Aripiprazole as protector against COVID-19 mortality

Scientific Reports, Journal Year: 2024, Volume and Issue: 14(1)

Published: May 29, 2024

Abstract The relation of antipsychotics with severe Coronavirus Disease 19 (COVID-19) outcomes is a matter debate since the beginning pandemic. To date, controversial results have been published on this issue. We aimed to prove whether might exert adverse or protective effects against fatal derived from COVID-19. A population-based retrospective cohort study (January 2020 November 2020) comprising inpatients (15,968 patients) who were at least 18 years old and had laboratory-confirmed COVID-19 infection. Two sub-cohorts delineated, total 2536 inpatients: individuals either no prescription medication prescribed an antipsychotic within 15 days preceding hospitalization. conducted survival odds ratio analyses assess association between use mortality, reporting both unadjusted covariate-adjusted results. computed average treatment effects, using untreated group as reference, effect treated, focusing solely antipsychotic-treated population. Among eight found be in use, only aripiprazole showed significant decrease risk death [adjusted (OR) = 0.86; 95% CI, 0.79–0.93, multiple-testing adjusted p-value < 0.05]. Importantly, these findings consistent for analyses. Aripiprazole has shown differentiated beneficial protecting clinical outcome infected individuals. speculate that differential controlling immunological pathways inducible inflammatory enzymes, are critical COVID19 illness, may associated our herein.

Language: Английский

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Antiviral efficacy of fluoxetine in early symptomatic COVID-19: an open-label, randomised, controlled, adaptive platform trial (PLATCOV)

EClinicalMedicine, Journal Year: 2025, Volume and Issue: 80, P. 103036 - 103036

Published: Jan. 18, 2025

Language: Английский

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Protective effects of psychiatric medications against COVID-19 mortality before vaccines

PLoS ONE, Journal Year: 2025, Volume and Issue: 20(2), P. e0310438 - e0310438

Published: Feb. 24, 2025

The coronavirus disease pandemic caused by the SARS-CoV-2, which emerged in United States late 2019 to early 2020 and quickly escalated into a national public health crisis. Research has identified psychiatric conditions as possible risk factors associated with COVID-19 infection symptom severity. This study aims determine whether specific classes of medications could reduce likelihood alleviate severity disease. objective this is investigate relationship between neuropsychiatric medication usage outcomes before widespread utilization vaccines. cross-sectional used Optum’s de-identified Clinformatics Data Mart Database identify patients diagnosed their prescriptions States. Ordered logistic regression was predict higher level for long-term new users. Results were adjusted demographic characteristics medical comorbidities. Most users classified user analysis group. Long-term 9% less likely have score (CI: 0.89–0.93, p-value < 0.001) than non-users. SSRI antidepressant users, both (OR: 1.09; CI: 1.06–1.12) short-term 1.17; 1.07–1.27) significantly more lower score. However, results varied across all classes. current suggest that psychopharmacological agents are reduced levels may protective role against COVID-19.

Language: Английский

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Antidepressant Drugs and COVID-19: A Review of Basic and Clinical Evidence

Journal of Clinical Medicine, Journal Year: 2022, Volume and Issue: 11(14), P. 4038 - 4038

Published: July 12, 2022

The COVID-19 pandemic has encouraged the repurposing of existing drugs as a shorter development strategy in order to support clinicians with this difficult therapeutic dilemma. There is evidence theory that some antidepressants can reduce concentrations different cytokines humans and animals and, recently, antiviral activity against SARS-CoV-2 been reported. aims narrative review are evaluate possible role treatment infection benefits risks patients taking for mental disorders infection. A was performed analyse current literature identify antidepressant medication patients. electronic search completed MEDLINE MedRxiv/BioRxiv published ClinicalTrials.gov ongoing clinical trials. results show from preclinical data observational studies about efficacy specific treating In addition, two phase II testing fluvoxamine showed positive deterioration hospitalization rate versus placebo. Seven trials fluvoxamine, fluoxetine, tramadol (as per its anti-inflammatory effect) still early phases. Although available limited, sum several provide basis evaluating use humans. Further investigations will be needed application.

