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Observational Study of Chlorpromazine in Hospitalized Patients with COVID-19.
Hoertel, Nicolas; Sánchez-Rico, Marina; Vernet, Raphaël; Jannot, Anne-Sophie; Neuraz, Antoine; Blanco, Carlos; Lemogne, Cédric; Airagnes, Guillaume; Paris, Nicolas; Daniel, Christel; Gramfort, Alexandre; Lemaitre, Guillaume; Bernaux, Mélodie; Bellamine, Ali; Beeker, Nathanaël; Limosin, Frédéric.
  • Hoertel N; DMU Psychiatrie et Addictologie, AP-HP. Centre-Université de Paris, Hôpital Corentin-Celton, 4 parvis Corentin Celton, 92130, Issy-les-Moulineaux, France.
  • Sánchez-Rico M; INSERM, Institut de Psychiatrie et Neurosciences de Paris, UMR_S1266, Paris, France.
  • Vernet R; Faculté de Santé, UFR de Médecine, Université de Paris, Paris, France.
  • Jannot AS; DMU Psychiatrie et Addictologie, AP-HP. Centre-Université de Paris, Hôpital Corentin-Celton, 4 parvis Corentin Celton, 92130, Issy-les-Moulineaux, France. marinals@ucm.es.
  • Neuraz A; Department of Psychobiology and Behavioural Sciences Methods, Faculty of Psychology, Universidad Complutense de Madrid, Campus de Somosaguas, Madrid, Spain. marinals@ucm.es.
  • Blanco C; Medical Informatics, Biostatistics and Public Health Department, AP-HP. Centre-Université de Paris, Hôpital Européen Georges Pompidou, 75015, Paris, France.
  • Lemogne C; Faculté de Santé, UFR de Médecine, Université de Paris, Paris, France.
  • Airagnes G; Medical Informatics, Biostatistics and Public Health Department, AP-HP. Centre-Université de Paris, Hôpital Européen Georges Pompidou, 75015, Paris, France.
  • Paris N; INSERM, UMR_S 1138, Cordeliers Research Center, Université de Paris, Paris, France.
  • Daniel C; INSERM, UMR_S 1138, Cordeliers Research Center, Université de Paris, Paris, France.
  • Gramfort A; Department of Medical Informatics, AP-HP. Centre-Université de Paris, Necker-Enfants Malades Hospital, 75015, Paris, France.
  • Lemaitre G; National Institute on Drug Abuse, Bethesda, MD, USA.
  • Bernaux M; DMU Psychiatrie et Addictologie, AP-HP. Centre-Université de Paris, Hôpital Corentin-Celton, 4 parvis Corentin Celton, 92130, Issy-les-Moulineaux, France.
  • Bellamine A; INSERM, Institut de Psychiatrie et Neurosciences de Paris, UMR_S1266, Paris, France.
  • Beeker N; Faculté de Santé, UFR de Médecine, Université de Paris, Paris, France.
  • Limosin F; DMU Psychiatrie et Addictologie, AP-HP. Centre-Université de Paris, Hôpital Corentin-Celton, 4 parvis Corentin Celton, 92130, Issy-les-Moulineaux, France.
Clin Drug Investig ; 41(3): 221-233, 2021 Mar.
Article in English | MEDLINE | ID: covidwho-1070973
Preprint
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ABSTRACT

INTRODUCTION:

Chlorpromazine has been suggested as being potentially useful in patients with coronavirus disease 2019 (COVID-19) on the grounds of its potential antiviral and anti-inflammatory effects.

OBJECTIVE:

The aim of this study was to examine the association between chlorpromazine use and mortality among adult patients hospitalized for COVID-19.

METHODS:

We conducted an observational, multicenter, retrospective study at Assistance Publique-Hôpitaux de Paris (AP-HP) Greater Paris University hospitals. Study baseline was defined as the date of first prescription of chlorpromazine during hospitalization for COVID-19. The primary endpoint was death. Among patients who had not been hospitalized in intensive care units (ICUs), we compared this endpoint between those who received chlorpromazine and those who did not, in time-to-event analyses adjusted for patient characteristics, clinical markers of disease severity, and other psychotropic medications. The primary analysis used a Cox regression model with inverse probability weighting. Multiple sensitivity analyses were performed.

RESULTS:

Of the 14,340 adult inpatients hospitalized outside ICUs for COVID-19, 55 patients (0.4%) received chlorpromazine. Over a mean follow-up of 14.3 days (standard deviation [SD] 18.2), death occurred in 13 patients (23.6%) who received chlorpromazine and 1289 patients (9.0%) who did not. In the primary analysis, there was no significant association between chlorpromazine use and mortality (hazard ratio [HR] 2.01, 95% confidence interval [CI] 0.75-5.40; p = 0.163). Sensitivity analyses included a Cox regression in a 15 ratio matched analytic sample that showed a similar result (HR 1.67, 95% CI 0.91-3.06; p = 0.100) and a multivariable Cox regression that indicated a significant positive association (HR 3.10, 95% CI 1.31-7.34; p = 0.010).

CONCLUSION:

Our results suggest that chlorpromazine prescribed at a mean daily dose of 70.8 mg (SD 65.3) was not associated with reduced mortality.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Main subject: Chlorpromazine / SARS-CoV-2 / COVID-19 Subject: Chlorpromazine / SARS-CoV-2 / COVID-19 Type of study: Controlled clinical trial / Observational study / Prognostic study / Risk factors Language: English Journal: Clin Drug Investig Clinical aspect: Prognosis / Therapy Year: 2021

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Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Main subject: Chlorpromazine / SARS-CoV-2 / COVID-19 Subject: Chlorpromazine / SARS-CoV-2 / COVID-19 Type of study: Controlled clinical trial / Observational study / Prognostic study / Risk factors Language: English Journal: Clin Drug Investig Clinical aspect: Prognosis / Therapy Year: 2021
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