Impact of Psychiatric and Related Somatic Medications on the Duration and Severity of COVID-19: A Retrospective Explorative Multi-center Study from the German Metropolitan Ruhr-area.
2021
Introduction Several psychiatric and somatic medications are assumed to
improve COVID-19-symptoms. These include antidepressants, antipsychotics, and
anticonvulsants as well as anticoagulants, statins, and
renin-angiotensin-aldosterone-system (RAAS)-inhibitors for somatic comorbid
conditions. All these agents may reduce the hyperinflammatory response to
SARS/CoV-2 or the related negative cardio-cerebrovascular outcomes. Methods In a retrospective longitudinal, multi-center inpatient study, we
sought to explore the influence of psychiatric medications on COVID-19,
comprising the period from diagnosing SARS/CoV-2-infection via PCR
(nasopharyngeal swab) up to the next 21 days. Ninety-six psychiatric inpatients
(mean age [SD] 65.5 (20.1), 54% females) were included. The primary
outcome was the COVID-19-duration. Secondary outcomes included symptom severity
and the presence of residual symptoms. Results COVID-19-related symptoms emerged in 60 (62.5%) patients,
lasting 6.5 days on average. Six (6.3%) 56–95 years old patients
died from or with COVID-19. COVID-19-duration and residual symptom-presence
(n=22, 18%) were not significantly related to any substance.
Respiratory and neuro-psychiatric symptom-load was significantly and negatively
related to prescription of antidepressants and anticoagulants, respectively.
Fatigue was negatively and positively related to RAAS-inhibitors and
proton-pump-inhibitors, respectively. These significant relationships
disappeared with p-value adjustment owed to multiple testing. The mean total
psychiatric burden was not worsened across the study. Discussion None of the tested medications was significantly associated
with the COVID-19-duration and -severity up to the end of post-diagnosing week
3. However, there were a few biologically plausible and promising relationships
with antidepressants, anticoagulants, and RAAS-inhibitors before p-value
adjustment. These should encourage larger and prospective studies to re-evaluate
the influence of somatic and psychiatric routine medications on COVID-19-related
health outcomes.
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