锂与严重COVID-19感染的风险：一项基于人群的回顾性登记研究

IF 3.5 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research Pub Date : 2025-02-13 DOI:10.1016/j.jpsychores.2025.112053

Niklas Harry Nilsson , Marie Bendix , Louise Öhlund , Anna Gibbs , Micael Widerström , Ursula Werneke , Martin Maripuu

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引用次数: 0

摘要

先前的研究表明，锂具有抗病毒特性，包括在体外对COVID-19的潜在有效性。本研究旨在探讨锂和其他精神药物对双相情感障碍患者因COVID-19死亡、住院和ICU住院风险的影响。主要目的是评估锂是否对现实世界人群中的covid -19感染有益。方法回顾性登记研究，使用来自多个瑞典患者登记册的数据，包括39063名瑞典双相情感障碍患者和处方情绪稳定剂。结果包括2020年3月11日至2021年3月10日期间与covid -19相关的死亡、住院和ICU入院。对年龄、性别和躯体合并症进行多因素logistic回归校正。结果44.2%的患者使用了单药或联合用药；其他心境稳定剂处方占55.8%。锂与covid -19相关的死亡、住院或ICU住院之间没有显着关联。非典型抗精神病药物与covid -19相关死亡（OR为1.58 [95% CI 1.01-2.47]）、住院（OR为1.80 [95% CI 1.49-2.18]）和ICU住院（OR为2.25 [95% CI 1.33-3.80]）的比值比增加相关。苯二氮卓类药物与covid -19相关死亡（OR为1.54 [95% CI 1.01-2.35]）和住院率（OR为1.26 [95% CI 1.03-1.53]）显著增加相关。然而，在一项特别分析中，锂单药治疗与住院率和ICU入院率降低有关。结论我们的研究结果削弱了锂可降低双相情感障碍患者与COVID-19感染相关的严重事件风险的假设。

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Lithium and the risk of severe COVID-19 infection: A retrospective population-based register study

Objectives

Previous research has suggested antiviral properties for lithium, including potential effectiveness against COVID-19 in vitro. This study aimed to investigate the impact of lithium and other psychotropic drugs on the risks of mortality, hospitalization, and ICU admission due to COVID-19 among individuals with bipolar disorder. The primary objective was to assess whether lithium was beneficial in COVID-19-infection in a real-world population.

Methods

Retrospective register study using data from multiple Swedish patient registers, including 39,063 individuals in Sweden with bipolar disorder and prescribed mood stabilizers. Outcomes included COVID-19-associated death, hospitalization, and ICU admission between 11 March 2020 and 10 March 2021. Multivariate logistic regression adjusted for age, sex, and somatic comorbidities was conducted.

Results

Lithium were prescribed to 44.2 % of patients, either as mono- or combination therapy; other mood stabilizers were prescribed to 55.8 %. There were no significant associations between lithium and COVID-19-associated death, hospitalization, or ICU admission. Atypical antipsychotics were associated with increased odds ratios for COVID-19-associated death (OR 1.58 [95 % CI 1.01–2.47]), hospitalization (OR 1.80 [95 % CI 1.49–2.18]), and ICU admission (OR 2.25 [95 % CI 1.33–3.80]). Benzodiazepines were associated with a significant increase in COVID-19-associated death (OR 1.54 [95 % CI 1.01–2.35]) and hospitalization OR 1.26 [95 % CI 1.03–1.53]). In an ad hoc analysis, lithium monotherapy was, however, associated with reduced hospitalizations and ICU admissions.

Conclusions

Our findings weaken the hypothesis that lithium reduces the risk of severe events associated with COVID-19 infection in bipolar disorder.

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来源期刊

Journal of Psychosomatic Research 医学-精神病学

CiteScore

7.40

自引率

6.40%

发文量

314

审稿时长

6.2 weeks

期刊介绍： The Journal of Psychosomatic Research is a multidisciplinary research journal covering all aspects of the relationships between psychology and medicine. The scope is broad and ranges from basic human biological and psychological research to evaluations of treatment and services. Papers will normally be concerned with illness or patients rather than studies of healthy populations. Studies concerning special populations, such as the elderly and children and adolescents, are welcome. In addition to peer-reviewed original papers, the journal publishes editorials, reviews, and other papers related to the journal''s aims.