Substance use disorders and COVID-19: An analysis of nation-wide Veterans Health Administration electronic health records
| Autor: | Deborah S. Hasin, David S. Fink, Mark Olfson, Andrew J. Saxon, Carol Malte, Katherine M. Keyes, Jaimie L. Gradus, Magdalena Cerdá, Charles C. Maynard, Salomeh Keyhani, Silvia S. Martins, Ofir Livne, Zachary L. Mannes, Scott E. Sherman, Melanie M. Wall |
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| Rok vydání: | 2022 |
| Předmět: |
Substance-Related Disorders
Veterans Health Opioid Substance use disorder Toxicology behavioral disciplines and activities Medical and Health Sciences Substance Misuse Cocaine Clinical Research mental disorders Humans Electronic Health Records Pharmacology (medical) Mortality health care economics and organizations Veterans Pharmacology Analgesics Veterans Health Administration Psychology and Cognitive Sciences Neurosciences Substance Abuse COVID-19 Health Services Brain Disorders Analgesics Opioid Hospitalization Psychiatry and Mental health Good Health and Well Being Drug Abuse (NIDA only) |
| Zdroj: | Drug and Alcohol Dependence. 234:109383 |
| ISSN: | 0376-8716 |
| Popis: | BackgroundSubstance use disorders (SUD) elevate the risk for COVID-19 hospitalization, but studies are inconsistent on the relationship of SUD to COVID-19 mortality.MethodsVeterans Health Administration (VHA) patients treated in 2019 and evaluated in 2020 for COVID-19 (n=5,556,315), of whom 62,303 (1.1%) tested positive for COVID-19 (COVID-19+). Outcomes were COVID-19+ by 11/01/20, hospitalization, ICU admission, or death within 60 days of a positive test. Main predictors were any ICD-10-CM SUDs, with substance-specific SUDs (cannabis, cocaine, opioid, stimulant, sedative) explored individually. Logistic regression produced unadjusted and covariate-adjusted odds ratios (OR; aOR).ResultsAmong COVID-19+ patients, 19.25% were hospitalized, 7.71% admitted to ICU, and 5.84% died. In unadjusted models, any SUD and all substance-specific SUDs except cannabis use disorder were associated with COVID-19+(ORs=1.06-1.85); adjusted models produced similar results. Any SUD and all substance-specific SUDs were associated with hospitalization (aORs: 1.24-1.91). Any SUD, cocaine and opioid disorder were associated with ICU admission in unadjusted but not adjusted models. Any SUD, cannabis, cocaine, and stimulant disorders were inversely associated with mortality in unadjusted models (OR=0.27-0.46). After adjustment, associations with mortality were no longer significant. In ad hoc analyses, adjusted odds of mortality were lower among the 49.9% of COVID-19+ patients with SUD who had SUD treatment in 2019, but not among those without such treatment.ConclusionsIn VHA patients, SUDs are associated with COVID-19 hospitalization but not COVID-19 mortality. SUD treatment may provide closer monitoring of care, ensuring that these patients received needed medical attention, enabling them to ultimately survive serious illness. |
| Databáze: | OpenAIRE |
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