Public Health Agency of Catalonia, Department of Health, Government of Catalonia, Programme on Substance Abuse, Barcelona, Spain.
Centre for Epidemiological Studies on Sexually Transmitted Infections and HIV/AIDS of Catalonia (CEEISCAT), Badalona, Spain.
Eur Addict Res. 2023;29(5):333-343. doi: 10.1159/000528647. Epub 2023 Aug 16.
People with substance use disorder (SUD) may be at increased risk of COVID-19 infection. However, there is little evidence regarding the incidence of and determinants associated with infection in this group. The aims of the study were to determine the cumulative incidence of COVID-19 among people who sought treatment for heroin, cocaine, cannabis, and alcohol use disorder in Catalonia; to identify sociodemographic, substance, and clinical determinants associated with COVID-19 infection among SUD patients; and to compare the cumulative incidence of COVID-19 infection in the population with SUD with that of the general population.
A patient-based retrospective observational study was conducted. The study population comprised people who sought treatment for heroin, cocaine, cannabis, or alcohol use disorder in Catalonia in 2018 and 2019. We analysed cumulative incidence of COVID-19 (confirmed by PCR test) from 25 February to 31 December 2020. Additionally, we used a log-link binomial generalized linear model for COVID-19 infection, using the substance as the exposition, adjusting for sociodemographic and clinical variables.
Of the 23,092 individuals who sought treatment for SUD, 38.15% were considered suspected cases of COVID-19, and 2.60% (95% CI = 2.41-2.82) were confirmed positive for COVID-19 by PCR test during the study period. Those who sought treatment for alcohol use (cumulative incidence of COVID-19 of 3% [95% CI = 2.70-3.34]) had a higher risk ratio than, those who sought treatment for heroin use (cumulative incidence of 1.94% [95% CI = 1.47-2.56]). Being born outside of Spain, living in an institutionalized residence, having HIV, and being in a high morbidity group were associated with higher risk of COVID-19 infection. Meanwhile, the cumulative incidence of COVID-19 in the general population, according to public COVID-19 test data, was 3.86% (95% CI = 3.85-3.87).
This study did not find higher cumulative incidence of COVID-19 infection among people with SUD in Catalonia in 2020, despite the clinical vulnerability of this population and their social disadvantage. However, differences were seen in the cumulative incidence of COVID-19 according to the substance for which treatment was sought. For example, those with alcohol dependence had a higher rate than those dependent on heroin. Further studies are needed to determine the factors contributing to these differences.
患有物质使用障碍（SUD）的人可能面临更高的 COVID-19 感染风险。然而，关于该人群感染的发生率和相关决定因素的证据很少。本研究的目的是确定在加泰罗尼亚寻求治疗海洛因、可卡因、大麻和酒精使用障碍的人群中 COVID-19 的累积发生率；确定与 SUD 患者 COVID-19 感染相关的社会人口学、物质和临床决定因素；并比较 SUD 人群与普通人群 COVID-19 感染的累积发生率。
进行了一项基于患者的回顾性观察研究。研究人群包括 2018 年和 2019 年在加泰罗尼亚寻求治疗海洛因、可卡因、大麻或酒精使用障碍的人群。我们分析了 2020 年 2 月 25 日至 12 月 31 日期间 COVID-19（通过 PCR 检测确诊）的累积发病率。此外，我们使用了基于物质的对数链接二项式广义线性模型来进行 COVID-19 感染分析，将物质作为暴露因素，同时调整了社会人口学和临床变量。
在寻求 SUD 治疗的 23092 人中，38.15%被认为是 COVID-19 的疑似病例，在研究期间，2.60%（95%CI=2.41-2.82）通过 PCR 检测确诊为 COVID-19 阳性。与寻求海洛因治疗者（COVID-19 的累积发病率为 3%[95%CI=2.70-3.34]）相比，寻求酒精治疗者（COVID-19 的累积发病率为 1.94%[95%CI=1.47-2.56]）的风险比更高。出生在西班牙境外、居住在机构化住所、感染艾滋病毒和处于高发病率组与 COVID-19 感染风险增加相关。与此同时，根据公共 COVID-19 检测数据，普通人群 COVID-19 的累积发病率为 3.86%（95%CI=3.85-3.87）。
尽管该人群存在临床脆弱性和社会劣势，但本研究并未发现 2020 年加泰罗尼亚 SUD 人群 COVID-19 感染的累积发生率更高。然而，根据治疗的物质，COVID-19 的累积发病率存在差异。例如，酒精依赖者的发病率高于海洛因依赖者。需要进一步的研究来确定导致这些差异的因素。
