“…1 , for detailed information see SI Table 2). Thus, it can be suggested that the protective effect of SGA against COVID-19 may depend on multiple factors such as treatment adherence and the specific type of SGA as previously detected [ 5 , 6 , 8 ], and our results add age and specific diagnosis as factors to consider. Fig.…”
supporting
confidence: 66%
“…Antipsychotics have anti-inflammatory, antioxidant, and neurotrophic properties beyond their canonical monoaminergic mechanisms, suggesting a potential protective effect of these drugs against COVID-19 [ 2 ]. This hypothesis is settled on various preliminary studies carried out in hospitalized patients with a mental illness diagnosis, in which a lower prevalence of COVID-19 severe symptoms was detected in inpatients under atypical or second-generation antipsychotic (SGA) treatment [ [5] , [6] , [7] ]. But also some investigations have failed to replicate these findings [ 8 ].…”
“…1 , for detailed information see SI Table 2). Thus, it can be suggested that the protective effect of SGA against COVID-19 may depend on multiple factors such as treatment adherence and the specific type of SGA as previously detected [ 5 , 6 , 8 ], and our results add age and specific diagnosis as factors to consider. Fig.…”
supporting
confidence: 66%
“…Antipsychotics have anti-inflammatory, antioxidant, and neurotrophic properties beyond their canonical monoaminergic mechanisms, suggesting a potential protective effect of these drugs against COVID-19 [ 2 ]. This hypothesis is settled on various preliminary studies carried out in hospitalized patients with a mental illness diagnosis, in which a lower prevalence of COVID-19 severe symptoms was detected in inpatients under atypical or second-generation antipsychotic (SGA) treatment [ [5] , [6] , [7] ]. But also some investigations have failed to replicate these findings [ 8 ].…”
“…A similar observation was reported by Villoutreix et al [43], who suggested a protective effect of psychotropic drugs. In a retrospective epidemiological study in Spain, patients treated with long-acting antipsychotics had a much lower risk for SARS-CoV-2 infection and a much better outcome of COVID-19 infection than a control group [44,45]. In a large observational study in France, Hoertel et al [46] found a reduced risk for intubation or death in hospitalized patients with COVID-19 when using antidepressant drugs.…”
Introduction In patients with a pre-existing mental disorder, an increased
risk for a first manifestation of a psychiatric disorder in COVID-19 patients, a
more severe course of COVID-19 and an increased mortality have been described.
Conversely, observations of lower COVID-19 incidences in psychiatric in-patients
suggested protective effects of psychiatric treatment and/or
psychotropic drugs against COVID-19.
Methods A retrospective multi-center study was conducted in 24 German
psychiatric university hospitals. Between April and December 2020 (the first and
partly second wave of COVID-19), the effects of COVID-19 were assessed on
psychiatric in-patient care, the incidence and course of a SARS-CoV-2 infection,
and treatment with psychotropic drugs.
Results Patients (n=36,322) were admitted to the hospitals.
Mandatory SARS-CoV-2 tests before/during admission were reported by 23
hospitals (95.8%), while 18 (75%) conducted regular testing
during the hospital stay. Two hundred thirty-two (0.6%) patients were
tested SARS-CoV-2-positive. Thirty-seven (16%) patients were receiving
medical treatment for COVID-19 at the psychiatric hospital, ten (4.3%)
were transferred to an intermediate/intensive care unit, and three
(1.3%) died. The most common prescription for SARS-CoV-2-positive
patients was for second-generation antipsychotics (n=79, 28.2%)
and antidepressants (SSRIs (n=38, 13.5%), mirtazapine
(n=36, 12.9%) and SNRIs (n=29, 10.4%)).
Discussion Contrary to previous studies, our results showed a low number
of infections and mortality in SARS-CoV-2-positive psychiatric patients. Several
preventive measures seem effective to protect this vulnerable group. Our
observations are compatible with the hypothesis of a protective effect of
psychotropic drugs against COVID-19 as the overall mortality and need for
specific medical treatment was low.
“…The BPS's size and comprehensiveness create an exceptional environment for conducting large-scale real-world evidence (RWE) studies. Based on our previous studies 22 , 23 we hypothesized that persons under aripiprazole treatment will show reductions in the risk of death by COVID-19.…”
The relation of antipsychotics with severe Coronavirus Disease 19 (COVID-19) outcomes is a matter of debate since the beginning of the pandemic. To date, controversial results have been published on this issue. We aimed to prove whether antipsychotics might exert adverse or protective effects against fatal outcomes derived from COVID-19. A population-based retrospective cohort study (January 2020 to November 2020) comprising inpatients (15,968 patients) who were at least 18 years old and had a laboratory-confirmed COVID-19 infection. Two sub-cohorts were delineated, comprising a total of 2536 inpatients: individuals who either had no prescription medication or were prescribed an antipsychotic within the 15 days preceding hospitalization. We conducted survival and odds ratio analyses to assess the association between antipsychotic use and mortality, reporting both unadjusted and covariate-adjusted results. We computed the average treatment effects, using the untreated group as the reference, and the average treatment effect on the treated, focusing solely on the antipsychotic-treated population. Among the eight antipsychotics found to be in use, only aripiprazole showed a significant decrease in the risk of death from COVID-19 [adjusted odds ratio (OR) = 0.86; 95% CI, 0.79–0.93, multiple-testing adjusted p-value < 0.05]. Importantly, these findings were consistent for both covariate-adjusted and unadjusted analyses. Aripiprazole has been shown to have a differentiated beneficial effect in protecting against fatal clinical outcome in COVID-19 infected individuals. We speculate that the differential effect of aripiprazole on controlling immunological pathways and inducible inflammatory enzymes, that are critical in COVID19 illness, may be associated with our findings herein.
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