Effectiveness of antidepressants in improving the prognosis of COVID-19: A systematic review and meta-analysis

• Published in: Atención primaria 2024-03, Vol.56 (3), p.102771-102771, Article 102771
• Main Authors: Cobos-Campos, Raquel, de Lafuente-Moríñigo, Arantxa Sáez, Cordero-Guevara, Jose Aurelio, Bermúdez-Ampudia, Cristina, Apiñaniz, Antxon, Parraza, Naiara
• Format: Article
• Language: English
• Subjects: Antidepresivos; Antidepressants; Covid-19; Inhibidores selectivos de la recaptación de serotonina; Original; Selective serotonin reuptake inhibitors
• ISSN: 0212-6567; 1578-1275
• DOI: 10.1016/j.aprim.2023.102771

A systematic review and meta-analysis was performed to evaluate the effectiveness of antidepressants in reducing the poor evolution of COVID-19 disease (a composite variable including death, hospitalization and need for mechanical ventilation), and mortality, according the guidelines for Systematic Reviews of Interventions published by the Cochrane library. MEDLINE, EMBASE and COCHRANE LIBRARY were consulted up to February 25, 2022. Unpublished studies were searched on clinicaltrials.gov platform. Seven masked and unmasked, observational and experimental studies evaluating death, hospitalization and need for mechanical ventilation were selected. A second subgroup analysis with mortality variable was performed. A full risk of bias assessment was performed addressing issues such as information and confounding bias. ROB2 and Robins-I tools for randomized and no randomized studies were employed respectively. In the quantitative analysis, the risk of publication bias, heterogeneity, estimation of pooled measure and a sensitivity analysis was performed. The pooled final measure was calculated as odds ratio with its correspondent 95% confidence interval. A random effects model was used for this purpose due to the heterogeneity between included studies. Finally, a sensitivity analysis was performed to assess the robustness of final pooled measure. Seven studies were finally considered to calculate the final pooled measure. The effect of intervention was OR 0.73; 95% CI 0.56–0.94. The use of antidepressants, and specially SSRI could be effective for reducing the risk of poor progression of COVID-19 disease. Se realizó una revisión sistemática y un metaanálisis para evaluar la eficacia de los antidepresivos en la reducción de la mala evolución de la enfermedad COVID-19 (variable compuesta que incluye muerte, hospitalización y necesidad de ventilación mecánica), y mortalidad, según las directrices para Revisiones Sistemáticas de Intervenciones publicadas por la biblioteca Cochrane. Se consultaron MEDLINE, EMBASE y la biblioteca Cochrane hasta el 25 de febrero de 2022. Se realizaron búsquedas de estudios no publicados en la plataforma clinicaltrials.gov. Se seleccionaron estudios observacionales y experimentales, enmascarados y no enmascarados, que evaluaron la muerte, la hospitalización y la necesidad de ventilación mecánica. Se realizó un segundo análisis de subgrupos con la variable mortalidad. Se realizó una evaluación completa del riesgo de sesgo que abordó temas