Moreno-Pérez Oscar, Merino Esperanza, Ramos Jose Manuel, Rodríguez Juan Carlos, Diaz Carmina, Mas Patricio, Reus Sergio, Sánchez-Martínez Rosario, Boix Vicente, Chico-Sánchez Pablo, Sánchez-Payá José, Portilla Joaquín
Endocrinology and Nutrition department, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain.
Clinical Medicine department, Miguel Hernández University, Elche, Spain.
Neurologia. 2022 Feb 14. doi: 10.1016/j.nrl.2022.01.007.
There is early evidence about Valproic acid (VPA) antiviral effect. Our aim was to investigate the incidence and severity of SARS-CoV-2 infection in VPA users as compared with the general population.
A case-control study nested within a cohort, carried out between March 1 and December 17, 2020. Retrospectively, we identified confirmed SARS-CoV-2 infection patients exposed to VPA in our health department (defined as case). We ascertained VPA regimen (all the time (AT) (292 days) or at least 20% of the study period (notAT) (≥58 days) and if VPA levels were in therapeutic range (ATR) (50–100 mcg/mL) in the last 24 months. We calculated the cumulative incidence of SARS-CoV-2 infection and hospital admission in the cases, comparing it with the general unexposed VPA population (controls).
During the study period, 6183 PCR+ were detected among 281,035 inhabitants, of these, 746 were hospitalized. 691 patients were on VPA notAT and 628 (90.1%) AT. The indication for VPA use was epilepsy in 54.9%. The incidence of PCR+ was 1.736% (OR 0.785 (95%CI 0.443–1.390) and 1.910% (OR 0.865 (95%CI 0.488–1.533), on VPA notAT and VPA AT patients, respectively vs. 2.201% in people without VPA regimen. Those patients with VPA ATR had a lower risk of PCR + (OR 0.233 (95%CI 0.057–0.951) notAT; OR 0.218 (95%CI 0.053–0.890) AT). Hospital admission incidence was lower in patient on VPA (OR was 0.543 (95% CI 0.076–3.871).
Patients with VPA within the therapeutic range had a reduction of SARS-Cov-2 infection incidence greater than 75%. There is a downward trend in the risk of COVID-19 admission by SARS-CoV-2 in patients on VPA therapy. These findings warrant further investigation.
有早期证据表明丙戊酸（VPA）具有抗病毒作用。我们的目的是调查与普通人群相比，VPA使用者中SARS-CoV-2感染的发生率和严重程度。
一项嵌套在队列中的病例对照研究，于2020年3月1日至12月17日进行。回顾性地，我们在我们的卫生部门确定了暴露于VPA的确诊SARS-CoV-2感染患者（定义为病例）。我们确定了VPA治疗方案（一直使用（AT）（292天）或至少占研究期的20%（非AT）（≥58天））以及过去24个月内VPA水平是否在治疗范围内（ATR）（50-100微克/毫升）。我们计算了病例中SARS-CoV-2感染和住院的累积发生率，并与未暴露于VPA的普通人群（对照）进行比较。
在研究期间，在281,035名居民中检测到6183例PCR阳性，其中746例住院。691例患者使用VPA非AT方案，628例（9
