The DOI matches its Crossref record; 49 of the 49 references it cites were found in a registry or an index; none of the 28 sources its claims cite is checked for support yet.
Association between antidepressant use and reduced risk of intubation or death in hospitalized patients with COVID-19: results from an observational study
Open accessPublished version of a preprint
Abstract
A prior meta-analysis showed that antidepressant use in major depressive disorder was associated with reduced plasma levels of several pro-inflammatory mediators, which have been associated with severe COVID-19. Recent studies also suggest that several antidepressants may inhibit acid sphingomyelinase activity, which may prevent the infection of epithelial cells with SARS-CoV-2, and that the SSRI fluoxetine may exert in-vitro antiviral effects on SARS-CoV-2. We examined the potential usefulness of antidepressant use in patients hospitalized for COVID-19 in an observational multicenter retrospective cohort study conducted at AP-HP Greater Paris University hospitals. Of 7230 adults hospitalized for COVID-19, 345 patients (4.8%) received an antidepressant within 48 h of hospital admission. The primary endpoint was a composite of intubation or death. We compared this endpoint between patients who received antidepressants and those who did not in time-to-event analyses adjusted for patient characteristics, clinical and biological markers of disease severity, and other psychotropic medications. The primary analysis was a multivariable Cox model with inverse probability weighting. This analysis showed a significant association between antidepressant use and reduced risk of intubation or death (HR, 0.56; 95% CI, 0.43-0.73, p < 0.001). This association remained significant in multiple sensitivity analyses. Exploratory analyses suggest that this association was also significant for SSRI and non-SSRI antidepressants, and for fluoxetine, paroxetine, escitalopram, venlafaxine, and mirtazapine (all p < 0.05). These results suggest that antidepressant use could be associated with lower risk of death or intubation in patients hospitalized for COVID-19. Double-blind controlled randomized clinical trials of antidepressant medications for COVID-19 are needed.
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31 Own result · 20 Not checked yet · 19 Own method · 3 Own interpretation · 1 No basis given
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Of the remaining 7230 adult inpatients, 345 patients (4.8%) received an antidepressant within 48 h of hospital admission at a mean fluoxetine-equivalent dose of 21.6 mg (SD = 14.1) per day (Fig. 1).”
§ Association between antidepressant use and reduced risk of intubation or death in hospitalized patients with COVID-19: results from an observational study > Characteristics of the cohort
plainn = 345- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Following adjustments, the primary multivariable analyses with inverse probability weighting showed significant associations between use of any antidepressant (HR, 0.56; 95% CI, 0.43-0.73,p < 0.001) (Fig. 2), SSRI antidepressants (HR, 0.51; 95% CI, 0.316-0.72,p < 0.001), and non-SSRI antidepressants (HR, 0.65; 95% CI, 0.45-0.93,p = 0.018) (Fig. 3) with reduced risk of intubation or death (Table 2)”
§ Association between antidepressant use and reduced risk of intubation or death in hospitalized patients with COVID-19: results from an observational study > Study endpoint
plaincorrelationaln = 45 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Following adjustments, the primary multivariable analyses with inverse probability weighting showed significant associations between use of any antidepressant (HR, 0.56; 95% CI, 0.43-0.73,p < 0.001) (Fig. 2), SSRI antidepressants (HR, 0.51; 95% CI, 0.316-0.72,p < 0.001), and non-SSRI antidepressants (HR, 0.65; 95% CI, 0.45-0.93,p = 0.018) (Fig. 3) with reduced risk of intubation or death (Table 2)”
§ Association between antidepressant use and reduced risk of intubation or death in hospitalized patients with COVID-19: results from an observational study > Study endpoint
plaincorrelationaln = 84 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Furthermore, our findings indicate that the association between antidepressant use and the endpoint was only observed for patients receiving an antidepressant during the visit and not in those who received it only within the 3 months before hospital admission.”
§ Association between antidepressant use and reduced risk of intubation or death in hospitalized patients with COVID-19: results from an observational study > Discussion
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“We found that individuals with psychiatric disorders and hospitalized for COVID-19 would be at higher risk of intubation or death, in line with findings of recent studies [33,34].”
