An overall protective effect of antipsychotic drugs against COVID-19 seems implausible

Outpatient Antipsychotic Use and Severe COVID-19: Avoiding the Impact of Age in a Real-World Data Study

“…Age is an important determinant of health status and during the pandemic was one of the main risk factors for COVID-19 morbidity-mortality ( Bonanad et al., 2020 ; Williamson et al., 2020 ; Bliek-Bueno et al., 2021 ; Baena et al., 2023 ), with the group aged older than 65 years having a 5-fold higher risk of hospitalization than the reference group aged 18 to 29 years ( Baena et al., 2023 ). This age effect is attributable to social (lack of physical activity, isolation, anxiety due to social stigma, increased difficulty for accessing healthcare services), economic (low income or pension dependent), and biological factors, such as a higher prevalence of dementia and geriatric syndromes, a greater degree of frailty, mobility, or communication problems, and/or lower physiological and functional reserve ( Bonanad et al., 2020 ; Baena et al., 2023 ), which could therefore act as confounding factors in relation to susceptibility to SARS-CoV-2 infection and severity of the illness ( Ruiz de Pellón-Santamaría et al., 2022 ). Many of these factors are associated with off-label AP use and are thus seldom reflected in the databases of RWD studies, thereby rendering it impossible to adjust for these variables ( Reilev et al., 2020 ; Bliek-Bueno et al., 2021 ; Cascini et al., 2022 ; Liberman et al., 2022 ; Chen et al., 2023 ).…”