Aripiprazole as protector against COVID-19 mortality

Area of Science:

• Pharmacology
• Infectious Diseases
• Epidemiology

Background:

• The relationship between antipsychotic medications and severe Coronavirus Disease 19 (COVID-19) outcomes remains controversial.
• Previous studies have yielded conflicting results regarding the potential adverse or protective effects of antipsychotics in COVID-19 patients.

Purpose of the Study:

• To investigate whether antipsychotics influence the risk of fatal outcomes in patients diagnosed with COVID-19.
• To determine if specific antipsychotic medications offer protective effects against COVID-19 mortality.

Main Methods:

• A population-based retrospective cohort study was conducted using data from January 2020 to November 2020.
• Inclusion criteria involved laboratory-confirmed COVID-19 inpatients aged 18 years or older (n=15,968).
• Two sub-cohorts (n=2536) were analyzed: those with no prior medication and those prescribed antipsychotics within 15 days of hospitalization. Survival and odds ratio analyses were performed.

Main Results:

• Among eight antipsychotics studied, only aripiprazole demonstrated a statistically significant reduction in the risk of death from COVID-19.
• The adjusted odds ratio (OR) for mortality with aripiprazole was 0.86 (95% CI, 0.79-0.93), with a multiple-testing adjusted p-value < 0.05.
• These findings remained consistent across both unadjusted and covariate-adjusted analyses, indicating a robust association.

Conclusions:

• Aripiprazole appears to have a distinct beneficial effect in protecting COVID-19 infected individuals from fatal clinical outcomes.
• The study speculates that aripiprazole's potential to modulate immunological pathways and inflammatory enzymes critical in COVID-19 pathogenesis may underlie these protective effects.