§ Association between antidepressant use and reduced risk of intubation or death in hospitalized patients with COVID-19: results from an observational study > Discussion
What the sources say
- Not checked yetcites [33] Wang QQ, Kaelber DC, Xu R, Volkow ND. COVID-19 risk and outcomes in patients with substance use disorders: analyses from electronic health records in the United States. Mol Psychiatry. 2021;26:30–9. source
- Not checked yetcites [34] Li L, Li F, Fortunati F, Krystal JH. Association of a prior psychiatric diagnosis with mortality among hospitalized patients with coronavirus disease 2019 (COVID-19) Infection. JAMA Netw Open. 2020;3:e2023282–e2023282. source
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Fifth, the low number of patients with antidepressants admitted to ICUs in our study (12 of 577 patients, i.e. 2.1%) and the significant association between antidepressant use and the endpoint in these patients further give strength to our conclusion.”
§ Association between antidepressant use and reduced risk of intubation or death in hospitalized patients with COVID-19: results from an observational study > Discussion
plaincorrelationaln = 577- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Exploratory analyses suggest that SSRI and non-SSRI antidepressants, and specifically the SSRIs escitalopram, fluoxetine, and paroxetine, and the SNRI venlafaxine, were significantly associated with reduced risk of intubation or death.”
§ Association between antidepressant use and reduced risk of intubation or death in hospitalized patients with COVID-19: results from an observational study > Discussion
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Patients who were prescribed an antidepressant in the three months before but not during the visit were significantly at higher risk of intubation or death than those who received an antidepressant only during the visit (Supplementary Table 18).”
§ Association between antidepressant use and reduced risk of intubation or death in hospitalized patients with COVID-19: results from an observational study > Study endpoint
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Fifth, the low number of patients with antidepressants admitted to ICUs in our study (12 of 577 patients, i.e. 2.1%) and the significant association between antidepressant use and the endpoint in these patients further give strength to our conclusion.”
§ Association between antidepressant use and reduced risk of intubation or death in hospitalized patients with COVID-19: results from an observational study > Discussion
plainn = 577- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Finally, when considering diazepam as an active comparator, we found similar results.”
§ Association between antidepressant use and reduced risk of intubation or death in hospitalized patients with COVID-19: results from an observational study > Discussion
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- It may state two separate claims as one. 16
- Probably not a substantial claim. 22
- The quote only partly states this claim. 3
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Among patients receiving any antidepressant, SSRIs, and non-SSRI antidepressants, the primary endpoint of intubation or death occurred respectively in 84 patients (24.3%), 45 patients (23.1%) and 39 patients (26.0%), while 1188 non-exposed patients (17.3%) had this outcome (Table 2).”
§ Association between antidepressant use and reduced risk of intubation or death in hospitalized patients with COVID-19: results from an observational study > Study endpoint
plainn = 84- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“When using intubation and death as separate endpoints, we found that antidepressant use was significantly associated with lower risks of death and intubation (Supplementary Table 22).”
§ Association between antidepressant use and reduced risk of intubation or death in hospitalized patients with COVID-19: results from an observational study > Study endpoint
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“However, its length was relatively limited (i.e., from January 24th until April 1st) and our main results remained unchanged following additional adjustment for it (Supplementary Tables 242526).”
§ Association between antidepressant use and reduced risk of intubation or death in hospitalized patients with COVID-19: results from an observational study > Discussion
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Finally, exposure to escitalopram, fluoxetine, paroxetine, venlafaxine or mirtazapine was significantly associated with reduced risk of intubation or death (all p < 0.05).”
§ Association between antidepressant use and reduced risk of intubation or death in hospitalized patients with COVID-19: results from an observational study > Study endpoint
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“All baseline characteristics, when examined independently, were significantly associated with the endpoint (Table 1).”
§ Association between antidepressant use and reduced risk of intubation or death in hospitalized patients with COVID-19: results from an observational study > Characteristics of the cohort
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This association remained significant in multiple sensitivity analyses.”
- Also stated in: § Discussion · plain
“Second, we performed sensitivity analyses that showed similar results.”
