Increased Mortality Risk in Patients with Illicit Substance Use and COVID-19: Analysis of a Large Brazilian Sample.

IF 1.7 4区医学 Q3 PSYCHIATRY Substance Use & Misuse Pub Date : 2025-01-01 Epub Date: 2025-02-17 DOI:10.1080/10826084.2025.2465978

Fabrício Emanuel Soares de Oliveira, Maria Christina L Oliveira, Daniella Reis Barbosa Martelli, Cristina Andrade Sampaio, Enrico A Colosimo, Eduardo A Oliveira, Hercílio Martelli Júnior

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Abstract

Background: Illicit substance use (ISU) may be a potential predisposing factor for severe COVID-19 outcomes.

Objective: To conduct a propensity score-matching analysis to assess and compare the mortality rate of individuals who reported ISU among a sizable cohort of hospitalized COVID-19 patients in Brazil.

Methods: This population-based retrospective cohort study analyzed a nationwide Brazilian database of patients hospitalized for COVID-19. Eligible patients were aged >18 years and tested positive for SARS-CoV-2 infection. The primary exposure of interest was ISU, defined as substances prohibited under Brazilian law, primarily marijuana, cocaine, and crack. Statistical analysis was performed using t-tests, chi-square tests, the Propensity Score Matching (PSM) technique to create a balanced comparison group, and the McNemar test for paired samples to assess mortality risk among patients with ISU.

Results: In a cohort of 2,124,285 patients, 1,845 had ISU. The mortality rate in the ISU group was slightly higher than that in the non-ISU group (33% vs. 32%). After PSM, we found a higher odds ratio for death in patients with ISU (OR 2.18; 95% CI 1.85-2.57; p < 0.001).

Conclusion: Our study highlights a significant association between ISU and an increased mortality risk in COVID-19 patients.

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非法药物使用和COVID-19患者死亡风险增加：对巴西大样本的分析

背景：非法药物使用（ISU）可能是COVID-19严重结局的潜在诱发因素。目的：进行倾向评分匹配分析，以评估和比较巴西相当大的住院COVID-19患者中报告ISU的个体的死亡率。方法：这项基于人群的回顾性队列研究分析了巴西全国COVID-19住院患者数据库。符合条件的患者年龄为18岁，SARS-CoV-2感染检测呈阳性。主要关注的是ISU，它被定义为巴西法律禁止的物质，主要是大麻、可卡因和快克。统计分析采用t检验、卡方检验、倾向得分匹配（PSM）技术创建平衡对照组，成对样本采用McNemar检验评估ISU患者的死亡风险。结果：在2124285例患者的队列中，1845例有ISU。ISU组的死亡率略高于非ISU组（33% vs. 32%）。PSM后，我们发现ISU患者死亡的优势比更高(OR 2.18；95% ci 1.85-2.57；结论：我们的研究强调了ISU与COVID-19患者死亡风险增加之间的显著关联。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Substance Use & Misuse 医学-精神病学

CiteScore

3.20

自引率

5.00%

发文量

200

审稿时长

3 months

期刊介绍： For over 50 years, Substance Use & Misuse (formerly The International Journal of the Addictions) has provided a unique international multidisciplinary venue for the exchange of original research, theories, policy analyses, and unresolved issues concerning substance use and misuse (licit and illicit drugs, alcohol, nicotine, and eating disorders). Guest editors for special issues devoted to single topics of current concern are invited. Topics covered include: Clinical trials and clinical research (treatment and prevention of substance misuse and related infectious diseases) Epidemiology of substance misuse and related infectious diseases Social pharmacology Meta-analyses and systematic reviews Translation of scientific findings to real world clinical and other settings Adolescent and student-focused research State of the art quantitative and qualitative research Policy analyses Negative results and intervention failures that are instructive Validity studies of instruments, scales, and tests that are generalizable Critiques and essays on unresolved issues Authors can choose to publish gold open access in this journal.