Die Bedeutung von Antidepressiva bei COVID-19 und Long-COVID – Ein Scoping-Review Update

Zusammenfassung

Einleitung Präklinisch zeigten Fluvoxamin und andere Antidepressiva (AD) antivirale und anti-inflammatorische Eigenschaften auch gegen SARS-COV-2. Daher liegt es nahe, die klinische Wirksamkeit von AD gegen COVID-19 und Long COVID zu testen.

Methodik Am 20.05.2024 identifizierte dieses systematische Scoping Review in PUBMED 1016 Artikel, die sich auf AD und COVID-19, Long COVID und SARS-COV-2 bezogen. Darunter waren 10 retrospektive „Large Scale“ Studien (> 20000 Chart-Reviews), 8 prospektive klinische Studien (plus 4 bezüglich Long COVID), 11 Placebo-kontrollierte randomisierte (RCT) (plus 2 bezüglich Long COVID) und 15 Meta-Analysen.

Resultate COVID-19: Retrospektive Studien mit Kohorten, die meistens AD wegen psychiatrischer Komorbiditäten oder chronischer Schmerzerkrankungen schon vor der SARS-COV-2 Infektion einnahmen, beschrieben dass diese Substanzklasse (am meisten untersucht: Selektive Serotonin Re-Uptake Hemmer (SSRI) und Selektive Serotonin Noradrenalin Re-Uptake Hemmer (SSNRI)) (i) mit signifikant weniger SARS-COV-2-Infektionen und (ii) mit einem leichter verlaufenden COVID-19 („COVID-19-Protektion“) assoziiert waren. Zehn der 11 bezüglich COVID-19 gefunden RCT prüften Fluvoxamin, da dieses ältere AD prophylaktisch gegen ein schweres COVID-19 geeignet erschien unter Berücksichtigung seiner in vitro Potenz gegen intrazelluläre Sepsis-Kaskaden. Deshalb bezogen sich auch die meisten (12 von 15) Meta-Analysen auf Fluvoxamin. Sie fanden (i) eine signifikante (meistens 40-70%ige Reduktion) von Mortalitäts-, Intubations- und Hospitalisierungs-Raten, wenn Fluvoxamin als add-on zur Standardtherapie bei mildem bis moderatem COVID-19 eingesetzt wurde. Schon im frühem Krankheitsstadium gegeben war das AD erfolgreicher als wenn es erst später bei fortgeschrittenem, schweren COVID-19 (z.B. Pneumonie, Sepsis) eingesetzt wurde. Weiterhin fiel eine Dosisabhängigkeit auf: 2x50 mg Fluvoxamin über 15 Tage waren weniger wirksam als 2x100 oder gar 3x100 mg bei einer Nebenwirkungsrate weiterhin auf dem Placebo-Niveau. Direkte Vergleiche mit gegen COVID-19 zugelassen Medikamenten existieren bisher nicht. Ein erster indirekter meta-analytischer Vergleich zeigte einen Vorteil von Paxlovid oder Molnupiravir versus Fluvoxamin gegen schwere COVID-19 Verläufe: Risiko-Reduktion um 95% (I2 = N/A, allerdings nur eine Studie) oder 78% (I2=0) versus 55% (I2=48). Ein add-on von Fluvoxamin war aber immer noch signifikant wirksamer als die symptomorientierte Standardtherapie alleine. Long COVID: Ein häufiger Long COVID Phänotyp mit dominierenden Angst- und Depressions-Symptomen, der insbesondere auf AD, Entspannungsmaßnahmen und/oder Psychotherapie positiv reagiert, ist inzwischen identifiziert worden. Kasuistiken beschreiben positive Einflüsse von AD auf Fatigue, kognitive und autonome Dysfunktionen. Eine erste große prospektive Open-Label RCT (N=995) zeigte soeben signifikant mehr günstige Verläufe, weniger Virus-Last, weniger pro-inflammatorische Cytokine bei der Behandlung von mildem bis moderatem COVID-19 mit Fluvoxamin versus Standard-Behandlung, auch bezüglich der späteren Entwicklung von neuropsychiatrischem und pulmonalem Long COVID oder Fatigue.

Schlussfolgerung Insgesamt gibt es vielversprechende Hinweise auf eine präventive Wirkung vom AD (insbesondere Fluvoxamin) gegen einen schweren COVID-19 Verlauf und gegen die Entwicklung von Long COVID. Die Möglichkeit, dass die gesamte Substanzkasse der AD hier effektiv sein könnte wird anhand der Ergebnisse retrospektiver Large Scale Studien wahrscheinlich, wartet aber auf eine Überprüfung durch besser kontrollierte Studien. Die potentielle Wirksamkeit (aktuell geringe beziehungsweise moderate Vertrauenswürdigkeit der Evidenz für die ganze Substanzklasse bzw. speziell Fluvoxamin) von AD als add-on gegen COVID-19 und gegebenenfalls direkt auch gegen Long COVID könnte ähnliche Projekte bei anderen Infektionserkrankungen stimulieren, die ebenfalls das Potential haben, die Gesundheit der Betroffenen nachhaltig zu schwächen. Wir meinen, dass die bisherigen Befunde ausreichen, um bei der Psychoedukation von Patienten mit COVID-19 oder Long COVID, die wegen anderer Erkrankungen AD erhalten, eine potentiell positive Wirkung dieser Substanzen - auch gerade gegen die mit der Viruserkrankung oder dessen Folgen verbundenen Beschwerden – hervorheben zu können. In Regionen, die weder Impfungen noch antivirale Substanzen vorhalten können, die aktuell zur Prävention oder Behandlung von COVID-19 zugelassen sind, wären AD und insbesondere Fluvoxamin eine kostengünstige Alternative zum Schutz vor einem schweren Verlauf, obwohl dieses AD schwächer gegen COVID-19 zu wirken scheint als die aktuell zugelassenen antiviralen Substanzen, jedoch bei mutmaßlich besserer Verträglichkeit. Eine direkte vergleichende klinische Studie mit zugelassenen antiviralen Wirkstoffen steht noch aus und sollte positiv ausfallen, um die Tür für eine leitliniengestützte Empfehlung von Fluvoxamin (oder AD) für COVID-19 oder dessen Folgeerscheinungen noch weiter zu öffnen.

Abstract

Introduction Preclinically, fluvoxamine and other antidepressants (AD) exerted antiviral and anti-inflammatory properties also against SARS-COV-2. Therfore, It makes sense to test the clinical effect of AD against COVID-19 and Long COVID.

