丁丙诺啡、美沙酮和药物滥用对 COVID-19 发病率和死亡率的影响。

IF 4.2 3区 医学 Q1 SUBSTANCE ABUSE Journal of Addiction Medicine Pub Date : 2024-10-30 DOI:10.1097/ADM.0000000000001386
Nicholaus J Christian, Xin Zhou, Rajiv Radhakrishnan
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引用次数: 0

摘要

目的:物质使用障碍与 COVID-19 感染的发病率增加有关。然而,人们对主动使用药物和阿片类药物使用障碍(MOUD)对 COVID-19 结果的影响知之甚少。我们开展了一项回顾性队列研究,以评估药物使用(即大麻、可卡因、酒精、镇静剂和阿片类药物的使用)以及丁丙诺啡或美沙酮对 COVID-19 发病率和死亡率的影响:利用一家大型城市医院系统的电子健康记录数据,纳入 2020 年 1 月 1 日至 2021 年 12 月 31 日期间 COVID-19 检测呈阳性的患者。根据入院前90天内的尿液毒理学和MOUD处方确定药物使用情况。COVID-19 结果包括死亡率、入住 ICU、插管需求、住院次数和住院时间。在控制了年龄、性别、医疗合并症、烟草使用和社会不利条件等变量后,进行了多变量逻辑回归:结果:在 COVID-19 阳性患者(n = 17,423)中,镇静剂、大麻、可卡因和阿片类药物的使用与重症监护室护理需求、呼吸支持需求、住院次数和住院时间的增加有统计学意义。使用药物与全因死亡率的增加无关。在 COVID-19 结果方面,美沙酮、丁丙诺啡和其他阿片类药物之间没有明显的统计学差异:结论:积极使用药物与 COVID-19 感染的发病率增加有关。与其他阿片类药物相比,MOUD 与 COVID-19 的恶化结果无关。未来对降低发病率的MOUD治疗方法的研究可能有助于改善COVID-19的临床治疗效果。
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Effects of Buprenorphine, Methadone, and Substance-Use on COVID-19 Morbidity and Mortality.

Objectives: Substance use disorder has been associated with increased morbidity in COVID-19 infection. However, less is known about the impact of active substance use and medications for opioid use disorder (MOUD) on COVID-19 outcomes. We conducted a retrospective cohort study to evaluate the impact of substance use, namely, cannabis, cocaine, alcohol, sedative and opioid use; and buprenorphine or methadone on COVID-19 morbidity and mortality.

Methods: Using electronic health record data at a large urban hospital system, patients who tested positive for COVID-19 between January 1, 2020, and December 31, 2021, were included. Substance use was identified from urine toxicology and MOUD prescriptions within 90 days prior to admission. COVID-19 outcomes included mortality, ICU admission, need for intubation, and number and duration of hospitalizations. Multivariable logistic regression was performed controlling for variables such as age, sex, medical comorbidity, tobacco use, and social disadvantage.

Results: Among COVID-19-positive patients (n = 17,423), sedative, cannabis, cocaine, and opioid use was associated with statistically significant increases in need for ICU care, need for ventilatory support, number of hospitalizations, and duration of hospitalization. Substance use was not associated with an increase in all-cause mortality. There were no statistically significant differences between methadone, buprenorphine, and other opioids on COVID-19 outcomes.

Conclusions: Active substance use was associated with increased morbidity in COVID-19 infection. MOUD was not associated with worse COVID-19 outcomes compared to other opioids. Future studies focused on MOUD treatments that reduce morbidity may help improve clinical outcomes in COVID-19.

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来源期刊
Journal of Addiction Medicine
Journal of Addiction Medicine 医学-药物滥用
CiteScore
6.10
自引率
9.10%
发文量
260
审稿时长
>12 weeks
期刊介绍: The mission of Journal of Addiction Medicine, the official peer-reviewed journal of the American Society of Addiction Medicine, is to promote excellence in the practice of addiction medicine and in clinical research as well as to support Addiction Medicine as a mainstream medical sub-specialty. Under the guidance of an esteemed Editorial Board, peer-reviewed articles published in the Journal focus on developments in addiction medicine as well as on treatment innovations and ethical, economic, forensic, and social topics including: •addiction and substance use in pregnancy •adolescent addiction and at-risk use •the drug-exposed neonate •pharmacology •all psychoactive substances relevant to addiction, including alcohol, nicotine, caffeine, marijuana, opioids, stimulants and other prescription and illicit substances •diagnosis •neuroimaging techniques •treatment of special populations •treatment, early intervention and prevention of alcohol and drug use disorders •methodological issues in addiction research •pain and addiction, prescription drug use disorder •co-occurring addiction, medical and psychiatric disorders •pathological gambling disorder, sexual and other behavioral addictions •pathophysiology of addiction •behavioral and pharmacological treatments •issues in graduate medical education •recovery •health services delivery •ethical, legal and liability issues in addiction medicine practice •drug testing •self- and mutual-help.
期刊最新文献
Clinician and Practice Characteristics Associated With Support of Office-Based Methadone: Findings From a National Survey. Current Self-reported Pain Before and After Cure of Hepatitis C Among Persons Who Actively Inject Drugs. Effects of Buprenorphine, Methadone, and Substance-Use on COVID-19 Morbidity and Mortality. Chronic Pain Associated Alcohol Use Disorder among Participants in a Small Clinical Trial. Response to: "Chronic Pain Associated Alcohol Use Disorder among Participants in a Small Clinical Trial".
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