The effect of antidepressants on the severity of COVID-19 in hospitalized patients: A systematic review and meta-analysis.

INTRODUCTION: Clinical Depression and the subsequent low immunity is a comorbidity that can act as a risk factor for the severity of COVID-19 cases. Antidepressants such as Selective serotonin reuptake inhibitor and Serotonin-norepinephrine reuptake inhibitors are associated with immune-modulatory effects, which dismiss inflammatory responses and reduce lung tissue damage. The current systematic review and meta-analysis aims to evaluate the effect of antidepressant drugs on the prognosis and severity of COVID-19 in hospitalized patients. METHODS: A systematic search was carried out in PubMed/Medline, EMBASE, and Scopus up to June 14, 2022. The following keywords were used: "COVID-19", "SARS-CoV-2", "2019-nCoV", "SSRI", "SNRI", "TCA", "MAOI", and "Antidepressant". A fixed or random-effect model assessed the pooled risk ratio (RR) with 95% CI. We considered P < 0.05 as statistically significant for publication bias. Data were analyzed by Comprehensive Meta-Analysis software, Version 2.0 (Biostat, Englewood, NJ). RESULTS: Fourteen studies were included in our systematic review. Five of them were experimental with 2350, and nine of them were observational with 290,950 participants. Eight out of fourteen articles revealed the effect of antidepressants on reducing the severity of COVID-19. Selective serotonin reuptake inhibitors drugs, including Fluvoxamine, Escitalopram, Fluoxetine, and Paroxetine, and among the Serotonin-norepinephrine inhibitors medications Venlafaxine, are reasonably associated with reduced risk of intubation or death. Five studies showed no significant effect, and only one high risk of bias article showed the negative effect of antidepressants on the prognosis of Covid-19. The meta-analysis of clinical trials showed that fluvoxamine could significantly decrease the severity outcomes of COVID-19 (RR: 0.763; 95% CI: 0.602-0.966, I2: 0.0). FINDINGS: Most evidence supports that the use of antidepressant medications, mainly Fluvoxamine, may decrease the severity and improve the outcome in hospitalized patients with SARS-CoV-2. Some studies showed contradictory findings regarding the effects of antidepressants on the severity of COVID-19. Further clinical trials should be conducted to clarify the effects of antidepressants on the severity of COVID-19.

Cytotoxic evaluation of nanostructured zinc oxide (ZnO) thin films and leachates.

Nanostructured ZnO films have potential use as coatings on medical devices and food packaging due to their antimicrobial and UV-protection properties. However, their influence on mammalian cells during clinical use is not fully understood. This study investigated the potential cytotoxicity of ZnO thin films in RAW 264.7 macrophages. ZnO thin films (∼96nm thick with a 50nm grain) were deposited onto silicon wafers using pulsed laser deposition. Cells grown directly on ZnO thin film coatings exhibited less toxicity than cells exposed to extracts of the coatings. Cells on ZnO thin films exhibited a 43% and 68% decrease in cell viability using the MTT and 7-AAD/Annexin V flow cytometry assays, respectively, after a 24-h exposure as compared to controls. Undiluted 100% 24- and 48-h extracts decreased viability by 89%, increased cell death by LDH release to 76% 24h after treatment, and increased ROS after 5-24h of exposure. In contrast, no cytotoxicity or ROS were observed for 25% and 50% extracts, indicating a tolerable concentration. Roughly 24 and 34µg/m(2) Zn leached off the surfaces after 24 and 48h of incubation, respectively. ZnO coatings may produce gradual ion release which becomes toxic after a certain level and should be evaluated using both direct exposure and extraction methods.