COVID-19 risk and outcomes in patients with substance use disorders: analyses from electronic health records in the United States.
Mol Psychiatry
; 26(1): 30-39, 2021 01.
Article
in English
| MEDLINE | ID: covidwho-766055
ABSTRACT
The global pandemic of COVID-19 is colliding with the epidemic of opioid use disorders (OUD) and other substance use disorders (SUD) in the United States (US). Currently, there is limited data on risks, disparity, and outcomes for COVID-19 in individuals suffering from SUD. This is a retrospective case-control study of electronic health records (EHRs) data of 73,099,850 unique patients, of whom 12,030 had a diagnosis of COVID-19. Patients with a recent diagnosis of SUD (within past year) were at significantly increased risk for COVID-19 (adjusted odds ratio or AOR = 8.699 [8.411-8.997], P < 10-30), an effect that was strongest for individuals with OUD (AOR = 10.244 [9.107-11.524], P < 10-30), followed by individuals with tobacco use disorder (TUD) (AOR = 8.222 ([7.925-8.530], P < 10-30). Compared to patients without SUD, patients with SUD had significantly higher prevalence of chronic kidney, liver, lung diseases, cardiovascular diseases, type 2 diabetes, obesity and cancer. Among patients with recent diagnosis of SUD, African Americans had significantly higher risk of COVID-19 than Caucasians (AOR = 2.173 [2.01-2.349], P < 10-30), with strongest effect for OUD (AOR = 4.162 [3.13-5.533], P < 10-25). COVID-19 patients with SUD had significantly worse outcomes (death 9.6%, hospitalization 41.0%) than general COVID-19 patients (death 6.6%, hospitalization 30.1%) and African Americans with COVID-19 and SUD had worse outcomes (death 13.0%, hospitalization 50.7%) than Caucasians (death 8.6%, hospitalization 35.2%). These findings identify individuals with SUD, especially individuals with OUD and African Americans, as having increased risk for COVID-19 and its adverse outcomes, highlighting the need to screen and treat individuals with SUD as part of the strategy to control the pandemic while ensuring no disparities in access to healthcare support.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Substance-Related Disorders
/
Electronic Health Records
/
COVID-19
Type of study:
Observational study
/
Prognostic study
Limits:
Humans
Country/Region as subject:
North America
Language:
English
Journal:
Mol Psychiatry
Journal subject:
Molecular Biology
/
Psychiatry
Year:
2021
Document Type:
Article
Affiliation country:
S41380-020-00880-7
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