Opioid use disorder and health service utilization among COVID-19 patients in the US: A nationwide cohort from the Cerner Real-World Data.
Opioid use disorder and health service utilization among COVID-19 patients in the US: A nationwide cohort from the Cerner Real-World Data.
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DOI：
10.1016/j.eclinm.2021.100938
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发表时间：
2021-07
影响因子：
15.1
通讯作者：
Madden EF
中科院分区：
文献类型：
--
作者：
Qeadan F;Tingey B;Bern R;Porucznik CA;English K;Saeed AI;Madden EF
阿片类药物使用和COVID-19都会影响呼吸和肺部健康，可能会使阿片类药物使用障碍（OUD）患者面临COVID-19并发症的风险。我们研究了OUD与后续住院、住院时间、有创呼吸机依赖（IVD）风险和COVID-19死亡率之间的关系。多变量logistic和指数回归模型，使用来自2020年1月至6月Cerner COVID-19去识别数据队列的电子健康记录数据。在52,312名COVID-19患者中，1.9%（n=1,013）患有OUD。与未发生OUD的患者相比，发生OUD的COVID-19患者的住院几率（aOR=3.44，95% CI=2.81-4.21）、最长住院时间（aOR=1.16，95% CI=1.09-1.22）和IVD几率（aOR=1.26，95% CI=1.06-1.49）更高，但在COVID-19死亡率方面没有差异。然而，与45岁以下无OUD的患者相比，45岁以下OUD患者的COVID-19死亡率更高（aOR=3.23，95%CI =1.59-6.56）。与未接受OUD治疗的患者相比，接受阿片类激动剂治疗（OAT）的OUD患者的住院几率更高（aOR=5.14，95% CI=2.75-10.60），最长住院时间更长（aOR =1.22，95% CI=1.01-1.48）;然而，IVD和COVID-19死亡率的风险没有差异。与未使用OUD的患者相比，使用纳洛酮的OUD患者的住院几率更高（aOR=32.19，95%CI =4.29- 4，119.83），最长住院时间更长（aOR =1.59，95%CI =1.06-2.38），IVD几率更高（aOR=3.15，95%CI =1.04-9.51），但死亡率无差异。未使用治疗药物的OUD患者住院的几率更高（aOR=4.05，95%CI =3.32-4.98），最长住院时间更长（=1.14，95%CI =1.08-1.21），IVD（aOR=1.25，95%CI =1.04-1.50）和COVID-19死亡率（aOR=1.31，95%CI =1.07-1.61）的几率高于无OUD的患者。这项研究表明，OUD和COVID-19患者通常需要更高水平的护理，而年轻或未使用OUD药物治疗的OUD患者特别容易因COVID-19而死亡。
Both opioid use and COVID-19 affect respiratory and pulmonary health, potentially putting individuals with opioid use disorders (OUD) at risk for complications from COVID-19. We examine the relationship between OUD and subsequent hospitalization, length of stay, risk for invasive ventilator dependence (IVD), and COVID-19 mortality. Multivariable logistic and exponential regression models using electronic health records data from the Cerner COVID-19 De-Identified Data Cohort from January through June 2020. Out of 52,312 patients with COVID-19, 1.9% (n=1,013) had an OUD. COVID-19 patients with an OUD had higher odds of hospitalization (aOR=3.44, 95% CI=2.81–4.21), maximum length of stay (=1.16, 95% CI=1.09–1.22), and odds of IVD (aOR=1.26, 95% CI=1.06–1.49) than patients without an OUD, but did not differ with respect to COVID-19 mortality. However, OUD patients under age 45 exhibited greater COVID-19 mortality (aOR=3.23, 95% CI=1.59–6.56) compared to patients under age 45 without an OUD. OUD patients using opioid agonist treatment (OAT) exhibited higher odds of hospitalization (aOR=5.14, 95% CI=2.75–10.60) and higher maximum length of stay (=1.22, 95% CI=1.01–1.48) than patients without OUDs; however, risk for IVD and COVID-19 mortality did not differ. OUD patients using naltrexone had higher odds of hospitalization (aOR=32.19, 95% CI=4.29–4,119.83), higher maximum length of stay (=1.59, 95% CI=1.06–2.38), and higher odds of IVD (aOR=3.15, 95% CI=1.04–9.51) than patients without OUDs, but mortality did not differ. OUD patients who did not use treatment medication had higher odds of hospitalization (aOR=4.05, 95% CI=3.32–4.98), higher maximum length of stay (=1.14, 95% CI=1.08–1.21), and higher odds of IVD (aOR=1.25, 95% CI=1.04–1.50) and COVID-19 mortality (aOR=1.31, 95% CI=1.07–1.61) than patients without OUDs. This study suggests people with OUD and COVID-19 often require higher levels of care, and OUD patients who are younger or not using medication treatment for OUDs are particularly vulnerable to death due to COVID-19.
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影响因子：
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作者：
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影响因子：
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DOI：
10.1176/appi.ps.202000534
发表时间：
2021-05-01
期刊：
Psychiatric services (Washington, D.C.)
影响因子：
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作者：
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通讯作者：
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影响因子：
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作者：
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通讯作者：
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