§ Association between antidepressant use and reduced risk of intubation or death in hospitalized patients with COVID-19: results from an observational study > Discussion
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The quote only partly states this claim.
- Also stated in: § Discussion · plain
None of the sources cited for this claim have been checked yet.
In the paper
“However, most associations observed between baseline characteristics and mortality or intubation are in line with prior epidemiological studies [17,19].”
§ Association between antidepressant use and reduced risk of intubation or death in hospitalized patients with COVID-19: results from an observational study > Discussion
What the sources say
- Not checked yetcites [17] Williamson E, Walker AJ, Bhaskaran KJ, Bacon S, Bates C, Morton CE, et al. OpenSAFELY: factors associated with COVID-19-related hospital death in the linked electronic health records of 17 million adult NHS patients. MedRxiv. 2020. https://doi.org/10.1101/2020.05.06.20092999. source
- Not checked yetcites [19] Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395:1054–62. source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Over a mean follow-up of 18.4 days (SD = 27.2;median = 5 days; range: 1-117 days), 1272 patients (18.1%) had a primary end-point event at the time of data cutoff on May 20th.”
§ Association between antidepressant use and reduced risk of intubation or death in hospitalized patients with COVID-19: results from an observational study > Characteristics of the cohort
plainn = 1,272- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“When considering diazepam as an active comparator, we found that antidepressant use was significantly associated with reduced risk of intubation or death in the crude (HR, 0.50; 95% CI, 0.32-0.77,p = 0.002) and in the main (HR, 0.47; 95% CI, 0.25-0.88,p = 0.018) analyses, as well as in sensitivity analyses (Supplementary Table 19).”
§ Association between antidepressant use and reduced risk of intubation or death in hospitalized patients with COVID-19: results from an observational study > Study endpoint
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Exposure to higher rather than lower doses of antidepressants was not significantly associated with the endpoint, except for tetracyclic antidepressants, for which higher doses were associated with an increased risk (Supplementary Table 20).”
§ Association between antidepressant use and reduced risk of intubation or death in hospitalized patients with COVID-19: results from an observational study > Study endpoint
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In the multivariable analysis, these associations remained significant, except for current smoking, any medication prescribed according to compassionate use or as part of a clinical trial, any current mood or anxiety disorder, any other current psychiatric disorder, any mood stabilizer medication, and any antipsychotic medication (Table 1).”
§ Association between antidepressant use and reduced risk of intubation or death in hospitalized patients with COVID-19: results from an observational study > Characteristics of the cohort
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Among non-SSRI antidepressants, there were no significant associations between the endpoint and exposures to each class of antidepressants, except for α2-antagonist antidepressants (HR, 0.22; 95% CI, 0.05-0.93,p = 0.040) (Table 2; Fig. 3).”
§ Association between antidepressant use and reduced risk of intubation or death in hospitalized patients with COVID-19: results from an observational study > Study endpoint
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“For all associations, we performed residual analyses to assess the fit of the data, check assumptions, including proportional hazards assumptions, and examined the potential influence of outliers.”
§ Association between antidepressant use and reduced risk of intubation or death in hospitalized patients with COVID-19: results from an observational study > Statistical analysis
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Furthermore, a recent study [10] suggests that functional inhibitors of acid sphingomyelinase activity (FIASMA), including several SSRI and non-SSRI antidepressants, may prevent the infection of epithelial cells with SARS-CoV-2 [11].”
§ Association between antidepressant use and reduced risk of intubation or death in hospitalized patients with COVID-19: results from an observational study > Introduction
What the sources say
- Not checked yetcites [10] Gulbins E, Palmada M, Reichel M, Lüth A, Böhmer C, Amato D, et al. Acid sphingomyelinase–ceramide system mediates effects of antidepressant drugs. Nat Med. 2013;19:934–8. source
- Not checked yetcites [11] Carpinteiro A, Edwards MJ, Hoffmann M, Kochs G, Gripp B, Weigang S, et al. Pharmacological inhibition of acid sphingomyelinase prevents uptake of SARS-CoV-2 by epithelial cells. Cell Reports Med. 2020;1:100142. source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“as did univariate Cox regression models in the matched analytic samples, except for the association between SNRI antidepressants and the endpoint, which was significant in both sensitivity analyses”
§ Association between antidepressant use and reduced risk of intubation or death in hospitalized patients with COVID-19: results from an observational study > Study endpoint
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Fifth, the criteria used to determine whether a patient with COVID-19 should be hospitalized or not might have varied during the study period.”