Methods On May 20, 2024, this systematic scoping review in PUBMED identified 1016 articles related to AD and COVID-19, Long COVID and SARS-COV-2. These included 10 retrospective “large scale” studies (> 20000 chart reviews), 8 prospective clinical trials (plus 4 regarding Long COVID), 11 placebo-controlled randomized (RCT) (plus 2 regarding Long COVID) and 15 meta-analyses.

Results COVID-19: Retrospective studies with cohorts taking AD primarily for psychiatric comorbidities or chronic pain conditions directly prior to SARS-COV-2 infection described that this substance class (most studied: Selective Serotonin Re-Uptake Inhibitors (SSRI) and Selective Serotonin Noradrenaline Re-Uptake Inhibitors (SSNRI)) were associated with (i) significantly fewer SARS-COV-2 infections and (ii) a milder course of COVID-19 (“COVID-19 protection”). Ten of the 11 RCTs found regarding COVID-19 tested fluvoxamine, as this old AD appeared suitable as a prophylactic agent against severe COVID-19, taking into account its in vitro potency against the progression of intracellular sepsis cascades. Therefore, most (12 out of 15) meta-analyses also referred to fluvoxamine. They found (iii) a significant (40-70% reduction) in mortality, intubation and hospitalization rates when fluvoxamine was used as an add-on to standard therapy for mild to moderate COVID-19. When this AD was used in the early stages of the disease, it was more successful than when it was given later in advanced, severe COVID-19 (e.g. severe pneumonia, final sepsis stages). A dose dependency was observed: 2x50 mg fluvoxamine over 15 days was less effective than 2x100 or even 3x100 mg with an adverse event profile still at the placebo level. Direct comparisons with drugs approved for COVID-19 do not yet exist. A first indirect meta-analytical comparison showed an advantage of paxlovid or molnupiravir versus fluvoxamine against the development of severe COVID-19: risk reduction of 95% (I2 = N/A, but only one study) or 78% (I2=0) versus 5+-5% (I2=48). However, an add-on of fluvoxamine was still significantly more efficacious than symptom-oriented standard therapy alone. Long COVID: A common Long COVID phenotype with dominant anxiety and depression symptoms, which responds to AD, relaxation therapy and/or psychotherapy, has now been identified. Casuistics report positive effects of AD on fatigue, cognitive and autonomic dysfunctions. A first large prospective open-label RCT has just shown significantly more favourable courses, less viral load and less pro-inflammatory cytokines in the treatment of mild to moderate COVID-19 with fluvoxamine versus standard treatment, also with regard to the subsequent development of neuropsychiatric and pulmonary Long COVID or fatigue.

Conclusion Overall, there is promising evidence of a preventive effect of AD (especially fluvoxamine) against progression to severe COVID-19 and against the development of Long COVID. It is likely, that the entire AD substance class could be effective here. This assumption is based on the results of retrospective large scale studies, but awaits verification by better controlled studies. The potential effectiveness/efficacy (currently low and moderate confidence of the evidence for the entire substance class and specifically fluvoxamine, respectively) of fluvoxamine as an add-on against COVID-19 and possibly also directly against Long COVID could stimulate similar projects in other infectious diseases that also have the potential to pose a lasting threat to the health of those affected. We consider the evidence to date to be sufficient to be able to emphasize a possible positive effect of these substances in the psychoeducation of patients with COVID-19 or Long COVID who are already receiving AD for other conditions - especially also against the symptoms associated with the viral disease or its consequences. In regions where neither vaccines nor antiviral agents currently approved for the prevention or treatment of COVID-19 are available, AD and in particular fluvoxamine would be a cost-effective alternative to protect against a severe course, even if this AD appears to have a smaller effect against COVID-19 than the currently approved antiviral agents, but with presumably better tolerability. A direct comparative clinical trial with approved antiviral agents is still pending and should be positive to further open the door for a guideline-based recommendation of fluvoxamine (or perhaps even AD) for COVID-19 or its aftermath.

Schlüsselwörter

Antidepressiva - Neuroleptika - Lithium - Resilienz - Sickness Behaviour

Keywords

Fatigue - Antidepressants - Antipsychotics - Lithium - Resilience - Sickness Behavior - Fatigue

