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Clin Microbiol Infect . COVID-19 mortality among selective serotonin reuptake inhibitor users - Results from a nationwide cohort

tetano

Editor, Senior Moderator
Clin Microbiol Infect


. 2023 May 5;S1198-743X(23)00203-3.
doi: 10.1016/j.cmi.2023.04.028. Online ahead of print. COVID-19 mortality among selective serotonin reuptake inhibitor users - Results from a nationwide cohort

Marius Ahm Stauning[SUP] 1 [/SUP], Dogukan Jesper Gür[SUP] 2 [/SUP], Christian Torp-Pedersen[SUP] 3 [/SUP], Jens Tingleff[SUP] 4 [/SUP]



Affiliations
Abstract

Objective: To examine differences in mortality and/or severe acute respiratory syndrome between selective serotonin reuptake inhibitor- (SSRI) users and non-SSRI-users up to 60 days after a positive severe-acute-respiratory-syndrome-coronavirus-2 (SARS-CoV-2) real-time reverse transcription-polymerase chain reaction (PCR) test.
Methods: Retrospective cohort study including all Danish residents above the age of eighteen with a positive SARS- CoV-2 PCR test from February 26[SUP]th[/SUP], 2020, to October 5[SUP]th[/SUP]2021. The follow-up period was 60 days. The primary outcome was all-cause mortality, and the secondary outcome was severe acute respiratory syndrome. Exposure of interest was SSRI-use. Differences between SSRI- users and non-users were examined with Cox Regression.
Results: 286447 SARS-CoV-2 positive individuals were identified, and 7113 met the criteria for SSRI-use. SSRI-users had a mean age of 50.4 years, and 34% were male. Non-SSRI users had a mean age of 41.4 years, and 50 % were male. Similar vaccination frequency was seen among the two groups. Sertraline was the most commonly used SSRI, followed by citalopram and escitalopram. We found 255 deaths among SSRI users (3.6%) and 2872 deaths among non-SSRI users (1.0%). SSRI-use was significantly associated with increased mortality, with a hazard ratio of 1.32 (95% CI [1.16 -1.50], p=0.015), even when adjusting for age, sex, vaccination status and comorbidities.
Conclusion: We found significantly higher mortality when comparing SSRI-users to non-SSRI-users within60 days after a positive SARS-CoV-2 PCR test. Even when considering possible residual confounding positive effect of SSRI-intake seems highly unlikely. Our study therefore speaks against the hypothesis of repurposing SSRI-drugs for COVID-19 treatment.


 
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