§ Association between antidepressant use and reduced risk of intubation or death in hospitalized patients with COVID-19: results from an observational study > Discussion
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“and in a subsample of patients excluding those receiving an antipsychotic medication, who might be at increased risk for immune dysregulation linked to a psychotic disorder (Supplementary Table 16)”
§ Association between antidepressant use and reduced risk of intubation or death in hospitalized patients with COVID-19: results from an observational study > Study endpoint
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The quote only partly states this claim.
In the paper
“Finally, a recent randomized trial suggests that fluvoxamine, a SSRI, sigma-1 receptor (S1R) agonist and FIASMA, may prevent clinical deterioration in outpatients with acute COVID-19 compared to placebo [13].”
§ Association between antidepressant use and reduced risk of intubation or death in hospitalized patients with COVID-19: results from an observational study > Introduction
What the sources say
- Not checked yetcites [13] Lenze EJ, Mattar C, Zorumski CF, Stevens A, Schweiger J, Nicol GE, et al. Fluvoxamine vs placebo and clinical deterioration in outpatients with symptomatic COVID-19: a randomized clinical trial. JAMA. 2020;324:2292–2300. source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“for COVID-19, viral load is associated with the worsening of symptoms [6]”
§ Association between antidepressant use and reduced risk of intubation or death in hospitalized patients with COVID-19: results from an observational study > Introduction
What the sources say
- Not checked yetcites [6] Liu Y, Yan L-M, Wan L, Xiang T-X, Le A, Liu J-M, et al. Viral dynamics in mild and severe cases of COVID-19. The Lancet Infectious Diseases. 2020;20:656–7. source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“First, prior studies suggest that several antidepressants may inhibit acid sphingomyelinase activity [10], which may prevent the infection of epithelial cells with SARS-CoV-2 [11].”
§ Association between antidepressant use and reduced risk of intubation or death in hospitalized patients with COVID-19: results from an observational study > Discussion
What the sources say
- Not checked yetcites [10] Gulbins E, Palmada M, Reichel M, Lüth A, Böhmer C, Amato D, et al. Acid sphingomyelinase–ceramide system mediates effects of antidepressant drugs. Nat Med. 2013;19:934–8. source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Other limitations include missing data for some baseline characteristic variables, including baseline clinical and biological markers of severity of COVID-19, which may be explained by the overwhelming of all hospital units during the COVID-19 peak incidence, and potential for inaccuracies in electronic health records in this context, especially for hand-written medical prescriptions.”
§ Association between antidepressant use and reduced risk of intubation or death in hospitalized patients with COVID-19: results from an observational study > Discussion
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“In the matched analytic samples, there were no significant differences in patient characteristics across the different exposures, except for exposures to any antidepressant, non-SSRI antidepressants and SNRI antidepressants, for which sex ratio significantly differed (Supplementary Tables 345678910111213).”
§ Association between antidepressant use and reduced risk of intubation or death in hospitalized patients with COVID-19: results from an observational study > Characteristics of the cohort
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Other limitations include missing data for some baseline characteristic variables, including baseline clinical and biological markers of severity of COVID-19, which may be explained by the overwhelming of all hospital units during the COVID-19 peak incidence, and potential for inaccuracies in electronic health records in this context, especially for hand-written medical prescriptions.”
§ Association between antidepressant use and reduced risk of intubation or death in hospitalized patients with COVID-19: results from an observational study > Discussion
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Fourth, information on the reason for prescribing the antidepressant, the duration and adherence to its prescription, the prescription record of patients before the admission, and the date that COVID-19 symptoms appeared, was not available.”
§ Association between antidepressant use and reduced risk of intubation or death in hospitalized patients with COVID-19: results from an observational study > Discussion
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“In the full sample, antidepressant use and exposure to each antidepressant class and each individual medication significantly differed according to most baseline characteristics.”
