Department of Internal Medicine and Sealy Center on Aging, University of Texas Medical Branch (UTMB), Galves-ton, Texas.
Department of Internal Medicine and Sealy Center on Aging; Department of Preventive Medicine and Commu-nity Health; and Institute for Translational Science, University of Texas Medical Branch (UTMB), Galveston, Texas.
J Opioid Manag. 2020 Nov-Dec;16(6):401-404. doi: 10.5055/jom.2020.0597.
Based on evidence of the immunosuppressive effects of chronic opioids, long-term users of prescription and illicit opioids comprise an unrecognized but growing population of Americans with compromised immune function and respiratory depression who may be at high risk of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease 19 (COVID-19)-related hospitalization, prolonged ICU stay, adverse events, and death. This perspective is of broad clinical and public health importance because the US has the highest population of long-term users of prescription opioids, a sequel of a decade-long practice of opioid overprescribing in the US. For long-term opioid users who are hospitalized for COVID-19, clinicians face clinical challenges arising from the suppressive effects of opioids on the respiratory and immune functions, as well as the potential for adverse drug-drug interaction when opioids have to be continued in long-term users. More research is needed to further understand the association of long-term opioid use and susceptibility to COVID-19 and other emerging infections.
基于慢性阿片类药物具有免疫抑制作用的证据，长期使用处方和非法阿片类药物的人群在美国是一个未被认识到但不断增长的群体，他们的免疫功能和呼吸抑制受损，可能面临感染严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）和与冠状病毒病 19（COVID-19）相关的住院、延长 ICU 停留时间、不良事件和死亡的高风险。这一观点具有广泛的临床和公共卫生意义，因为美国拥有最多的长期使用处方类阿片类药物的人群，这是美国长达十年的阿片类药物过度处方的后果。对于因 COVID-19 住院的长期阿片类药物使用者，临床医生面临着阿片类药物对呼吸和免疫功能的抑制作用所带来的临床挑战，以及当长期使用者需要继续使用阿片类药物时，潜在的药物相互作用不良的问题。需要进一步研究来更深入地了解长期使用阿片类药物与 COVID-19 和其他新发感染易感性之间的关联。
