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

Abstract

Objective, and material and methodsA 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. Source of dataMEDLINE, EMBASE and COCHRANE LIBRARY were consulted up to February 25, 2022. Unpublished studies were searched on clinicaltrials.gov platform. Selection of studiesSeven 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. Data extractionA 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. ResultsSeven studies were finally considered to calculate the final pooled measure. The effect of intervention was OR 0.73; 95% CI 0.56–0.94. ConclusionsThe use of antidepressants, and specially SSRI could be effective for reducing the risk of poor progression of COVID-19 disease.