- Also stated in: § Characteristics of the cohort · hedged
“The direction of these associations indicated older age [mean age of patients exposed to antidepressants was 73.7 (SD = 15.8)years, whereas it was 56.8 (SD = 19.3)years in those who were not] and overall greater medical severity of patients who received antidepressants than those who did not.”
§ Association between antidepressant use and reduced risk of intubation or death in hospitalized patients with COVID-19: results from an observational study > Characteristics of the cohort
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one. The quote only partly states this claim.
- Also stated in: § Characteristics of the cohort · hedged
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Third, inflation of type I error might have occurred in exploratory analyses due to multiple testing.”
§ Association between antidepressant use and reduced risk of intubation or death in hospitalized patients with COVID-19: results from an observational study > Discussion
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“For these latter analyses, we decided a priori to select one control for each exposed case for exposures to any antidepressant and each class of antidepressants, and two controls for each exposed case for individual antidepressant medications, based on the same variables used for both the inverse-probability-weighted and the multivariable Cox regression analyses.”
§ Association between antidepressant use and reduced risk of intubation or death in hospitalized patients with COVID-19: results from an observational study > Statistical analysis
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Short-term use of low to moderate doses of antidepressants, and particularly of SSRIs, is generally well tolerated [14], and notably in older adults [15][16][17].”
§ Association between antidepressant use and reduced risk of intubation or death in hospitalized patients with COVID-19: results from an observational study > Introduction
What the sources say
- Not checked yetcites [14] Cipriani A, Furukawa TA, Salanti G, Chaimani A, Atkinson LZ, Ogawa Y, et al. Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis. Focus. 2018;16:420–9. source
- Not checked yetcites [15] Tham A, Jonsson U, Andersson G, Söderlund A, Allard P, Bertilsson G. Efficacy and tolerability of antidepressants in people aged 65 years or older with major depressive disorder–a systematic review and a meta-analysis. J Affect Disord. 2016;205:1–12. source
- Not checked yetcites [16] Krause M, Gutsmiedl K, Bighelli I, Schneider-Thoma J, Chaimani A, Leucht S. Efficacy and tolerability of pharmacological and non-pharmacological interventions in older patients with major depressive disorder: A systematic review, pairwise and network meta-analysis. Eur Neuropsychopharmacol. 2019;29:1003–22. source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“We followed the recommendations of The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Initiative [32].”
§ Association between antidepressant use and reduced risk of intubation or death in hospitalized patients with COVID-19: results from an observational study > Statistical analysis
What the sources say
- Not checked yetcites [32] Von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Ann Intern Med. 2007;147:573–7. source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“A recent in-vitro study [12] also supports antiviral effects of the SSRI fluoxetine on SARS-CoV-2, although this effect was not observed for other SSRIs, including paroxetine and escitalopram.”
§ Association between antidepressant use and reduced risk of intubation or death in hospitalized patients with COVID-19: results from an observational study > Introduction
What the sources say
- Not checked yetcites [12] Zimniak M, Kirschner L, Hilpert H, Seibel J, Bodem J. The serotonin reuptake inhibitor Fluoxetine inhibits SARS-CoV-2. BioRxiv. 2020. https://www.biorxiv.org/content/10.1101/2020.06.14.150490v2. source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Finally, despite the multicenter design, our results may not be generalizable to outpatients and other countries.”
§ Association between antidepressant use and reduced risk of intubation or death in hospitalized patients with COVID-19: results from an observational study > Discussion
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“To reduce the effects of confounding, optimal matching was used in order to obtain the smallest average absolute distance across all clinical characteristics between exposed patients and non-exposed matched controls.”
§ Association between antidepressant use and reduced risk of intubation or death in hospitalized patients with COVID-19: results from an observational study > Statistical analysis
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Statistical significance was fixed a priori at two-sided p value < 0.05.”
§ Association between antidepressant use and reduced risk of intubation or death in hospitalized patients with COVID-19: results from an observational study > Statistical analysis
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“We conducted sensitivity analyses, including multivariable Cox regression models comprising as covariates the same variables as the inverse-probability-weighted analyses, and univariate Cox regression models in matched analytic samples.”
