Institute of Neuroregeneration and Neurorehabilitation, Department of Pathophysiology, School of Basic Medicine, Qingdao University, Shandong, China.
Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
BMC Med. 2023 Jun 21;21(1):209. doi: 10.1186/s12916-023-02877-9.
Currently, the main pharmaceutical intervention for COVID-19 is vaccination. While antidepressant (AD) drugs have shown some efficacy in treatment of symptomatic COVID-19, their preventative potential remains largely unexplored. Analysis of association between prescription of ADs and COVID-19 incidence in the population would be beneficial for assessing the utility of ADs in COVID-19 prevention.
Retrospective study of association between AD prescription and COVID-19 diagnosis was performed in a cohort of community-dwelling adult mental health outpatients during the 1st wave of COVID-19 pandemic in the UK. Clinical record interactive search (CRIS) was performed for mentions of ADs within 3 months preceding admission to inpatient care of the South London and Maudsley (SLaM) NHS Foundation Trust. Incidence of positive COVID-19 tests upon admission and during inpatient treatment was the primary outcome measure.
AD mention was associated with approximately 40% lower incidence of positive COVID-19 test results when adjusted for socioeconomic parameters and physical health. This association was also observed for prescription of ADs of the selective serotonin reuptake inhibitor (SSRI) class.
This preliminary study suggests that ADs, and SSRIs in particular, may be of benefit for preventing COVID-19 infection spread in the community. The key limitations of the study are its retrospective nature and the focus on a mental health patient cohort. A more definitive assessment of AD and SSRI preventative potential warrants prospective studies in the wider demographic.
目前，针对 COVID-19 的主要药物干预措施是接种疫苗。虽然抗抑郁药（AD）在治疗有症状的 COVID-19 方面显示出一定疗效，但它们的预防潜力在很大程度上仍未得到探索。分析人群中 AD 处方与 COVID-19 发病率之间的关联，将有助于评估 AD 在 COVID-19 预防中的效用。
在英国 COVID-19 大流行的第一波期间，对社区居住的成年精神科门诊患者队列进行了 AD 处方与 COVID-19 诊断之间关联的回顾性研究。对 3 个月内入院前在南伦敦和莫兹利（SLaM）国民保健系统基金会信托基金接受住院治疗的临床记录进行了交互式搜索（CRIS），以查找 AD 的提及。入院时和住院期间 COVID-19 检测呈阳性的发生率是主要的结局测量指标。
调整社会经济参数和身体健康状况后，AD 提及与 COVID-19 检测结果呈阳性的发生率降低约 40%相关。这种关联也适用于选择性 5-羟色胺再摄取抑制剂（SSRI）类 AD 的处方。
这项初步研究表明，AD，特别是 SSRI，可能有助于预防社区中 COVID-19 的传播。该研究的主要局限性是其回顾性性质和对精神科患者队列的关注。需要在更广泛的人群中进行前瞻性研究，以更明确地评估 AD 和 SSRI 的预防潜力。
