Ongoing Use of SSRIs Does Not Alter Outcome in Hospitalized COVID-19 Patients: A Retrospective Analysis
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Abstract
SARS-CoV-2 continues to have devastating consequences worldwide. Though vaccinations have helped reduce spread, new strains still pose a threat. Therefore, it is imperative to identify treatments that prevent severe COVID-19 infection. Recently, acute use of SSRI antidepressants in COVID+ patients was shown to reduce symptom severity. The aim of this retrospective observational study was to determine whether COVID+ patients already on SSRIs upon hospital admission had reduced mortality compared to COVID+ patients not on chronic SSRI treatment. Electronic medical records of 9044 patients with laboratory-confirmed COVID-19 from six hospitals were queried for demographic and clinical information. Using R, a logistic regression model was run with mortality as the outcome and SSRI status as the exposure. In this sample, no patients admitted on SSRIs had them discontinued. There was no significant difference in the odds of dying between COVID+ patients on chronic SSRIs vs. those not taking SSRIs, after controlling for age category, gender, and race. This study shows the utility of large clinical databases in determining what commonly prescribed drugs might be useful in treating COVID-19. During pandemics due to novel infectious agents, it is critical to evaluate safety and efficacy of drugs that might be repurposed for treatment.
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SciScore for 10.1101/2021.10.25.21265218: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics not detected. Sex as a biological variable One person was dropped from the analysis because their self-reported gender [female, male] was listed as “ unknown”. Randomization not detected. Blinding not detected. Power Analysis not detected. Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:As noted previously, the initial study from France that implicated SSRIs as potential therapeutic tools in COVID-19 was beset by a number of limitations …
SciScore for 10.1101/2021.10.25.21265218: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics not detected. Sex as a biological variable One person was dropped from the analysis because their self-reported gender [female, male] was listed as “ unknown”. Randomization not detected. Blinding not detected. Power Analysis not detected. Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:As noted previously, the initial study from France that implicated SSRIs as potential therapeutic tools in COVID-19 was beset by a number of limitations (7). A few other small studies have supported the results from France. In a randomized prospective clinical trial of 152 outpatients with confirmed COVID-19 given either fluvoxamine or placebo, early clinical introduction of fluvoxamine decreased likelihood of clinical deterioration over a 15-day period (15). The authors readily acknowledged the difficulty in recruiting patients. The short duration and small sample size were other limiting variables. The authors recommended larger prospective clinical trials. A larger clinical trial on fluvoxamine was recently completed in Brazil led by investigators from Brazil and Canada (16). This study appears to support the value of fluvoxamine in early intervention in COVID-19 patients in preventing progression, serious complications and mortality. This study is pending formal publication. Another important SSRI investigation took place early in the pandemic at a San Francisco Bay Area racetrack (17). A large number of racetrack employees were diagnosed with COVID-19 in a very brief period of time. The racetrack physician offered fluvoxamine to the infected racetrack employees and approximately 50% of the employees took the drug while the remainder declined. There was no treatment available for early intervention in COVID-19 at that point in time besides supportive care. According to th...
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
Results from scite Reference Check: We found no unreliable references.
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