Department of Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain.
Department of Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiology and Public Health - CIBERESP), Madrid, Spain; Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain.
Eur Neuropsychopharmacol. 2023 Jun;71:96-108. doi: 10.1016/j.euroneuro.2023.03.011. Epub 2023 Apr 4.
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 decrease in the risk of hospitalisation (aOR=0.70; 95% CI 0.49-0.99, p = 0.049) and progression to severe COVID-19 (aOR=0.64; 95% CI 0.43-0.96, p = 0.032). Paroxetine was associated with a statistically significant decrease in risk of mortality (aOR=0.34; 95% CI 0.12 - 0.94, p = 0.039). No class effect was observed for SSRIs overall, nor was any other effect found for the remaining SSRIs. The results of this large-scale, real-world data study indicate that, citalopram, could be a candidate drug for being repurposed as preventive treatment aimed at reducing COVID-19 patients' risk of progressing to severe stages of the disease.
世界卫生组织提议寻找 COVID-19 的预防和治疗疫苗替代品，其中一种替代品是选择性 5-羟色胺再摄取抑制剂（SSRIs）。因此，本研究旨在评估：先前使用 SSRIs 抗抑郁药治疗对 COVID-19 严重程度（住院风险、入住重症监护病房 [ICU] 和死亡率）的影响，以及对 SARS-CoV-2 易感性和向严重 COVID-19 进展的影响。我们在西班牙西北部的一个地区进行了一项基于人群的多病例对照研究。数据来自电子健康记录。使用多水平逻辑回归计算调整后的优势比（aOR）和 95%置信区间（CI）。我们共收集了 86602 名患者的数据：3060 名 PCR+患者、26757 名非住院 PCR+患者和 56785 名对照（无 PCR+）。西酞普兰显示出住院风险（aOR=0.70；95%CI 0.49-0.99，p=0.049）和向严重 COVID-19 进展的风险（aOR=0.64；95%CI 0.43-0.96，p=0.032）显著降低。帕罗西汀与死亡率风险降低相关（aOR=0.34；95%CI 0.12-0.94，p=0.039）。总体而言，SSRIs 没有观察到类效应，也没有发现其他 SSRIs 有任何其他作用。这项大规模的真实世界数据研究的结果表明，西酞普兰可能是一种候选药物，可重新用于预防治疗，旨在降低 COVID-19 患者发展为疾病严重阶段的风险。