Publication History

Received: 03 July 2023

Accepted after revision: 21 July 2024

Article published online:
23 September 2024

• Literatur

• 1 WHO (World Health Organization). Jan 16, 2024 https://www.who.int/europe/de/emergencies/overview/16-01-2024-covid-19-vaccinations-have-saved-more-than-1.4-million-lives-in-the-who-european-region--a-new-study-finds zuletzt aufgerufen am 20.05.2024.
• 2 Robert Koch Institut. STIKO: Aktualisierung der COVID-19-Impfempfehlung Epidemiologisches Bulletin 2024: 2.
• 3 Xie Y, Choi T, Al-Aly Z. Mortality in Patients Hospitalized for COVID-19 vs Influenza in Fall-Winter 2023-2024. JAMA. 2024; May 15 e247395 Epub ahead of print.
• 4 Liang CY, Raju S, Liu Z. et al. Imprinting of serum neutralizing antibodies by Wuhan-1 mRNA vaccines. Nature 24 May 15 Epub ahead of print.
• 5 Balzulat A, Schmidtko A. Drug-Repurposing – Neue Indikationen für etablierte Wirkstoffe. Arzneimitteltherapie 2020; 38: 504-508
• 6 Hoertel N, Sánchez-Rico M, Cougoule C. et al. Repurposing antidepressants inhibiting the sphingomyelinase acid/ceramide system against COVID-19: current evidence and potential mechanisms. Mol Psychiatry 2021; 26: 7098-7099
• 7 Fico G, Isayeva U, De Prisco M. et al. Psychotropic drug repurposing for COVID-19: A Systematic Review and Meta-Analysis. Eur Neuropsychopharmacol 2023; 66: 30-44
• 8 Kluge S, Janssens U, Welte T. et al. S3-Leitlinie – Empfehlungen zur stationären Therapie von Patienten mit COVID-19. Stand 31.01.2024 AWMF-Register.2022 https://register.awmf.org/assets/guidelines/113-001LGl_S3_Empfehlungen-zur-stationaeren-Therapie-von-Patienten-mit-COVID-19_2022-09_1.pdf zuletzt aufgerufen am 20.05.2024.
• 9 Tang SW, Leonard BE, Helmeste DM. Long COVID, neuropsychiatric disorders, psychotropics, present and future. Acta Neuropsychiatr 2022; 34: 109-126
• 10 Bonnet U, Juckel G. COVID-19 Outcomes: Does the Use of Psychotropic Drugs Make a Difference? Accumulating Evidence of a Beneficial Effect of Antidepressants-A Scoping Review. J Clin Psychopharmacol 2022; 42: 284-292
• 11 Fotuhi M, Mian A, Meysami S. et al. Neurobiology of COVID-19. J Alzheimers Dis 2020; 76: 3-19
• 12 Dos Santos AAC, Rodrigues LE, Alecrim-Zeza AL. et al. Molecular and cellular mechanisms involved in tissue-specific metabolic modulation by SARS-CoV-2. Front Microbiol 2022; 13: 1037467
• 13 Bonnet U, Juckel G, Kuhn J. Antidepressants for prevention of severe COVID-19, Long COVID and outlook for other viral diseases. Front Med (Lausanne) 2024; 11: 1305184
• 14 Goldsmith DR, Rapaport MH, Miller BJ. A meta-analysis of blood cytokine network alterations in psychiatric patients: comparisons between schizophrenia, bipolar disorder and depression. Mol Psychiatry 2016; 21: 1696-1709
• 15 Bonnet U, Juckel G, Scherbaum N. et al. Are Persons Treated with Antidepressants and/or Antipsychotics Possibly Better Protected against Severe COVID 19?. Pharmacopsychiatry 2021; 54: 142-143
• 16 Glebov OO. Understanding SARS-CoV-2 endocytosis for COVID-19 drug repurposing. FEBS J 2020; 287: 3664-3671
• 17 Kornhuber J, Hoertel N, Gulbins E. The acid sphingomyelinase/ceramide system in COVID-19. Mol Psychiatry 2022; 27: 307-314
• 18 Thümmler L, Beckmann N, Sehl C. et al. Fluoxetine and Sertraline Potently Neutralize the Replication of Distinct SARS-CoV-2 Variants. Viruses. 2024; 16: 545 38675888 PMC11053511
• 19 Mohamed FF, Anhlan D, Schöfbänker M. et al. Hypericum perforatum and Its Ingredients Hypericin and Pseudohypericin Demonstrate an Antiviral Activity against SARS-CoV-2. Pharmaceuticals (Basel) 2022; 5: 530 35631357
• 20 Jittamala P, Boyd S, Schilling WHK. et al. Antiviral efficacy of fluoxetine in early symptomatic COVID-19: an open-label, randomised, controlled, adaptive platform trial (PLATCOV). MEDRXIV 2024; https://www.medrxiv.org/content/ zuletzt aufgerufen am 20.05.2024 – zu diesem Zeitpunkt noch Preprint.
• 21 Rosen DA, Seki SM, Fernández-Castañeda A. et al. Modulation of the sigma-1 receptor–IRE1 pathway is beneficial in preclinical models of inflammation and sepsis. Sci Transl Med 2019; 11: eaau5266
• 22 Lenze EJ, Mattar C, Zorumski CF. et al. Fluvoxamine vs Placebo and Clinical Deterioration in Outpatients With Symptomatic COVID-19: A Randomized Clinical Trial. JAMA 2020; 324: 2292-2300
• 23 Vela JM. Repurposing Sigma-1 Receptor Ligands for COVID-19 Therapy?. Front Pharmacol 2020; 11: 582310
• 24 Carpinteiro A, Edwards MJ, Hoffmann M. et al. Pharmacological Inhibition of Acid Sphingomyelinase Prevents Uptake of SARS-CoV-2 by Epithelial Cells. Cell Rep Med. 2020; 1: 100142
• 25 Hindmarch I, Hashimoto K. Cognition and depression: the effects of fluvoxamine, a sigma-1 receptor agonist, reconsidered. Hum Psychopharmacol 2010; 25: 193-200
• 26 Benkert O, Hippius H. Kompendium der Psychiatrischen Pharmakotherapie. 14. Auflage. Springer; 2023
• 27 Ge S, Wang X, Hou Y. et al. Repositioning of histamine H1 receptor antagonist: Doxepin inhibits viropexis of SARS-CoV-2 Spike pseudovirus by blocking ACE2. Eur J Pharmacol 2021; 896: 173897
• 28 Wong AC, Devason AS, Umana IC. et al. Serotonin reduction in post-acute sequelae of viral infection. Cell. 2023; 186: 4851-4867 e20
• 29 Witt CE, Mena S, Holmes J. et al. Serotonin is a common thread linking different classes of antidepressants. Cell Chem Biol 2023; 30: 1557-1570.e6
• 30 Ghanbari R, El Mansari M, Blier P. Enhancement of serotonergic and noradrenergic neurotransmission in the rat hippocampus by sustained administration of bupropion. Psychopharmacology (Berl) 2011; 217: 61-73