§ Association between antidepressant use and reduced risk of intubation or death in hospitalized patients with COVID-19: results from an observational study > Statistical analysis
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
The paper relies on this without support.
At the time of the study, no clinical study had examined the potential usefulness of antidepressants in patients hospitalized for COVID-19.
“To our knowledge, no clinical study has examined to date the potential usefulness of antidepressants in patients hospitalized for COVID-19.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“Taking fluoxetine lowers the risks of intubation and death by reducing the “cytokine storm” [29,30].”
From Antimicrobial Properties of Antidepressants and Antipsychotics—Possibilities and Implications (2021) · cites this paper as [29]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Association between antidepressant use and reduced risk of intubation or death in hospitalized patients with COVID-19: results from an observational study > Study endpoint
“SSRI antidepressants (HR, 0.51; 95% CI, 0.316-0.72,p < 0.001)”
§ Association between antidepressant use and reduced risk of intubation or death in hospitalized patients with COVID-19: results from an observational study > Discussion
“0.51 (0.36-0.72; <0.001*)”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Association between antidepressant use and reduced risk of intubation or death in hospitalized patients with COVID-19: results from an observational study > Discussion
“in the matched analytic sample using a 1:1 ratio (n = 648)”
§ Association between antidepressant use and reduced risk of intubation or death in hospitalized patients with COVID-19: results from an observational study > Discussion
“Number of events/Number | of patients in the matched | control groups | Events/N (%) | Ref. | | 136/345 (39.4)”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
“Among patients exposed to antidepressants, 298 (86.4%) were exposed to only one antidepressant, and 47 (15.8%) were exposed to at least two antidepressants.”
§ Association between antidepressant use and reduced risk of intubation or death in hospitalized patients with COVID-19: results from an observational study > Characteristics of the cohort
Reported 15.8 · recomputed 13.623188
Citations
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Metadata
- Authors
- Hoertel, N., Sánchez-Rico, M., Vernet, R., Beeker, N., Jannot, A.-S., Neuraz, A., Salamanca, E., Paris, N., Daniel, C., Gramfort, A., Lemaitre, G., Bernaux, M., Bellamine, A., Lemogne, C., Airagnes, G., Burgun, A., Limosin, F., & On behalf of AP-HP / Universities / INSERM COVID-19 Research Collaboration and AP-HP COVID CDR Initiative
- Affiliations
- Inserm (FR)
- Assistance Publique – Hôpitaux de Paris (FR)
- Hôpital Cochin (FR)
- Hôpital Necker-Enfants Malades (FR)
- Institut national de recherche en sciences et technologies du numérique (FR)
- Corresponding author
- Hoertel, Nicolas
- ORCID
- Venue
- Molecular Psychiatry
- Published
- 2021-02-04
- Volume
- 26
- Issue
- 9
- Pages
- 5199-5212
- ISSN
- 1359-4184 (ISSN-L)
- 1476-5578
- OpenAlex
- W3128622946
- Semantic Scholar
- a2067d6c851793d8f54fbca350ac5f77f6bd4f16
- Cited by
- 269
- References
- 47
- Citations by year
- 2026: 7 · 2025: 11 · 2024: 23 · 2023: 42 · 2022: 86 · 2021: 94
- FWCI
- 19.34
- Type
- journal article
- Language
- en
- Open access
- green
- doi.org
- Locations
- Molecular Psychiatry (publishedVersion)
- medRxiv (acceptedVersion)
- PubMed (publishedVersion)
- HAL (submittedVersion)
- Funders
- Assistance publique-Hôpitaux de Paris
- Topics
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
- Keywords
- antidepressants, COVID-19 pandemic, intubation, mortality, hospitalized patients, major depressive disorder, fluoxetine, selective serotonin reuptake inhibitors, SARS-CoV-2, antiviral activity, pro-inflammatory mediators, mirtazapine, paroxetine, escitalopram, venlafaxine
- MeSH terms
- COVID-19, SARS-CoV-2, Antidepressive Agents, Major Depressive Disorder, Humans, Intubation, Intratracheal, Retrospective Studies, Multicenter Studies as Topic, Observational Studies as Topic
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