Hydroxychloroquine, Interleukin-6 Receptor Antagonists and Corticoid Treatments of Acute COVID-19 Infection: Psychiatric Symptoms and Mental Disorders 4 Months Later

Matthieu Gasnier; Walid Choucha; David Montani; Nicolas Noël; Céline Verstuyft; Francois Radiguer; Xavier Monnet; Laurent Becquemont; Emmanuelle Corruble; Romain Colle; COMEBAC Study Group

doi:10.9758/cpn.2022.20.4.762

Hydroxychloroquine, Interleukin-6 Receptor Antagonists and Corticoid Treatments of Acute COVID-19 Infection: Psychiatric Symptoms and Mental Disorders 4 Months Later

Clin Psychopharmacol Neurosci. 2022 Nov 30;20(4):762-767. doi: 10.9758/cpn.2022.20.4.762.

Authors

Matthieu Gasnier^{1

2}, Walid Choucha^{1

2}, David Montani³, Nicolas Noël, Céline Verstuyft^{2

4}, Francois Radiguer⁵, Xavier Monnet⁶, Laurent Becquemont^{2

7}, Emmanuelle Corruble^{1

2}, Romain Colle^{1

2}; COMEBAC Study Group

Affiliations

¹ Department of Psychiatry, Bicêtre Hospital, Mood Center Paris Saclay, AP-HP, Paris-Saclay University, Le Kremlin Bicêtre, France.
² MOODS Team, INSERM 1018, CESP, Paris-Saclay University, Le Kremlin Bicêtre, France.
³ Department of Pneumology, Bicêtre Hospital, AP-HP, Paris-Saclay University, Inserm UMR_S999, Le Kremlin Bicêtre, France.
⁴ Department of Molecular Genetics and Pharmacogenetics, Bicêtre Hospital, AP-HP, Paris-Saclay University, Le Kremlin Bicêtre, France.
⁵ Post-surgical Intensive Care Unit, Bicêtre Hospital, AP-HP, Paris-Saclay University, Inserm UMR_S999, Le Kremlin Bicêtre, France.
⁶ Intensive Care Unit, Bicêtre Hospital, AP-HP, Paris-Saclay University, Inserm UMR_S999, FHU SEPSIS, Le Kremlin Bicêtre, France.
⁷ Clinical Research Center, Bicêtre Hospital, Mood Center Paris Saclay, AP-HP, Paris-Saclay University, Le Kremlin Bicêtre, France.

Abstract

Objective: Psychiatric symptoms and mental disorders are common after Coronavirus Disease-19 (COVID-19). Some drugs used to treat acute COVID-19 have psychiatric side effects. We assessed the psychiatric symptoms and mental disorders of patients treated for acute COVID-19 with hydroxychloroquine (HCQ), interleukin-6 receptor antagonists (anti-IL-6), and corticoids (CTC).

Methods: We evaluated 177 patients in a day hospital 4 months after acute infection.

Results: In a multivariate analysis, HCQ was associated with significant anxiety symptoms (odds ratio [OR] = 5.9, 95% confidence interval [95% CI] = 1.8-20.0, p = 0.003) and mental disorders (OR = 4.1, 95% CI = 1.2-13.9, p = 0.02). In a bivariate analysis with propensity matched cohorts, HCQ was associated with significant anxiety symptoms (9 patients [50.0%] with significant symptoms in the HCQ group versus 15 [20.1%] in the control group, OR = 3.8, 95% CI = 1.3-11.3, p = 0.01). Anti-IL-6 and CTC were not associated with significant psychiatric symptoms or mental disorders.

Conclusion: We recommend monitoring psychiatric symptoms, especially anxiety, in patients treated with HCQ during COVID-19 infection. Further studies with larger samples and prospective assessments are needed to confirm our results.

Keywords: Anxiety; COVID-19; Major depressive disorder.