• 31 Yeoh YK, Zuo T, Lui GC. et al. Gut microbiota composition reflects disease severity and dysfunctional immune responses in patients with COVID-19. Gut 2021; 70: 698-706
• 32 Ancona G, Alagna L, Alteri C. et al. Gut and airway microbiota dysbiosis and their role in COVID-19 and long-COVID. Front Immunol 2023; [Epub Ahead of Print] Mar 8;14:1080043
• 33 Blackett JW, Sun Y, Purpura L. et al. Decreased Gut Microbiome Tryptophan Metabolism and Serotonergic Signaling in Patients With Persistent Mental Health and Gastrointestinal Symptoms After COVID-19. Clin Transl Gastroenterol 2022; 13: e00524
• 34 Viel T, Chinta S, Rane A. et al. Microdose lithium reduces cellular senescence in human astrocytes – a potential pharmacotherapy for COVID-19?. Aging (Albany NY). 220 12: 10035-10040
• 35 Lionetto L, Ulivieri M, Capi M. et al. Increased kynurenine-to-tryptophan ratio in the serum of patients infected with SARS-CoV2: An observational cohort study. Biochim Biophys Acta Mol Basis Dis 2021; 1867: 166042
• 36 Gusev EY, Zotova NV. Cellular Stress and General Pathological Processes. Curr Pharm Des 2019; 25: 251-297
• 37 Casanova A, Wevers A, Navarro-Ledesma S. et al. Mitochondria: It is all about energy. Front Physiol 2023; 14: 1114231
• 38 Jin H, Li M, Jeong E, Castro-Martinez F. et al. A body-brain circuit that regulates body inflammatory responses. Nature. 2024; May 1 Epub ahead of print.
• 39 Bonnet U, Bingmann D, Wiltfang J. et al. Modulatory effects of neuropsychopharmaca on intracellular pH of hippocampal neurones in vitro. Br J Pharmacol. 2010; 159: 474-483 Epub 2009 Dec 10 20015293 PMC2825368
• 40 Bonnet U, Wiemann M. Neuropsychopharmaka verändern den intrazellulären pH-Wert von zentralen Neuronen [Neuropsychopharmaca influence the intracellular pH value of central neurons]. Fortschr Neurol Psychiatr. 2012; 80: 201-212 German
• 41 Bonnet U, Bingmann D, Speckmann EJ. et al. Small intraneuronal acidification via short-chain monocarboxylates: First evidence of an inhibitory action on over-excited human neocortical neurons. Life Sci 2018; 204: 65-70
• 42 Gusev E, Zhuravleva Y. Inflammation: A New Look at an Old Problem. Int J Mol Sci 2022; 23: 4596
• 43 Zeng Y, Sun B, Zhang F. et al. The core inflammatory factors in patients with major depressive disorder: a network analysis. Front Psychiatry 2023; 14: 1216583
• 44 Shetty PA, Ayari L, Madry J. et al. The Relationship Between COVID-19 and the Development of Depression: Implications on Mental Health. Neurosci Insights. 2023; 18 26331055231191513
• 45 Rook GA, Lowry CA, Raison CL. Microbial 'Old Friends', immunoregulation and stress resilience. Evol Med Public Health 2013; 2013: 46-64
• 46 Czarny P, Wigner P, Galecki P. et al. The interplay between inflammation, oxidative stress, DNA damage, DNA repair andmitochondrial dysfunction in depression. Prog Neuropsychopharmacol Biol Psychiatry 2018; 80: 309-321
• 47 WHO (World Health Organization). Post COVID-19 condition (Long COVID). https://www.who.int/europe/news-room/fact-sheets/item/post-covid-19-condition 2022 zuletzt aufgerufen am 20.05.2024.
• 48 Peters MD, Godfrey CM, Khalil H. et al Guidance for conducting systematic scoping reviews. Int J Evid Based Health 2015; 13: 141-146
• 49 Eichler M. Das menschliche Urteil in der evidenzbasierten Medizin. Onkologe 2020; 26: 456-464
• 50 Cochrane. Die Vertrauenswürdigkeit von Evidenz nach GRADE. 27. August 2021 / Evidenz Verstehen, Rund um Cochrane / GRADE. 2021 https://wissenwaswirkt.org/die-vertrauenswuerdigkeit-von-evidenz-nach-grade zuletzt aufgerufen am 20.05.2024
• 51 Firouzabadi D, Kheshti F, Abdollahifard S. et al. The effect of selective serotonin and norepinephrine reuptake inhibitors on clinical outcome of COVID-19 patients: A systematic review and meta-analysis. Health Sci Rep 2022; 5: e892
• 52 Fei L, Santarelli G, D'Anna G. et al. Can SSRI/SSNRI antidepressants decrease the 'cytokine storm' in the course of COVID-19 pneumonia?. Panminerva Med 2023; 65: 321-326 2021
• 53 Németh ZK, Szûcs A, Vitrai J. et al. Fluoxetine use is associated with improved survival of patients with COVID-19 pneumonia: A retrospective case-control study. Ideggyogy Sz 2021; 74: 389-396
• 54 Calusic M, Marcec R, Luksa L. et al. Safety and efficacy of fluvoxamine in COVID-19 ICU patients: An open label, prospective cohort trial with matched controls. Br J Clin Pharmacol 88: 2065-2073
• 55 Seftel D, Boulware DR. Prospective Cohort of Fluvoxamine for Early Treatment of Coronavirus Disease 19. Open Forum Infect Dis 2021; 8: ofab050
• 56 Oskotsky T, Maric I, Tang A. et al. Mortality Risk Among Patients With COVID-19 Prescribed Selective Serotonin Reuptake Inhibitor Antidepressants. JAMA Netw Open 2021; 4: e2133090
• 57 Reis G, Dos Santos Moreira-Silva EA, Silva DCM. et al. Effect of early treatment with fluvoxamine on risk of emergency care and hospitalisation among patients with COVID-19: the TOGETHER randomised, platform clinical trial. Lancet Glob Health 2022; 10: e42-e51
• 58 Poblador-Plou B, Carmona-Pírez J, Ioakeim-Skoufa I. et al. Baseline Chronic Comorbidity and Mortality in Laboratory-Confirmed COVID-19 Cases: Results from the PRECOVID Study in Spain. Int J Environ Res Public Health 2020; 17: 5171
• 59 Public Health Scotland COVID-19 Health Protection Study Group. McKeigue PM, Kennedy S, Weir A. et al. Relation of severe COVID-19 to polypharmacy and prescribing of psychotropic drugs: the REACT-SCOT case-control study. BMC Med 2021; 19: 51
• 60 Diez-Quevedo C, Iglesias-González M, Giralt-López M. et al. Mental disorders, psychopharmacological treatments, and mortality in 2150 COVID-19 Spanish inpatients. Acta Psychiatr Scand 2021; 143: 526-534
