19 diagnosis are not at a reduced risk of subsequent hospitalization and death compared to their non-prescribed peers: population-based matched cohort study

Trkulja et al., European Journal of Clinical Pharmacology, doi:10.1007/s00228-023-03479-3 (date from preprint)
Nov 2022  
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Retrospective COVID+ patients in Croatia, showing no significant difference in outcomes with fluvoxamine prophylaxis.
risk of death, 27.0% lower, RR 0.73, p = 0.41, treatment 749, control 31,336, cohort A vs. B, propensity score matching.
risk of hospitalization, 37.0% higher, RR 1.37, p = 0.50, treatment 749, control 31,336, cohort A vs. B, COVID-related, propensity score matching.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Trkulja et al., 7 Nov 2022, retrospective, Croatia, peer-reviewed, 2 authors.
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Outpatients prescribed with fluvoxamine around the time of COVID-19 diagnosis are not at a reduced risk of subsequent hospitalization and death compared to their non-prescribed peers: population-based matched cohort study
Vladimir Trkulja, Ivan Kodvanj
European Journal of Clinical Pharmacology, doi:10.1007/s00228-023-03479-3
Purpose To assess the effect of exposure to fluvoxamine around the COVID-19 diagnosis on subsequent hospitalizations and mortality in COVID-19 outpatients in a real-life setting. Methods Using nationwide administrative data, we identified adult COVID-19 outpatients diagnosed up to August 15, 2021 and conducted two cohort studies. Study 1 included subjects prescribed fluvoxamine around the index COVID-19 diagnosis (Cohort A), their peers suffering similar psychiatric difficulties but not prescribed fluvoxamine (Cohort B) and those free of psychiatric difficulties/treatments (Cohort C). Study 2 included subjects prescribed fluvoxamine (Cohort Fluvoxamine) and their peers prescribed paroxetine (Cohort Paroxetine). Cohorts were mutually exactly matched and incidence of COVID-19-related hospitalization, 30-day all-cause hospitalization and of COVID-19-related mortality was estimated.
Supplementary Information The online version contains supplementary material available at https:// doi. org/ 10. 1007/ s00228-023-03479-3. Author contribution Vladimir Trkulja and Ivan Kodvanj designed the study, prepared and analyzed the data, drafted the manuscript and completed the final version. Both authors meet the ICMJE criteria for authorship. Declarations Ethics approval This study used anonymized administrative data standardly collected on routine procedures, hence ethical approval was waived by the Ethics Committee of the Zagreb University School of Medicine and Croatian Institute for Public Healthy. Competing interests The authors declare no competing interests. Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
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