Department of Preventive Medicine and Population Health (all authors), and Department of Internal Medicine (Kuo, Raji), University of Texas Medical Branch, Galveston.
Psychiatr Serv. 2021 May 1;72(5):578-581. doi: 10.1176/appi.ps.202000534. Epub 2020 Nov 3.
The goal of this study was to examine the impact of substance use disorder on the risk of hospitalization, complications, and mortality among adult patients diagnosed as having COVID-19.
The authors conducted a propensity score (PS)-matched double-cohort study (N=5,562 in each cohort) with data from the TriNetX Research Network database to identify 54,529 adult patients (≥18 years) diagnosed as having COVID-19 between February 20 and June 30, 2020.
Primary analysis (PS matched on demographic characteristics and presence of diabetes and obesity) showed that substance use disorder was associated with an increased risk of hospitalization (odds ratio [OR]=1.84, 95% confidence interval [CI]=1.69-2.01), ventilator use (OR=1.45, 95% CI=1.22-1.72), and mortality (OR=1.30, 95% CI=1.08-1.56).
The findings suggest that COVID-19 patients with substance use disorders are at increased risk for adverse outcomes. The attenuation of ORs in the model that matched for chronic respiratory and cardiovascular diseases associated with substance abuse suggests that the observed risks may be partially mediated by these conditions.
本研究旨在探讨物质使用障碍对 COVID-19 成年患者住院、并发症和死亡率风险的影响。
作者采用来自 TriNetX 研究网络数据库的倾向评分（PS）匹配的双队列研究（每组队列 n=5562），纳入 2020 年 2 月 20 日至 6 月 30 日期间确诊为 COVID-19 的 54529 名成年患者（≥18 岁）。
主要分析（PS 匹配了人口统计学特征以及糖尿病和肥胖的存在情况）显示，物质使用障碍与住院风险增加相关（优势比 [OR]=1.84，95%置信区间 [CI]=1.69-2.01）、呼吸机使用（OR=1.45，95% CI=1.22-1.72）和死亡率（OR=1.30，95% CI=1.08-1.56）。
研究结果表明，COVID-19 合并物质使用障碍的患者发生不良结局的风险增加。在匹配与物质滥用相关的慢性呼吸系统和心血管疾病的模型中，OR 减弱，这表明观察到的风险可能部分由这些情况介导。
