ABSTRACT
Objective: We explore the association between montelukast use and the risk of developing COVID-19 complications in people with confirmed or suspected COVID- 19. Material and/or methods: Study based on electronic health records from the SIDIAP database, which includes 5,835,000 people in Catalonia (80% of total population). In a cohort of people with confirmed or suspected COVID-19 (diagnosis registry, positive PCR and/or a serologic test or non-confirmed diagnosis or test along with a record of hospitalization, pneumonia and/or death related to COVID-19), we identified people on montelukast treatment (an active prescription or a prescription ending 90 days before the index date) (confirmed or suspected Covid register) from March to June 2020 (exposed group). The non-exposed to montelukast cohort was built by pairing cases in a 1:4 ratio based on gender and age at the time of infection. We obtained socioeconomic risk factors and active comorbidities in the two previous years, and concomitant drugs. The COVID-19-related severe events analysed were hospitalization, pneumonia, death or any of the previous outcomes. For each outcome, we fitted a conditional logistic regression model to estimate the odds ratio with its 95% confidence interval (OR;CI95%) associated with montelukast use. The study was approved by the Clinical Research Ethics Committee IDIAPJGol. Results: During the study period, there were 183 (6.67%) hospitalizations in the exposed group and 554 (6.09%) in the non-exposed group, 40 (1.46%) and 176 (1.93%) pneumonias, 85 (3.1%) and 429 (4.72%) deaths and 258 (9.40%) and 996 (10.95%) of any of the outcomes, respectively. The corresponding multivariable ORs were 0.92 (CI95% 0.70-1.21) for hospitalization, 0.67 (0.44-1.00) for pneumonia, 0.79 (0.60-1.031) for death and 0.79 (0.63-0.99) for any of the outcomes. Conclusions: The results suggest that montelukast use could decrease the risk of complications in people with COVID-19.