Comparing COVID-19-related Morbidity and Mortality Between Patients
With and Without Substance Use Disorders: A Retrospective Cohort
Study.
SUBSTANCE ABUSE: RESEARCH AND TREATMENT 2023;
17:11782218231160014. [PMID:
36968974 PMCID:
PMC10034287 DOI:
10.1177/11782218231160014]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 02/09/2023] [Indexed: 03/24/2023]
Abstract
Objectives:
People with substance use disorders (SUD) are suggested to have higher risk
of hospitalization, intubation, or death from coronavirus disease 2019
(COVID-19), although data are mixed. Little is known about other
COVID-19-related complications in this group. We compared morbidity and
mortality among individuals with and without SUD who were admitted to an
urban safety net hospital with COVID-19 early in the pandemic,
contemporaneous to other published studies on this subject.
Methods:
We performed a retrospective study of patients ⩾18 years old admitted with
COVID-19 from March 16th to April 8th, 2020. SUD included alcohol, opioid,
cocaine, amphetamine, and benzodiazepine use disorders and was identified
using diagnostic codes, free text clinical documentation, and urine drug
screens. The primary outcome was inpatient mortality. Secondary outcomes
included clinical complications (eg, secondary infections, venous
thromboembolism) and resource utilization (eg, mechanical ventilation,
length of stay). We used multivariable regression to assess the relationship
between SUD and mortality.
Results:
Of 409 patients, the mean age was 56 years and 13.7% had SUD. Those with SUD
were more likely to be male, have experienced homelessness, have pulmonary
disease or hepatitis C, or use tobacco or cannabis. After multivariable
analysis, SUD was not associated with mortality (aOR 1.03; 95% CI,
0.31-3.10). Secondary outcomes were also similar between groups.
Conclusions:
Our findings suggest that persons with and without SUD have similar
COVID-19-related outcomes. Previously reported increased COVID-19
complications may be from medical comorbidities.
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