• 61 Nemani K, Conderino S, Marx J. et al. Association Between Antipsychotic Use and COVID-19 Mortality Among People With Serious Mental Illness. JAMA Psychiatry 2021; 78: 1391-1393
• 62 Cobos-Campos R, de Lafuente-Moríñigo AS, Cordero-Guevara JA. et al. Antidepressants Are Associated With a Reduction in the Risk of Death in COVID-19 Disease Patients. Am J Ther 2023; 30: e285-e288
• 63 Rauchman SH, Mendelson SG, Rauchman C. et al. Ongoing Use of SSRIs Does Not Alter Outcome in Hospitalized COVID-19 Patients: A Retrospective Analysis. J Clin Med 2021; 11: 70
• 64 Nakhaee H, Zangiabadian M, Bayati R. et al. The effect of antidepressants on the severity of COVID-19 in hospitalized patients: A systematic review and meta-analysis. PLoS One 2022; 17: e0267423
• 65 Lenze E. Fluvoxamine for early treatment of COVID-19: a fully-remote, randomized placebo controlled trial. ClinicalTrials.gov. 2021 https://clinicaltrials.gov/ct2/show/NCT04668950 zuletzt aufgerufen am 20.05.2024.
• 66 Reiersen AM, Mattar C, Bender Ignacio RA. et al. The STOP COVID 2 Study: Fluvoxamine vs Placebo for Outpatients With Symptomatic COVID-19, a Fully Remote Randomized Controlled Trial. Open Forum Infect Dis 2023; 10: ofad419
• 67 Seo H, Kim H, Bae S. et al. Fluvoxamine Treatment of Patients with Symptomatic COVID-19 in a Community Treatment Center: A Preliminary Result of Randomized Controlled Trial. Infect Chemother. 2022; 54: 102-113 Erratum in: Infect Chemother. 2022; 54(2): 391 35384422
• 68 Boretti A. Effectiveness of fluvoxamine at preventing COVID-19 infection from turning severe. Eur Neuropsychopharmacol 2023; 67: 83-85
• 69 COVID-OUT Trial Team. Bramante CT, Huling JD, Tignanelli CJ. et al. Randomized Trial of Metformin, Ivermectin, and Fluvoxamine for Covid-19. N Engl J Med 2022; 387: 599-610
• 70 Pineda E, Singh J, Pineda MV. et al. Impact of fluvoxamine on outpatient treatment of COVID-19 in Honduras in a prospective observational real-world study. Front Pharmacol 2022; 13: 1054644
• 71 Accelerating COVID-19 Therapeutic Interventions and Vaccines (ACTIV)-6 Study Group and Investigators. McCarthy MW, Naggie S, Boulware DR. et al. Effect of Fluvoxamine vs Placebo on Time to Sustained Recovery in Outpatients With Mild to Moderate COVID-19: A Randomized Clinical Trial. JAMA 2023; 329: 296-305
• 72 Fritz BA, Hoertel N, Lenze EJ. et al. Association between antidepressant use and ED or hospital visits in outpatients with SARS-CoV-2. Transl Psychiatry 2022; 12: 341
• 73 Trkulja V, Kodvanj I. Outpatients prescribed with fluvoxamine around the time of COVID-19 diagnosis are not at a reduced risk of subsequent hospitalization and death compared to their non-prescribed peers: population-based matched cohort study. Eur J Clin Pharmacol 2023; 79: 643-655
• 74 Lee TC, Vigod S, Bortolussi-Courval É. et al. Fluvoxamine for Outpatient Management of COVID-19 to Prevent Hospitalization: A Systematic Review and Meta-analysis. JAMA Netw Open 2022; 5: Me226269
• 75 Nyirenda JL, Sofroniou M, Toews I. et al. Fluvoxamine for the treatment of COVID-19. Cochrane Database Syst Rev 2022; 9: CD015391
• 76 Bhuta S, Khokher W, Kesireddy N. et al. Fluvoxamine in Nonhospitalized Patients With Acute COVID-19 Infection and the Lack of Efficacy in Reducing Rates of Hospitalization, Mechanical Ventilation, and Mortality in Placebo-Controlled Trials: A Systematic Review and Meta-Analysis. Am J Ther 2022; 29: e298-e304
• 77 Lu LC, Chao CM, Chang SP. et al. Effect of fluvoxamine on outcomes of nonhospitalized patients with COVID-19: A systematic review and meta-analysis. J Infect Public Health 2022; 15: 1259-1264
• 78 Wen W, Chen C, Tang J. et al. Efficacy and safety of three new oral antiviral treatment (molnupiravir, fluvoxamine and Paxlovid) for COVID-19: a meta-analysis. Ann Med 2022; 54: 516-523
• 79 Vatvani AD, Kurniawan A, Hariyanto TI. Efficacy and Safety of Fluvoxamine as Outpatient Treatment for Patients With Covid-19: A Systematic Review and Meta-analysis of Clinical Trials. Ann Pharmacother 2023; 57: 1389-1397
• 80 Deng J, Rayner D, Ramaraju HB. et al. Efficacy and safety of selective serotonin reuptake inhibitors in COVID-19 management: a systematic review and meta-analysis. Clin Microbiol Infect 2023; 29: 578-586
• 81 McCullumsmith C. Fluoxetine to reduce intubation and death after COVID19 Infection. ClinicalTrials. gov 2022 https://clinicaltrials.gov/ct2/show/NCT04377308 zuletzt aufgerufen am 20.05. 2024
• 82 Deng J, Moskalyk M, Zuo QK. et al. Evaluating fluvoxamine for the outpatient treatment of COVID-19: A systematic review and meta-analysis. Rev Med Virol 2024; 34: e2501
• 83 Ibrahim M, Shehta M. Treatment with fluvoxamine in nonhospitalized ccoronavirus disease 2019 patients. Egypt J Chest Dis Tuberc 2023; 72: 40
• 84 Siripongboonsitti T, Ungtrakul T, Tawinprai K. et al. Efficacy of combination therapy of fluvoxamine and favipiravir vs favipiravir monotherapy to prevent severe COVID-19 among mild to moderate COVID-19 patients: open-label randomized controlled trial (EFFaCo study). Int J Infect Di 2023; 134: 211-219
• 85 Naggie S. Effect of higher-dose fluvoxamine vs placebo on time to sustained recovery in outpatients with mild to moderate COVID-19: a randomized clinical trial. medRxiv [Internet] 2023;
• 86 Zhou Q, Zhao G, Pan Y. et al. The efficacy and safety of fluvoxamine in patients with COVID-19: A systematic review and meta-analysis from randomized controlled trials. PLoS One 2024; 19: e0300512
