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0 0.5 1 1.5 2+ Mortality -103% Improvement Relative Risk ICU admission -395% Hospitalization 40% Progression 32% Case 12% Fluvoxamine  Visos-Varela et al.  Prophylaxis Is prophylaxis with fluvoxamine beneficial for COVID-19? Retrospective 86,602 patients in Spain Higher mortality (p=0.52) and ICU admission (p=0.24), not sig. c19early.org Visos-Varela et al., European Neuropsy.., Apr 2023 Favors fluvoxamine Favors control

Repurposing selective serotonin reuptake inhibitors for severity of COVID-19: A population-based study

Visos-Varela et al., European Neuropsychopharmacology, doi:10.1016/j.euroneuro.2023.03.011
Apr 2023  
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27th 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.
3,900+ studies for 60+ treatments. c19early.org
Retrospective 86,602 patients in Spain, showing lower COVID-19 risk SSRIs citalopram and paroxetine. There were no significant difference for fluvoxamine, which few patients were taking.
risk of death, 103.0% higher, OR 2.03, p = 0.52, treatment 1 of 413 (0.2%) cases, 7 of 7,408 (0.1%) controls, adjusted per study, case control OR.
risk of ICU admission, 395.0% higher, OR 4.95, p = 0.24, treatment 1 of 228 (0.4%) cases, 2 of 4,398 (0.0%) controls, adjusted per study, case control OR.
risk of hospitalization, 40.0% lower, OR 0.60, p = 0.39, treatment 3 of 3,060 (0.1%) cases, 69 of 56,785 (0.1%) controls, adjusted per study, case control OR.
risk of progression, 32.0% lower, OR 0.68, p = 0.56, treatment 3 of 3,060 (0.1%) cases, 25 of 26,757 (0.1%) controls, adjusted per study, case control OR.
risk of case, 12.0% lower, OR 0.88, p = 0.60, treatment 28 of 29,817 (0.1%) cases, 69 of 56,785 (0.1%) controls, adjusted per study, case control OR.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Visos-Varela et al., 23 Apr 2023, retrospective, Spain, peer-reviewed, 8 authors. Contact: maruxa.zapata@usc.es.
This PaperFluvoxamineAll
Repurposing selective serotonin reuptake inhibitors for severity of COVID-19: A population-based study
Irene Visos-Varela, Maruxa Zapata-Cachafeiro, María Piñeiro-Lamas, Eduardo Carracedo-Martínez, Marc Saez, María Teresa Herdeiro, Adolfo Figueiras, Ángel Salgado-Barreira
European Neuropsychopharmacology, doi:10.1016/j.euroneuro.2023.03.011
The World Health Organization has proposed that a search be made for alternatives to vaccines for the prevention and treatment of COVID-19, with one such alternative being selective serotonin reuptake inhibitors (SSRIs). This study thus sought to assess: the impact of previous treatment with SSRI antidepressants on the severity of COVID-19 (risk of hospitalisation, admission to an intensive care unit [ICU], and mortality), its influence on susceptibility to SARS-CoV-2 and progression to severe COVID-19. We conducted a population-based multiple case-control study in a region in the north-west of Spain. Data were sourced from electronic health records. Adjusted odds ratios (aORs) and 95%CIs were calculated using multilevel logistic regression. We collected data from a total of 86,602 subjects: 3060 cases PCR + , 26,757 non-hospitalised cases PCR + and 56,785 controls (without PCR + ). Citalopram displayed a statistically significant
Role of funding source This study was sponsored by the Carlos III Institute of Health via the "COV20/00470" project (co-funded by the European Regional Development Fund , "A way to make Europe"). Contributors IVV: wrote paper. MZC: designed study, wrote paper. MPL: designed study, analysed data, revised paper. ECM: designed study, revised paper MS: analysed data, revised paper. MTH: designed study, revised paper. AF: designed study, analysed data, revised paper. ASB: designed study, analysed data, revised paper. All authors contributed to and have approved the final manuscript. Conflicts of Interest The authors declare that they have no conflicts of interest. Supplementary materials Supplementary material associated with this article can be found, in the online version, at doi: 10.1016/j.euroneuro. 2023.03.011 .
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