Language: Английский

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An Update on SARS-CoV-2 Clinical Trial Results—What We Can Learn for the Next Pandemic

International Journal of Molecular Sciences, Journal Year: 2023, Volume and Issue: 25(1), P. 354 - 354

Published: Dec. 26, 2023

The coronavirus disease 2019 (COVID-19) pandemic has claimed over 7 million lives worldwide, providing a stark reminder of the importance preparedness. Due to lack approved antiviral drugs effective against coronaviruses at start pandemic, world largely relied on repurposed efforts. Here, we summarise results from randomised controlled trials date, as well selected in vitro data directly acting antivirals, host-targeting and immunomodulatory drugs. Overall, repurposing efforts evaluating antivirals targeting other viral families were unsuccessful, whereas several led clinical improvement hospitalised patients with severe disease. In addition, accelerated drug discovery during progressed multiple novel efficacy, including small molecule inhibitors monoclonal antibodies. We argue that large-scale investment is required prepare for future pandemics; both develop an arsenal broad-spectrum beyond build worldwide trial networks can be rapidly utilised.

Language: Английский

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Antiviral efficacy of fluoxetine in early symptomatic COVID-19: an open-label, randomised, controlled, adaptive platform trial (PLATCOV)

medRxiv (Cold Spring Harbor Laboratory), Journal Year: 2024, Volume and Issue: unknown

Published: Jan. 18, 2024

Abstract Background The selective serotonin reuptake inhibitors (SSRIs) fluoxetine and fluvoxamine were repurposed for the treatment of early COVID-19 based on their antiviral activity in vitro , observational clinical trial evidence suggesting they prevented progression to severe disease. However, these SSRIs have not been recommended guidelines vivo has characterised. Methods PLATCOV is an open-label, multicentre, phase 2, randomised, controlled, adaptive pharmacometric platform running Thailand, Brazil, Pakistan, Laos. We recruited low-risk adult outpatients aged 18-50 with symptomatic (symptoms <4 days). Patients assigned using block randomisation one eleven arms including oral (40mg/day 7 days), or no study drug. Uniform ratios applied across active groups while drug group comprised ≥20% patients at all times. primary endpoint was rate oropharyngeal viral clearance assessed a modified intention-to-treat population (>2 days follow-up). estimated under Bayesian hierarchical linear model fitted log10 densities standardised duplicate swab eluates taken daily over week (18 measurements per patient). This ongoing registered ClinicalTrials.gov ( NCT05041907 ). Findings Between 5 April 2022 8 May 2023 271 concurrently randomised either (n=120) (n=151). Fluoxetine well tolerated accelerated relative arm by 15% (95% credible interval (CrI): 2% 34%). In pooled meta-analysis unblinded substantially less than ritonavir-boosted nirmatrelvir-85% increase CrI: 61 112%); remdesivir 35% (14 59%), molnupiravir 37% 60%), casirivimab/imdevimab 29% (10 48%). Interpretation against SARS-CoV-2. Although level efficacy other currently available drugs, might still be useful prophylaxis where effect required. Funding Wellcome Trust Grant ref: 223195/Z/21/Z through Therapeutics Accelerator. Evidence before this proposed as therapeutics initially observational, evidence. reports suggested that taking had reduced probability developing dying. searched PubMed EMBASE studies English up until 30 th November search terms “fluoxetine”, “fluvoxamine” “COVID-19” restricted controlled trials (RCTs). Eight outpatient RCTs identified. There outpatients. A compatible moderate reduction hospitalisation death risk ratio 0.80 CI: 0.62,1.01). Added value showed illness SSRI weak . antivirals such nirmatrelvir molnupiravir. approach described here provides quantitative measure effects tractable sample sizes. Implications COVID-19. insufficient but, required prevent infection, could beneficial prophylaxis.

Language: Английский

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Excess mortality and its causes among older adults with schizophrenia versus those with bipolar disorder and major depressive disorder: a 5-year prospective multicenter study

European Archives of Psychiatry and Clinical Neuroscience, Journal Year: 2024, Volume and Issue: unknown

Published: Jan. 31, 2024

Language: Английский

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Medications Modulating the Acid Sphingomyelinase/Ceramide System and 28-Day Mortality among Patients with SARS-CoV-2: An Observational Study

