Insight into potential long COVID effects: Antidepressant use in post SARS-CoV-2 Infection scenarios. A multiregional nested case-control study

Valentina Rosolen; Yvonne Beorchia; Luigi Castriotta; Caterina Fanizza; Francesco Profili; Marco Floridia; Marina Giuliano; Flavia Pricci; Marika Villa; Tiziana Grisetti; Tiziana Grassi; Dorina Tiple; Andrea Silenzi; Paolo Francesconi; Lucia Bisceglia; Fabio Barbone; Silvio Brusaferro; Graziano Onder

doi:10.1016/j.psychres.2024.116290

Insight into potential long COVID effects: Antidepressant use in post SARS-CoV-2 Infection scenarios. A multiregional nested case-control study

Psychiatry Res. 2024 Nov 28:344:116290. doi: 10.1016/j.psychres.2024.116290. Online ahead of print.

Authors

Valentina Rosolen¹, Yvonne Beorchia², Luigi Castriotta³, Caterina Fanizza⁴, Francesco Profili⁵, Marco Floridia⁶, Marina Giuliano⁶, Flavia Pricci⁶, Marika Villa⁶, Tiziana Grisetti⁶, Tiziana Grassi⁶, Dorina Tiple⁶, Andrea Silenzi⁷, Paolo Francesconi⁵, Lucia Bisceglia⁴, Fabio Barbone⁸, Silvio Brusaferro⁹, Graziano Onder¹⁰

Affiliations

¹ Central Directorate for Health, Social Policies and Disability, Friuli Venezia Giulia Region, Trieste, Italy.
² Institute of Hygiene and Evaluative Epidemiology, Friuli Centrale University Health Authority, Udine, Italy.
³ Central Directorate for Health, Social Policies and Disability, Friuli Venezia Giulia Region, Trieste, Italy; Institute of Hygiene and Evaluative Epidemiology, Friuli Centrale University Health Authority, Udine, Italy. Electronic address: [email protected].
⁴ Strategic Regional Agency for Health and Social Affairs, Apulia Region, Bari, Italy.
⁵ Tuscany Regional Health Agency, Tuscany Region, Florence, Italy.
⁶ Italian National Institute of Health, Rome, Italy.
⁷ Italian Ministry of Health, Rome, Italy.
⁸ Central Directorate for Health, Social Policies and Disability, Friuli Venezia Giulia Region, Trieste, Italy; Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy.
⁹ Accreditation, Clinical Risk Management, and Health Care Performance Evaluation Udine, Friuli Centrale University Health Authority, Udine, Italy.
¹⁰ Università Cattolica del Sacro Cuore, Rome, Italy; Fondazione Policlinico Gemelli IRCCS, Rome, Italy.

PMID: 39644590
DOI: 10.1016/j.psychres.2024.116290

Abstract

This study aimed to investigate the impact of previous SARS-CoV-2 infection and the role of vaccination in the onset of neuropsychiatric conditions, evaluated through antidepressant prescriptions. This case-control study evaluated the risk of new antidepressant prescriptions in relation to previous exposure to SARS-CoV-2 infection and vaccination. It was conducted in three Italian Regions on adults who did not receive antidepressant prescriptions in the year preceding the study period. Individuals with newly prescribed antidepressants (cases) were matched by sex and age to non-users of antidepressants (controls). Pooled estimates of regional Odds Ratios (ORs) were obtained through a meta-analysis. Findings showed that individuals previously infected with SARS-CoV-2 had a higher risk of receiving a new prescription of antidepressants. Moreover, this association was stronger among subjects hospitalized due to infection, and SARS-CoV-2 vaccination may have acted as an effect modifier by reducing that risk. In fact, the pooled OR for receiving a new antidepressant prescription was higher for unvaccinated individuals than for those vaccinated. The results of this study confirm the role of SARS-CoV-2 infection as a risk factor for the onset of neuropsychiatric symptoms. Antidepressant treatment initiation was much more likely after severe COVID-19 infection but vaccination reduced such a risk.

Keywords: Administrative database; Drug utilization; Mental health; Post-covid conditions; Public health; Vaccination.