Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Evangelisches Krankenhaus Castrop-Rauxel, Academic Teaching Hospital, University of Duisburg-Essen, Grutholzallee 21, 44577, Castrop-Rauxel, Germany.
Department of Psychiatry and Psychotherapy, Faculty of Medicine, LVR-Hospital Essen, University of Duisburg-Essen, Essen, Germany.
J Neural Transm (Vienna). 2023 Jan;130(1):7-18. doi: 10.1007/s00702-022-02564-8. Epub 2022 Nov 8.
The interaction between cannabis use or addiction and SARS-COV-2 infection rates and COVID-19 outcomes is obscure. As of 08/01/2022 among 57 evaluated epidemiological/clinical studies found in Pubmed-database, most evidence for how cannabis use patterns were influenced by the pandemic was given by two systematic reviews and 17 prospective studies, mostly involving adolescents. In this age group, cannabis use patterns have not changed markedly. For adults, several cross-sectional studies reported mixed results with cannabis use having increased, decreased or remained unchanged. Two cross-sectional studies demonstrated that the severity of adults´ cannabis dependence was either increased as a consequence of increasing cannabis use during the pandemic or not changed. Regarding the effect of cannabis use on COVID-19 outcomes, we found only five retrospective/cross-sectional studies. Accordingly, (i) cannabis use did not impact mild COVID-19 symptoms; (ii) cannabis using individuals experienced more COVID-19-related hospitalizations; (iii) cannabis using veterans were associated with reduced SARS-COV-2 infection rates; (iv) frequent cannabis use was significantly associated with COVID-19 mortality, and (v) cannabis dependents were at higher risk of COVID-19 breakthrough after vaccination. It should be outlined that the validity of these retrospective/cross-sectional studies (all self-reports or register/e-health-records) is rather low. Future prospective studies on the effects of cannabis use on SARS-COV-2 infection rates and COVID-19 outcomes are clearly required for conclusive risk-benefit assessments of the role of cannabis on users' health during the pandemic. Moreover, substance dependence (including cannabis) is associated with (often untreated) somatic comorbidity, which severity is a proven key risk factor for worse COVID-19 outcomes.
大麻使用或成瘾与 SARS-CoV-2 感染率和 COVID-19 结局之间的相互作用尚不清楚。截至 2022 年 8 月 1 日，在 Pubmed 数据库中评估的 57 项流行病学/临床研究中，大多数关于大麻使用模式如何受到大流行影响的证据来自两项系统评价和 17 项前瞻性研究，这些研究主要涉及青少年。在这个年龄段，大麻使用模式没有明显变化。对于成年人，几项横断面研究报告的结果喜忧参半，大麻使用量增加、减少或保持不变。两项横断面研究表明，由于大流行期间大麻使用量增加，成年人的大麻依赖严重程度要么增加，要么不变。关于大麻使用对 COVID-19 结局的影响，我们只发现了五项回顾性/横断面研究。因此，（i）大麻使用不会影响 COVID-19 的轻症症状；（ii）大麻使用者更有可能因 COVID-19 住院；（iii）使用大麻的退伍军人与 SARS-CoV-2 感染率降低有关；（iv）频繁使用大麻与 COVID-19 死亡率显著相关，（v）大麻依赖者在接种疫苗后 COVID-19 突破性感染的风险更高。应该指出的是，这些回顾性/横断面研究（均为自我报告或登记/电子健康记录）的有效性相当低。需要进行未来前瞻性研究，以确定大麻使用对 SARS-CoV-2 感染率和 COVID-19 结局的影响，从而对大流行期间大麻对使用者健康的作用进行明确的风险效益评估。此外，物质依赖（包括大麻）与（常未治疗的）躯体合并症有关，其严重程度是 COVID-19 结局恶化的一个已证实的关键危险因素。
