Igwe Joseph-Kevin, Alaribe Ugo
Department of Medicine, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX, 77030, USA.
Caribbean Medical University School of Medicine, 5600 N River Rd Suite 800, Rosemont, IL, 60018, USA.
J Cannabis Res. 2024 Apr 6;6(1):18. doi: 10.1186/s42238-024-00228-w.
Prior reports indicate that modulation of the endocannabinoid system (ECS) may have a protective benefit for Covid-19 patients. However, associations between cannabis use (CU) or CU not in remission (active cannabis use (ACU)), and Covid-19-related outcomes among hospitalized patients is unknown.
In this multicenter retrospective observational cohort analysis of adults (≥ 18 years-old) identified from 2020 National Inpatient Sample database, we utilize multivariable regression analyses and propensity score matching analysis (PSM) to analyze trends and outcomes among Covid-19-related hospitalizations with CU and without CU (N-CU) for primary outcome of interest: Covid-19-related mortality; and secondary outcomes: Covid-19-related hospitalization, mechanical ventilation (MV), and acute pulmonary embolism (PE) compared to all-cause admissions; for CU vs N-CU; and for ACU vs N-ACU.
There were 1,698,560 Covid-19-related hospitalizations which were associated with higher mortality (13.44% vs 2.53%, p ≤ 0.001) and worse secondary outcomes generally. Among all-cause hospitalizations, 1.56% of CU and 6.29% of N-CU were hospitalized with Covid-19 (p ≤ 0.001). ACU was associated with lower odds of MV, PE, and death among the Covid-19 population. On PSM, ACU(N(unweighted) = 2,382) was associated with 83.97% lower odds of death compared to others(N(unweighted) = 282,085) (2.77% vs 3.95%, respectively; aOR:0.16, [0.10-0.25], p ≤ 0.001).
These findings suggest that the ECS may represent a viable target for modulation of Covid-19. Additional studies are needed to further explore these findings.
先前的报告表明，调节内源性大麻素系统（ECS）可能对新冠病毒疾病（Covid-19）患者具有保护作用。然而，住院患者中大麻使用（CU）或未缓解的大麻使用（活跃大麻使用（ACU））与Covid-19相关结局之间的关联尚不清楚。
在这项对从2020年全国住院患者样本数据库中识别出的成年人（≥18岁）进行的多中心回顾性观察队列分析中，我们利用多变量回归分析和倾向评分匹配分析（PSM）来分析有CU和无CU（非CU）的Covid-19相关住院患者的趋势和结局，以关注主要结局：Covid-19相关死亡率；以及次要结局：与所有原因入院相比，Covid-19相关住院、机械通气（MV）和急性肺栓塞（PE）；比较CU与非CU；以及ACU与非ACU。
共有1,698,560例Covid-19相关住院患者，这些患者的死亡率较高（13.44%对2.53%，p≤0.001），并且一般次要结局也较差。在所有原因住院患者中，1.56%的CU患者和6.29%的非CU患者因Covid-19住院（p≤0.001）。在Covid-19人群中，ACU与MV、PE和死亡的较低几率相关。在PSM分析中，与其他患者（未加权N = 282,085）相比，ACU（未加权N = 2,382）的死亡几率降低了83.97%（分别为2.77%对3.95%；调整后比值比：0.16，[0.10 - 0.25]，p≤0.001）。
这些发现表明，ECS可能是调节Covid-19的一个可行靶点。需要进一步的研究来进一步探索这些发现。
