Psychopharmacological factor in the course of COVID-19 among psychiatric inpatients

TL;DR

This study explores how psychopharmacological drugs affect the severity and duration of COVID-19 in psychiatric patients.

Contribution

The study identifies associations between specific psychotropic drugs and outcomes of COVID-19 in psychiatric inpatients.

Findings

Psychotropic agents were linked to a 0.9% increased risk of severe COVID-19 in patients with intellectual disability.

FIASMA-active drugs and high PLR values were associated with prolonged viral shedding.

Antidepressants and elevated C-reactive protein levels were linked to reduced predicted duration of viral shedding.

Abstract

It is known that many psychopharmacological drugs have anti-inflammatory, as well as antibacterial and antiviral effects.

To investigate the association between the severity and duration criteria of COVID-19 with psychopharmacotherapy in double-diagnosed patients.

A total of 169 case histories from a specialized infectious psychiatric department (May 2020 to January 2021) were evaluated. Progression indicators of severe and mild COVID-19, along with the duration of persistent SARS-CoV-2 viral shedding, were assessed in correlation with the administration of antidepressants, antipsychotics, and acid sphingomyelinase inhibitors (FIASMA-active drugs).

The use of any psychotropic agents was associated with a 0.9% increase in the risk of severe course of COVID-19 for each unit increase in the systemic inflammation index PLR, specifically in patients with intellectual disability (ICD-10 codes F70-79), when compared to patients with schizophrenia (ICD-10 codes F20-29): R²McF=0.138; AIC=181; χ²=25.8; df=9; p=0.002. High PLR values and the use of FIASMA-active drugs were associated with prolonged COVID-19 duration, while antidepressant therapy and elevated C-reactive protein levels were associated with a reduced predicted duration of viral shedding in 13.8% of variance: R²=0.0864; AIC=1299; F=5.2(3), p=0.002. Including the nosology of psychiatric disorders in the regression model increased the proportion of explained variance to 22.8%.

Thymoanaleptic therapy for individuals with psychiatric disorders may act as a protective factor against COVID-19. There is no evidence suggesting adverse effects of antipsychotics on the severity and duration of COVID-19. Further research is necessary to investigate the effects of FIASMA-active psychopharmacological agents within nosologically homogeneous groups.

None Declared