• 87 Stewart TG, Rebolledo PA, Mourad A. et al. Accelerating COVID-19 Therapeutic Interventions and Vaccines (ACTIV)-6 Study Group and Investigators. Higher-Dose Fluvoxamine and Time to Sustained Recovery in Outpatients With COVID-19: The ACTIV-6 Randomized Clinical Trial. JAMA. 2023; 330: 2354-2363
• 88 Vai B, Mazza MG, Delli Colli C. et al. Mental disorders and risk of COVID-19-related mortality, hospitalisation, and intensive care unit admission: a systematic review and meta-analysis. Lancet Psychiatry 2021; 8: 797-812
• 89 Cochrane Deutschland. Bewertung des Biasrisikos (Risiko systematischer Fehler) in klinischen Studien https://www.cochrane.de/news/bewertung-des-biasrisikos-risiko-systematischer-fehler-klinischen-studien zuletzt aufgerufen am 20.05.2024.
• 90 Sánchez-Rico M, Rezaei K, Lenze EJ. et al. Efficacy of Fluvoxamine in Outpatients With COVID-19: Understanding Conflicting Conclusions From 2 Recent Meta-Analyses of the Same Clinical Trials. Ann Pharmacother 2023; Nov 28 10600280231211304 Epub ahead of print.
• 91 Asadi Anar M, Foroughi E, Sohrabi E. et al. Selective serotonin reuptake inhibitors: New hope in the fight against COVID-19. Front Pharmacol 2022; 13: 1036093
• 92 Zheng W, Sun HL, Cai H. et al. Antidepressants for COVID-19: A systematic review. J Affect Disord 2022; 307: 108-114
• 93 Mas M, García-Vicente JA, Estrada-Gelonch A. et al. Antidepressant Drugs and COVID-19: A Review of Basic and Clinical Evidence. J Clin Med 2022; 11: 4038
• 94 Sedighi F, Zarghami M, Alizadeh Arimi F. et al. Efficacy and safety of adding fluoxetine to the treatment regimen of hospitalized patients with non-critical COVID-19 pneumonia: A double-blind randomized, placebo-controlled clinical trial. Neuropsychopharmacol Rep 2023; 43: 202-212
• 95 Kirenga BJ, Mugenyi L, Sánchez-Rico M. et al. Association of fluvoxamine with mortality and symptom resolution among inpatients with COVID-19 in Uganda: a prospective interventional open-label cohort study. Mol Psychiatry 2023; 28: 5411-5418
• 96 Lemerini W, Zatla I, Boublenza L. The impact of stress on COVID-19 severity: Exploring antidepressants as a potential intervention. Current Topics in Pharmacology 2023; 27: 63-662023
• 97 Wannigamnah DL, Hurst C, Phattharapornjaroen P. et al. Early treatment with fluvoxamine, bromhexine, cyproheptadine, and niclosamide to prevent clinical deterioration in patients with symptomatic COVID-19: a randomized clinical trial. EClinicalMedicine 2024; 70: 102517
• 98 Stauning MA, Gür DJ, Torp-Pedersen C. et al. COVID-19 mortality among selective serotonin reuptake inhibitor users-results from a nationwide cohort. Clin Microbiol Infect 2023; 29: 1075-1082
• 99 Rus CP, Kooij JJS. Re: COVID-19 mortality among selective serotonin reuptake inhibitor users by Stauning et al. Clin Microbiol Infect. 2024; Feb 10 S1198-S1743 (24)00082-X Epub ahead of print.
• 100 Visos-Varela I, Zapata-Cachafeiro M, Piñeiro-Lamas M. et al. Repurposing selective serotonin reuptake inhibitors for severity of COVID-19: A population-based study. Eur Neuropsychopharmacol 2023; 71: 96-108
• 101 Schultebraucks K, Blekic W, Basaraba C. et al. The impact of preexisting psychiatric disorders and antidepressant use on COVID-19 related outcomes: a multicenter study. Mol Psychiatry 2023; [Epub Ahead of Print]
• 102 Ma Y, Li S, Yang H. et al. Effect of psychotropics on the risk of COVID-19 in middle-aged and older adults. Eur Neuropsychopharmacol 2023; 66: 67-77
• 103 Hasse A, Korwek KM, Poland RE. Reduced risk of mortality among COVID-19 patients with in-hospital selective serotonin reuptake inhibitor administration. Journal of Pharmaceutical Health Services Research 2023; 14: 262-268
• 104 Hoertel N, Rezaei K, Sánchez-Rico M. et al. Medications Modulating the Acid Sphingomyelinase/Ceramide System and 28-Day Mortality among Patients with SARS-CoV-2: An Observational Study. Pharmaceuticals (Basel) 2023; 16: 1107
• 105 Wang H, Wei Y, Hung CT. et al. Relationship between antidepressants and severity of SARS-CoV-2 Omicron infection: a retrospective cohort study using real-world data. Lancet Reg Health West Pac. 2023; 34: 100716
• 106 Bramante CT, Buse JB, Liebovitz D. et al. Outpatient treatment of Covid-19 with metformin, ivermectin, and fluvoxamine and the development of Long Covid over 10-month follow-up. medRxiv [preprint]. 2022;
• 107 Farahani RH, Ajam A, Naeini AR. Effect of fluvoxamine on preventing neuropsychiatric symptoms of post COVID syndrome in mild to moderate patients, a randomized placebo-controlled double-blind clinical trial. BMC Infect Dis 2023; 23: 197
• 108 Di Nicola M, Pepe M, Montanari S. et al. Vortioxetine improves physical and cognitive symptoms in patients with post-COVID-19 major depressive episodes. Eur Neuropsychopharmacol 2023; 70: 21-28
• 109 Frontera JA, Thorpe LE, Simon NM. et al. Post-acute sequelae of COVID-19 symptom phenotypes and therapeutic strategies: A prospective, observational study. PLoS One 2022; 17: e0275274
• 110 Mazza MG, Zanardi R, Palladini M. et al. Rapid response to selective serotonin reuptake inhibitors in post-COVID depression. Eur Neuropsychopharmacol 2022; 54: 1-6
• 111 Gonzalez-Martinez A, Guerrero-Peral ÁL, Arias-Rivas S. et al. Amitriptyline for post-COVID headache: effectiveness, tolerability, and response predictors. J Neurol 2022; 269: 5702-5709
• 112 La Sala MS, Reinfeld S, Constantino E. Treatment of Long-COVID Neuropsychiatric Sequelae Using Tricyclic Antidepressants: A Case Series. J Clin Psychopharmacol 2023; 43: 458-460
• 113 Rus CP, de Vries BEK, de Vries IEJ. et al. Treatment of 95 post-Covid patients with SSRIs. Sci Rep 2023; 13: 18599
