Use of second-generation antipsychotic drugs tied to reduced risk of Covid-19 infection: JAMA

The usage of second-generation antipsychotic medicines was related with a lower incidence of COVID-19 infection in people hospitalized with significant mental illness, but valproic acid was associated with a greater risk, says an article published in the Journal of American Medical Association.

Individuals suffering from severe mental illness are at a higher risk of contracting COVID-19. Several psychotropic medicines have been discovered as possible therapeutic agents for COVID-19 prevention or treatment, although they have not been well studied in this group. As a result, Katlyn Nemani and her colleagues did this research. To investigate the relationship between the use of psychotropic drugs and the risk of COVID-19 infection in persons receiving long-term inpatient psychiatric care.

This retrospective cohort research looked at persons with significant mental illnesses who were hospitalized in New York's statewide psychiatric hospital system between March 8 and July 1, 2020. The deadline for follow-up was December 1, 2020. The research included 1958 successive adult inpatients with serious mental illness who were consistently hospitalized from March 8 to medical discharge or July 1, 2020 and were tested for SARS-CoV-2 by reverse transcriptase–polymerase chain reaction or anti nucleocapsid antibodies. Participants who had been provided psychotropic drugs previous to the COVID-19 assessment were taken into account.

The key findings of this study were as follows :

1. The study comprised 1958 (93.8%) of the 2087 adult inpatients with significant mental illness who were continuously hospitalized during the study period; 1442 (73.6%) were men, and the mean (SD) age was 51.4 (14.3) years.

2. A total of 969 patients (49.5%) developed laboratory-confirmed COVID-19 infection while hospitalized, with 38 (3.9 %) dying.

3. The usage of second-generation antipsychotic drugs as a class was linked to a lower risk of infection, while mood stabilizers were linked to a higher risk of infection.

4. In a multivariable model of individual drugs, paliperidone was related with a lower risk of infection, whereas valproic acid was associated with an increased risk of infection.

5. In unadjusted analyses, clozapine usage was linked with a lower risk of death.

In conclusion, several psychotropic medicines were linked to an increased risk of COVID-19 infection in inpatients with major mental illness; second-generation antipsychotics were linked to a lower risk, with paliperidone dosage having the biggest effect size. The usage of valproic acid was linked to an increased risk of infection.

Reference:

Nemani, K., Williams, S. Z., Olfson, M., Leckman-Westin, E., Finnerty, M., Kammer, J., Smith, T. E., Silverman, D. J., Lindenmayer, J.-P., Capichioni, G., Clelland, J., & Goff, D. C. (2022). Association Between the Use of Psychotropic Medications and the Risk of COVID-19 Infection Among Long-term Inpatients With Serious Mental Illness in a New York State–wide Psychiatric Hospital System. In JAMA Network Open (Vol. 5, Issue 5, p. e2210743). American Medical Association (AMA). https://doi.org/10.1001/jamanetworkopen.2022.10743