Impact of vortioxetine on depressive symptoms moderated by symptoms of anxiety in persons with post-COVID-19 condition: A secondary analysis

Psychiatry Res. 2024 Sep:339:116068. doi: 10.1016/j.psychres.2024.116068. Epub 2024 Jun 28.

Abstract

Objective: Recovery from a COVID-19 infection can lead to post-COVID-19 condition (PCC), which causes a multitude of debilitating symptoms that negatively affect an individual's health-related quality of life, including depressive and anxiety symptoms. We aim to examine the mediatory effects of anxiety on depressive symptoms in persons with PCC receiving vortioxetine.

Methods: We performed a post-hoc analysis of a randomized, double-blinded, placebo-controlled clinical trial investigating vortioxetine treatment on cognitive functioning in persons with PCC. Anxiety and depressive symptoms were measured by the 7-Item Generalized Anxiety Disorder (GAD-7) Scale and the 16-Item Quick Inventory of Depressive Symptomatology (QIDS-SR-16), respectively.

Results: Based on data of 147 participants, GAD-7 scores were significantly positively associated with QIDS-SR-16 scores (β=0.038, 95 % CI [0.029,0.047], p < 0.001). After adjusting for covariates, a significant group (χ2=176.786, p < 0.001), time (χ2=8.914, p = 0.003), and treatment x time x GAD-7 score interaction (χ2=236.483, p < 0.001) effect was observed. Vortioxetine-treated participants had a significant difference in overall change in depressive symptoms (mean difference=-3.15, SEM=0.642, 95 % CI [-4.40,-1.89], p < 0.001).

Conclusion: Anxiety symptoms were significantly associated with depressive symptoms in persons with PCC. Antidepressant efficacy on ameliorating depressive symptoms is dependent on improving anxiety symptoms, underscoring significant implications in improving treatment efficacy and patient quality of life.

Keywords: Anxiety symptoms; Depressive symptoms; Long covid; PCC; Post-COVID condition; Post-COVID-19.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Antidepressive Agents / pharmacology
  • Antidepressive Agents / therapeutic use
  • Anxiety Disorders / drug therapy
  • Anxiety* / drug therapy
  • COVID-19* / complications
  • COVID-19* / psychology
  • Depression* / drug therapy
  • Depression* / etiology
  • Double-Blind Method
  • Female
  • Humans
  • Male
  • Middle Aged
  • Quality of Life
  • Vortioxetine* / pharmacology
  • Vortioxetine* / therapeutic use

Substances

  • Vortioxetine
  • Antidepressive Agents