Common antidepressants don't appear to protect against severe COVID-19
Selective serotonin reuptake inhibitors (SSRIs), the most commonly used class of antidepressants in the United States, don't appear to prevent severe COVID-19 or death among outpatients, according to a study presented this week at the American Heart Association's Scientific Sessions in Chicago.
Researchers from Intermountain Healthcare in Salt Lake City retrospectively studied 33,088 nonhospitalized people who tested positive for COVID-19 from Mar 14, 2020, to Dec 31, 2021. Of that number, 25% were taking the SSRIs fluoxetine or fluvoxamine.
A greater proportion of the SSRI group were hospitalized or died than among those not taking the antidepressants, and not taking an SSRI was tied to a lower risk of COVID-related hospitalization at 14 days.
The authors said the findings don't imply that taking an SSRI leads to severe infection, only that they didn't seem to provide any protection in this study. But they do cast doubt on the conclusions of observational studies conducted early in the pandemic suggesting that the anti-inflammatory and anti-clotting properties of SSRIs could help fend off severe illness.
"At the start of the pandemic, everyone was searching for how to help prevent severe COVID, and SSRIs became a focus of interest," principal investigator Heidi May, PhD, said in an Intermountain press release. "However, those initial observations of a possible connection didn’t pan out when we looked for a possible link on our patient population."
Nov 6 Intermountain Healthcare press release
Risk of severe COVID spotlighted in those with chronic kidney disease
A new report presented at the American Society of Nephrology Kidney Week shows that people with chronic kidney disease (CKD) are vulnerable to developing severe COVID-19 and that acute kidney injury is a common complication of COVID-19, placing chronic kidney disease in the same risk category for developing severe COVID as heart disease, diabetes, and high blood presure.
The study was based on 64,246 COVID-19 cases seen during four waves of virus activity at Columbia University Medical Center in New York City. In total, 8% of cases were labeled as severe, and 18% required hospitalization.
Acute kidney injury occurred in 49% of severe cases and 35% of hospitalized ones.
"Pre-existing CKD was one of the most consistent clinical predictors of COVID-19 severity, complications, and poor outcomes across multiple pandemic waves," said lead author Ning Shang, PhD, in a press release.
The authors of the study said hospitals should consider kidney disease patients in future waves of the virus.
"Hospitals could include kidney function evaluation in patient populations as part of consideration for planning treatments and evaluating hospital capacities during future pandemic waves," said coauthor Krzysztof Kiryluk, MD.
Nov 5 American Society of Nephrology press release
Officials responding to more than 6,000 cholera cases in Malawi
From early March through October, Malawi has reported 6,056 cholera cases, including 183 deaths, the World Health Organization (WHO) said in an update today.
The outbreak in the landlocked country in southeastern Africa has affected all but 2 of 29 districts and is Malawi's largest in 10 years, the WHO said. The disease is endemic in the country but typically surges during the wet season. This year, cases have increased dramatically during the dry season.
The outbreak originated in the south but is now hitting northern districts the hardest and is especially affecting men 21 to 30 years old. "The upcoming rainy season in November poses the threat of further disease spread nationwide," the WHO said. The southern region is low-lying and flat, and prone to flooding during the rainy season.
Five districts account for 79% of the reported cases and 68% of the deaths: Nkhata Bay (1,128 cases and 31 deaths), Nkhotakota (811 and 40), Rumphi (783 and 13), Karonga (683 and 14), and Blantyre (650 and 26). The overall case-fatality rate is 3.0%.
Health officials from Malawi and the WHO are conducting emergency response activities, and the WHO emphasized the risk of further spread not only in Malawi but internationally. Across the border, Mozambique declared a cholera outbreak in Lago district in September.
Nov 7 WHO update