Reduced risk of mortality among COVID-19 patients with in-hospital selective serotonin reuptake inhibitor administration

Abstract

The anti-inflammatory properties of selective serotonin reuptake inhibitors (SSRI)s, particularly fluvoxamine, have been hypothesized to reduce clinical deterioration in patients with COVID-19 when administered early in the disease course. The objective of this analysis was to examine the effect of maintenance SSRI administration, including variation among different medications, on the outcomes of hospitalized patients with COVID-19. Retrospective analysis of disease progression and mortality risk of over 230,000 patients hospitalized with COVID-19 at facilities associated with a large healthcare system in the United States. Receipt of SSRIs during the hospital encounter occurred in approximately 10.6% (n = 24,690) of COVID-19 patients. When matched for patient characteristics, disease severity and other treatments, receipt of any SSRI was associated with a 30% reduction in the relative risk of mortality (RR: 0.70, 95% confidence interval [CI]: 0.67–0.73; adjusted P-value <0.001). Similar reductions in the relative risk of mortality were seen with nearly every individual SSRI; for sertraline-treated patients, the most commonly used SSRI in the data set, there was a 29% reduction in the relative risk of mortality (RR: 0.71, 95% CI: 0.66–0.77; adjusted P-value <0.001). In total, this retrospective analysis suggests that there is a significant association between SSRI antidepressants and reduced morality among patients hospitalized with COVID-19.