Analysis of the impact of antidepressants and other medications on COVID-19 infection risk in a chronic psychiatric in-patient cohort
Background During the first wave of the coronavirus disease 2019 (COVID-19) pandemic, patients with confirmed cases in New York State accounted for roughly 25% of total US cases, with psychiatric hospital in-patients at particularly high risk for COVID-19 infection. Aims The beneficial effects of m...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2022-01-01
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| Series: | BJPsych Open |
| Subjects: | |
| Online Access: | https://www.cambridge.org/core/product/identifier/S205647242101053X/type/journal_article |
| _version_ | 1811156895905349632 |
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| author | Catherine L. Clelland Krista Ramiah Louisa Steinberg James D. Clelland |
| author_facet | Catherine L. Clelland Krista Ramiah Louisa Steinberg James D. Clelland |
| author_sort | Catherine L. Clelland |
| collection | DOAJ |
| description | Background
During the first wave of the coronavirus disease 2019 (COVID-19) pandemic, patients with confirmed cases in New York State accounted for roughly 25% of total US cases, with psychiatric hospital in-patients at particularly high risk for COVID-19 infection.
Aims
The beneficial effects of mental health medications, such as selective serotonin reuptake inhibitors (SSRIs), on the severity of COVID-19 disease outcomes have been documented. Protective effects against infection have also been suggested for these medications. We therefore tested the hypothesis that medication use modifies the risk of COVID-19 infection in a long-stay, chronic in-patient psychiatry setting, where the potential for exposure was likely uniform across the facility, and where these medications were routinely prescribed.
Method
This was a retrospective cohort study of an adult psychiatric facility operated by the New York State Office of Mental Health. Current medication information and COVID-19 status was collected from electronic medical records for 165 people who were in-patients during the period January to July 2020, and logistic regression was employed to model the main effects of medication use on COVID-19 infection.
Results
A significant protective association was observed between antidepressant use and COVID-19 infection (odds ratio (OR) = 0.33, 95% CI 0.15–0.70, adjusted P < 0.05). Analysis of individual antidepressant classes showed that SSRI, serotonin-norepinephrine reuptake inhibitor and the serotonin-2 antagonist reuptake inhibitor classes of antidepressants, drove this protective effect. Exploratory analyses of individual antidepressants demonstrated an association between lower risk of infection and fluoxetine use (P = 0.023), as well as trazodone use (P = 0.001).
Conclusions
The novel finding of reduced COVID-19 infection risk for psychiatric in-patients taking antidepressants, suggests that antidepressants may be an important weapon in the continued fight against COVID-19 disease. This finding may become particularly salient for in-patient settings if vaccine-resistant strains of the virus appear.
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| first_indexed | 2024-04-10T04:58:46Z |
| format | Article |
| id | doaj.art-140b5a2fb1334853bb92c4fdc2303921 |
| institution | Directory Open Access Journal |
| issn | 2056-4724 |
| language | English |
| last_indexed | 2024-04-10T04:58:46Z |
| publishDate | 2022-01-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | BJPsych Open |
| spelling | doaj.art-140b5a2fb1334853bb92c4fdc23039212023-03-09T12:29:18ZengCambridge University PressBJPsych Open2056-47242022-01-01810.1192/bjo.2021.1053Analysis of the impact of antidepressants and other medications on COVID-19 infection risk in a chronic psychiatric in-patient cohortCatherine L. Clelland0https://orcid.org/0000-0002-9364-3974Krista Ramiah1Louisa Steinberg2James D. Clelland3https://orcid.org/0000-0002-2597-1140Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Irving Medical Center, USA; Department of Pathology and Cell Biology, Columbia University Irving Medical Center, USA; and Department of Psychiatry, Columbia University Irving Medical Center, USAClinical Research Department, The Nathan S. Kline Institute for Psychiatric Research, USAClinical Research Department, The Nathan S. Kline Institute for Psychiatric Research, USA; and Department of Psychiatry, NYU Grossman School of Medicine, USAClinical Research Department, The Nathan S. Kline Institute for Psychiatric Research, USABackground During the first wave of the coronavirus disease 2019 (COVID-19) pandemic, patients with confirmed cases in New York State accounted for roughly 25% of total US cases, with psychiatric hospital in-patients at particularly high risk for COVID-19 infection. Aims The beneficial effects of mental health medications, such as selective serotonin reuptake inhibitors (SSRIs), on the severity of COVID-19 disease outcomes have been documented. Protective effects against infection have also been suggested for these medications. We therefore tested the hypothesis that medication use modifies the risk of COVID-19 infection in a long-stay, chronic in-patient psychiatry setting, where the potential for exposure was likely uniform across the facility, and where these medications were routinely prescribed. Method This was a retrospective cohort study of an adult psychiatric facility operated by the New York State Office of Mental Health. Current medication information and COVID-19 status was collected from electronic medical records for 165 people who were in-patients during the period January to July 2020, and logistic regression was employed to model the main effects of medication use on COVID-19 infection. Results A significant protective association was observed between antidepressant use and COVID-19 infection (odds ratio (OR) = 0.33, 95% CI 0.15–0.70, adjusted P < 0.05). Analysis of individual antidepressant classes showed that SSRI, serotonin-norepinephrine reuptake inhibitor and the serotonin-2 antagonist reuptake inhibitor classes of antidepressants, drove this protective effect. Exploratory analyses of individual antidepressants demonstrated an association between lower risk of infection and fluoxetine use (P = 0.023), as well as trazodone use (P = 0.001). Conclusions The novel finding of reduced COVID-19 infection risk for psychiatric in-patients taking antidepressants, suggests that antidepressants may be an important weapon in the continued fight against COVID-19 disease. This finding may become particularly salient for in-patient settings if vaccine-resistant strains of the virus appear. https://www.cambridge.org/core/product/identifier/S205647242101053X/type/journal_articleAntidepressantsfluoxetinetrazodonepsychiatric illnessCOVID-19 |
| spellingShingle | Catherine L. Clelland Krista Ramiah Louisa Steinberg James D. Clelland Analysis of the impact of antidepressants and other medications on COVID-19 infection risk in a chronic psychiatric in-patient cohort BJPsych Open Antidepressants fluoxetine trazodone psychiatric illness COVID-19 |
| title | Analysis of the impact of antidepressants and other medications on COVID-19 infection risk in a chronic psychiatric in-patient cohort |
| title_full | Analysis of the impact of antidepressants and other medications on COVID-19 infection risk in a chronic psychiatric in-patient cohort |
| title_fullStr | Analysis of the impact of antidepressants and other medications on COVID-19 infection risk in a chronic psychiatric in-patient cohort |
| title_full_unstemmed | Analysis of the impact of antidepressants and other medications on COVID-19 infection risk in a chronic psychiatric in-patient cohort |
| title_short | Analysis of the impact of antidepressants and other medications on COVID-19 infection risk in a chronic psychiatric in-patient cohort |
| title_sort | analysis of the impact of antidepressants and other medications on covid 19 infection risk in a chronic psychiatric in patient cohort |
| topic | Antidepressants fluoxetine trazodone psychiatric illness COVID-19 |
| url | https://www.cambridge.org/core/product/identifier/S205647242101053X/type/journal_article |
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