Pharmaceuticals, Journal Year: 2023, Volume and Issue: 16(8), P. 1107 - 1107

Published: Aug. 4, 2023

Prior evidence indicates the potential central role of acid sphingomyelinase (ASM)/ceramide system in infection cells with SARS-CoV-2. We conducted a multicenter retrospective observational study including 72,105 adult patients laboratory-confirmed SARS-CoV-2 who were admitted to 36 AP-HP (Assistance Publique-Hôpitaux de Paris) hospitals from 2 May 2020 31 August 2022. examined association between ongoing use medications functionally inhibiting (FIASMA), which reduces vitro, upon hospital admission 28-day all-cause mortality 1:1 ratio matched analytic sample based on clinical characteristics, disease severity and other (N = 9714). The univariate Cox regression model showed that FIASMA medication at was associated significantly lower risks (HR 0.80; 95% CI 0.72-0.88; p < 0.001). In this study, substantially reduced among hospitalized COVID-19. These findings support continuation these during treatment infections. Randomized trials (RCTs) are needed confirm results, starting molecules greatest effect size e.g., fluoxetine, escitalopram, amlodipine.

Language: Английский

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Association between benzodiazepine receptor agonist use and mortality in patients hospitalised for COVID-19: a multicentre observational study

Epidemiology and Psychiatric Sciences, Journal Year: 2022, Volume and Issue: 31

Published: Jan. 1, 2022

To examine the association between benzodiazepine receptor agonist (BZRA) use and mortality in patients hospitalised for coronavirus disease 2019 (COVID-19).A multicentre observational study was performed at Greater Paris University hospitals. The sample involved 14 381 COVID-19. A total of 686 (4.8%) inpatients received a BZRA hospital admission mean daily diazepam-equivalent dose 19.7 mg (standard deviation (s.d.) = 25.4). baseline date admission, primary endpoint death. We compared this who BZRAs those did not time-to-event analyses adjusted sociodemographic characteristics, medical comorbidities other medications. analysis Cox regression model with inverse probability weighting (IPW).Over follow-up 14.5 days (s.d. 18.1), occurred 186 (27.1%) 1134 (8.3%) not. There significant increased both crude (hazard ratio (HR) 3.20; 95% confidence interval (CI) 2.74-3.74; p < 0.01) IPW (HR 1.61; CI 1.31-1.98, 0.01), dose-dependent relationship 1.55; 1.08-2.22; 0.02). This remained sensitivity analyses. Exploratory indicate that most may be associated an among COVID-19, except diazepam, which reduced any treatment.BZRA suggesting potential benefit decreasing or tapering off gradually these medications when possible.

Language: Английский

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Relationship between antidepressants and severity of SARS-CoV-2 Omicron infection: a retrospective cohort study using real-world data

The Lancet Regional Health - Western Pacific, Journal Year: 2023, Volume and Issue: 34, P. 100716 - 100716

Published: Feb. 27, 2023

Few studies have used real-world data to evaluate the impact of antidepressant use on risk developing severe outcomes after SARS-CoV-2 Omicron infection.This is a retrospective cohort study using propensity-score matching examine relationship between and COVID-19 severity. Inpatient medication records all adult patients in Hong Kong during Omicron-predominated period were obtained. Severe clinical including intensive care unit admission inpatient death first positive results reverse transcription polymerase chain reaction as well composite outcome both studied. Cox proportional hazard models applied estimate crude adjusted ratios (HR).Of 60,903 hospitalised admitted, 40,459 included for matching, among which 3821 (9.4%) prescribed antidepressants. The rates admission, death, event 3.9%, 25.5%, 28.3% respectively unexposed group, 1.3%, 20.0%, 21.1% exposed with HR equal 0.332 (95% CI, 0.245-0.449), 0.868 0.800-0.942), 0.786 0.727-0.850) respectively. result was generally consistent when stratified by selective serotonin reuptake inhibitors (SSRIs) non-SSRIs. Antidepressants functional inhibition acid sphingomyelinase activity, specifically fluoxetine, also negatively associated outcomes. effect antidepressants more apparent female fully vaccinated patients.Antidepressant lower COVID-19. findings support continuation COVID-19, provide evidence treatment potential COVID-19.This research supported Health Medical Research Fund [grant numbers COVID190105, COVID19F03, INF-CUHK-1], Collaborative University Grants Committee C4139-20G], National Natural Science Foundation China (NSFC) [71974165], Group Scheme from Chinese Kong.

Language: Английский

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