• 114 Sidky H, Hansen KA, Girvin AT. et al. Assessing the effect of selective serotonin reuptake inhibitors in the prevention of post-acute sequelae of COVID-19. Comput Struct Biotechnol J. 2024; 24: 115-125
• 115 Mazza MG, Palladini M, Villa G. et al. Prevalence of depression in SARS-CoV-2 infected patients: An umbrella review of meta-analyses. Gen Hosp Psychiatry 2023; 80: 17-25
• 116 Fenton C, Lee A. Antidepressants with anti-inflammatory properties may be useful in long COVID depression. Drugs Ther Perspect 2023; 39: 65-70
• 117 Bonnet U. Initiation of antidepressants in patients infected with SARS-COV-2: Don't forget Caution for "Paradoxical" Anxiety/Jitteriness syndrome-Commentary: Prescription of selective serotonin reuptake inhibitors in COVID-19 infection needs caution. Front Psychiatry 2023; 14: 1095244
• 118 Clelland CL, Ramiah K, Steinberg L. et al. Analysis of the impact of antidepressants and other medications on COVID-19 infection risk in a chronic psychiatric in-patient cohort. BJPsych Open 2021; 8: e6
• 119 De Picker LJ, Leboyer M, Geddes JR. et al. Association between serum lithium level and incidence of COVID-19 infection. Br J Psychiatry 2022; 221: 425-427
• 120 D'Andrea G, Pascale R, Vatamanu O. et al. Exposure to psychotropic medications and COVID-19 course after hospital admission: Results from a prospective cohort study. J Psychosom Res 2023; 167: 111199
• 121 Schwarzinger M, Luchini S, Teschl M. et al. Mental disorders, COVID-19-related life-saving measures and mortality in France: A nationwide cohort study. PLoS Med 2023; 20: e1004134
• 122 Hoertel N, Sánchez-Rico M, de la Muela P. et al. Risk of Death in Individuals Hospitalized for COVID-19 With and Without Psychiatric Disorders: An Observational Multicenter Study in France. Biol Psychiatry Glob Open Sci. 2023; 3: 56-67
• 123 Channer B, Matt SM, Nickoloff-Bybel EA. et al. Dopamine, Immunity, and Disease. Pharmacol Rev 2023; 75: 62-158
• 124 Vidal PM, Pacheco R. Targeting the Dopaminergic System in Autoimmunity. J Neuroimmune Pharmacol 2020; 15: 57-73
• 125 Aweimer A, Petschulat L, Jettkant B. et al. Mortality rates of severe COVID-19-related respiratory failure with and without extracorporeal membrane oxygenation in the Middle Ruhr Region of Germany. Sci Rep 2023; 13: 5143
• 126 Fei L, Bozza B, Melani G. et al. SSRIs in the course of COVID-19 pneumonia: Evidence of effectiveness of antidepressants on acute inflammation. A retrospective study. Hum Psychopharmacol 2024; 39: e2887
• 127 Sánchez-Rico M, Rezaei K, Delgado-Álvarez A. et al. Comorbidity Patterns and Mortality Among Hospitalized Patients with Psychiatric Disorders and COVID-19. Braz J Psychiatry. 2023; 45: 327-333
• 128 Min KH, Kim TH, Oh SJ. et al. COVID-19 Prognosis in Association with Antidepressant Use. Pharmacopsychiatry 2022; 55: 220-227
• 129 Patidar V, Sharma A, Garg V. et al. Methylene blue in management of COVID19. J Assoc Physicians India 2022; 70: 11-12 35443513
• 130 Kothalkar AD, Jambhale D, Hingane V. et al. Precision Medicine for COVID-19 Based on the Inflammatory Response: Validation of an Individualized Treatment Regimen With Fluvoxamine. Infectious Diseases in Clinical Practice 2024; 32: e1371
• 131 Garrido-Mesa J, Adams K, Galvez J, Garrido-Mesa N. Repurposing tetracyclines for acute respiratory distress syndrome (ARDS) and severe COVID-19: a critical discussion of recent publications. Expert Opin Investig Drugs 2022; 31: 475-482
• 132 Rosenblat JD, McIntyre RS. Efficacy and tolerability of minocycline for depression: A systematic review and meta-analysis of clinical trials. J Affect Disord 2018; 227: 219-225
• 133 Yang Q, Luo L, Sun T. et al. Chronic minocycline treatment exerts antidepressant effect, inhibits neuroinflammation, and modulates gut microbiota in mice. Psychopharmacology (Berl) 2020; 237: 3201-3213
• 134 Valdebenito-Navarrete H, Fuentes-Barrera V, Smith CT. et al. Can Probiotics, Particularly Limosilactobacillus fermentum UCO-979C and Lacticaseibacillus rhamnosus UCO-25A, Be Preventive Alternatives against SARS-CoV-2?. Biology (Basel) 2023; 12: 384
• 135 Scheibenbogen C, Renz-Polster H, Hohberger B. et al. Post COVID und Post-Vakzin-Syndrom. Die Pandemie nach der Pandemie. Deutsches Ärzteblatt 2023; 120: A 566-A 569
• 136 Tsampasian V, Elghazaly H, Chattopadhyay R. et al. Risk Factors Associated With Post-COVID-19 Condition: A Systematic Review and Meta-analysis. JAMA Intern Med 2023; 183: 566-580
• 137 Boscolo-Rizzo P, Hummel T, Spinato G. et al. Olfactory and Gustatory Function 3 Years After Mild COVID-19-A Cohort Psychophysical Study. JAMA Otolaryngol Head Neck Surg 2024; 150: 79-81
• 138 Yang L, Kim TW, Han Y. et al. SARS-CoV-2 infection causes dopaminergic neuron senescence. Cell Stem Cell 2024; 31: 196-211.e6
• 139 Bin NR, Prescott SL, Horio N. et al. An airway-to-brain sensory pathway mediates influenza-induced sickness. Nature 2023; 615: 660-667
• 140 Fine JS, Ambrose AF, Didehbani N. et al. Multi-disciplinary collaborative consensus guidance statement on the assessment and treatment of cognitive symptoms in patients with post-acute sequelae of SARS-CoV-2 infection (PASC). PM R. 2022; 14: 96-111
• 141 Erbguth F, Förstl H, Kleinschnitz C. Long COVID und die Psycho-Ecke. Widergeburt eines reduktionistischen Krankheitsverständnisses. Deutsches Ärzteblatt 2023; 120: A 563-A 565
• 142 Blankenfeld H, Kaduszkiewicz H, Kochen MM. et al. Hausärztezentrum SARS-CoV-2/COVID-19-Informationen & Praxishilfen für niedergelassene Hausärztinnen und Hausärzte. S2e-Leitlinie. 2022. AWMF-Register-Nr. 053-054 https://register.awmf.org/assets/guidelines/053-054l_S2e_SARS-CoV-2-Covid-19-Informationen-Praxishilfen-Hausaerztinnen-Hausaerzte_2022-12.pdf zuletzt aufgerufen am 20.05.2024.
• 143 Cortes Rivera M, Mastronardi C, Silva-Aldana CT. et al. Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Comprehensive Review. Diagnostics (Basel) 2019; 9: 91
• 144 Finnigan LEM, Cassar MP, Koziel MJ. et al. Efficacy and tolerability of an endogenous metabolic modulator (AXA1125) in fatigue-predominant long COVID: a single-centre, double-blind, randomised controlled phase 2a pilot study. EClinicalMedicine 2023; 59: 101946
• 145 Cope JR, Ingram I, Romanson B. Treating Long-COVID Brain Fog With ME/CFS Guidelines. Medscape. 2023 https://www.medscape.com/viewarticle/989887 zuletzt aufgerufen am 20.05.2024
• 146 IQWiG. ME/CFS: Der aktuelle Kenntnisstand. 15.03.2023. 2013 https://www.iqwig.de/presse/pressemitteilungen/pressemitteilungen-detailseite_93184.html zuletzt aufgerufen am 20.05.2024.
• 147 Ludwig B, Olbert E, Trimmel K. et al. Myalgische Enzephalomyelitis/chronisches Fatigue-Syndrom: eine Übersicht zur aktuellen Evidenz [Myalgic encephalomyelitis/chronic fatigue syndrome: an overview of current evidence]. Nervenarzt. 2023; 94: 725-733 German
• 148 Tholl G. Krankheitsbild Neurasthenie Der Burnout des frühen 20. Jahrhunderts https://www.spiegel.de/geschichte/neurasthenie-burnout-des-fruehen-20-jahrhunderts-a-960000.html zuletzt aufgerufen am 20.05.2024.
• 149 Bonnet U, Kuhn J. Serotonin deficiency and psychiatric long COVID: both caused specifically by the virus itself or an adaptive general stress response?. Eur Arch Psychiatry Clin Neurosci 2024; Feb 27 Epub ahead of print.
• 150 Rivas-Vazquez RA, Carrazana EJ, Rivas-Vazquez EV. et al. Growing Evidence for Potential Use of Antidepressants for Long COVID. Prim Care Companion CNS Disord 2024; 26: 23lr03690
• 151 Massoumi LE, Rosenbaum A. Case Report on High Dose Lithium Treatment for Post-COVID Depression, Recurrent Fevers, and Skin Lesions. Psychopharmacol Bull 2024; 54: 39-45
• 152 Baldwin K, Wanson A, Gilecki LA. et al. Intranasal ketamine as a treatment for psychiatric complications of long COVID: A case report. Ment Health Clin 2023; 13: 239-243
• 153 Köhler-Forsberg O, Otte C, Gold SM. et al. Statins in the treatment of depression: Hype or hope. Pharmacol Ther 2020; 215: 107625
• 154 Gillespie AL, Wigg C, Van Assche I. et al. Associations Between Statin Use and Negative Affective Bias During COVID-19: An Observational, Longitudinal UK Study Investigating Depression Vulnerability. Biol Psychiatry 2022; 92: 543-551
• 155 Min KH, Kim TH, Oh SJ. et al. COVID-19 Prognosis in Association with Antidepressant Use. Pharmacopsychiatry 2022; 55: 220-227
• 156 Chiou WC, Hsu MS, Chen YT. et al. Repurposing existing drugs: identification of SARS-CoV-2 3C-like protease inhibitors. J Enzyme Inhib Med Chem 2021; 36: 147-153
• 157 Ostadkarampour M, Putnins EE. Monoamine Oxidase Inhibitors: A Review of Their Anti-Inflammatory Therapeutic Potential and Mechanisms of Action. Front Pharmacol 2021; 12: 676239
• 158 Petri H. Interaktionen der SSRI-Antidepressiva. Dtsch Ärztebl 2015; 1: 31-23
• 159 Bundesinstitut für Arzneimittel und Medizinprodukte (BfArM). Rote Hand Brief vom 21.03.2024: Paxlovid (Nirmatrelvir, Ritonavir): Erinnerung an bereits bekannte und in der Fachinformation enthaltene Arzneimittelwechselwirkungen mit bestimmten Immunsuppressiva, einschließlich Tacrolimus, mit möglichen lebensbedrohlichen und tödlichen Folgen
• 160 Petrelli F, Grappasonni I, Nguyen CTT. et al. Metformin and Covid-19: a systematic review of systematic reviews with meta-analysis. Acta Biomed 2023; 94: e2023138
• 161 Li Y, Yang X, Yan P. et al. Metformin in Patients With COVID-19: A Systematic Review and Meta-Analysis. Front Med (Lausanne) 2021; 8: 704666
• 162 Mura C, Preissner S, Nahles S. et al. Real-world evidence for improved outcomes with histamine antagonists and aspirin in 22,560 COVID-19 patients. Signal Transduct Target Ther. 2021; 6: 267 antagonists and aspirin in 22,560 COVID-19 patients.
• 163 Blankenfeld H, Kaduszkiewicz H, Kochen MM. et al. Hausärztezentrum SARS-CoV-2/COVID-19-Informationen & Praxishilfen für niedergelassene Hausärztinnen und Hausärzte. S2e-Leitlinie. 2022. AWMF-Register-Nr. 053-054 https://register.awmf.org/assets/guidelines/053-054l_S2e_SARS-CoV-2-Covid-19-Informationen-Praxishilfen-Hausaerztinnen-Hausaerzte_2022-12.pdf zuletzt aufgerufen am 20.05.2024
• 164 FOSA Psychische Gesundheit 2023 https://napkon.de/die-fosa-psychische-gesundheit-stellt-sich-vor/ zuletzt aufgerufen am 20.05.2024.
• 165 Pliszka AG. Modafinil: A Review and Its Potential Use in the Treatment of Long COVID Fatigue and Neurocognitive Deficits. American Journal of Psychiatry Residents' Journal 2022; 17: 5-7 zuletzt aufgerufen am 20.05.2024
• 166 Watanabe A, Iwagami M, Yasuhara J. et al. Protective effect of COVID-19 vaccination against long COVID syndrome: A systematic review and meta-analysis. Vaccine. 2023; 41: 1783-1790
• 167 Scheppke KA, Pepe PE, Jui J. et al. Remission of severe forms of long COVID following monoclonal antibody (MCA) infusions: A report of signal index cases and call for targeted research. Am J Emerg Med 2024; 75: 122-127
• 168 Levine H. Five Keys to Helping Long-COVID Patients Recover. Medscape. 2024 https://www.medscape.com/viewarticle/five-keys-helping-long-covid-patients-recover-2024a10004v7?form=fpf zuletzt aufgerufen am 20.05.2024
• 169 Bonnet U, Juckel G. COVID-19 und Long-COVID mit Antidepressiva verhindern? Potenzial, die Infektion zu bremsen und die Resilienz zu stärken. DNP – Die Neurologie & Psychiatrie 2023; 5: 34-39