Abstract
Data from several cohorts of coronavirus disease 2019 (COVID-19) suggest that the most common comorbidities for severe COVID-19 disease are the elderly, high blood pressure, and diabetes; however, it is not currently known whether the previous use of certain drugs help or hinder recovery. This study aims to explore the association of previous hospitalisation use of medication on the mortality of COVID-19 disease. A retrospective case-control from two hospitals in Madrid, Spain, included all patients aged 18 years or above hospitalised with a diagnosis of COVID-19. A Propensity Score matching (PSM) analysis was performed. Confounding variables were considered to be age, sex, and the number of comorbidities. Finally, 3712 patients were included. Of these, 687 (18.5%) patients died (cases). The 22,446 medicine trademarks used previous to admission were classified according to the ATC, obtaining 689 final drugs; all of them were included in PSM analysis. Eleven drugs displayed a reduction in mortality: azithromycin, bemiparine, budesonide-formoterol fumarate, cefuroxime, colchicine, enoxaparin, ipratropium bromide, loratadine, mepyramine theophylline acetate, oral rehydration salts, and salbutamol sulphate. Eight final drugs displayed an increase in mortality: acetylsalicylic acid, digoxin, folic acid, mirtazapine, linagliptin, enalapril, atorvastatin, and allopurinol. Medication associated with survival (anticoagulants, antihistamines, azithromycin, bronchodilators, cefuroxime, colchicine, and inhaled corticosteroids) may be candidates for future clinical trials. Drugs associated with mortality show an interaction with the underlying conditions.
Highlights
Data from several cohorts of coronavirus disease 2019 (COVID-19) suggest that the most common comorbidities for severe COVID-19 disease are the elderly, high blood pressure, and other comorbidities; it is not currently known whether certain drugs help or hinder recovery [1,2,3,4,5,6,7]
This study explores the association between previous use of medications and the mortality of patients hospitalised due to COVID-19
The results should be interpreted with great caution as propensity score matching cannot assess and balance all the factors that come into play in the clinical management of patients and that may be present in the circumstances of the study
Summary
Data from several cohorts of coronavirus disease 2019 (COVID-19) suggest that the most common comorbidities for severe COVID-19 disease are the elderly, high blood pressure, and other comorbidities; it is not currently known whether certain drugs help or hinder recovery [1,2,3,4,5,6,7]. The ACE2 receptor is expressed in a high percentage of lung cells. It is visible in other extrapulmonary tissues, such as the endothelium, heart, kidney, and intestine, which casts doubt on the use of drugs that may impact the renin-angiotensin-aldosterone axis by increasing the probability of acquiring infection. Several reviews have proposed candidates to study in clinical trials [13,14,15]. As newer interventions will take months or years to develop, to detail the pool of existing therapeutic options, the principles behind their use to treat COVID-19, current application, and adverse effects could offer candidates for clinical trials [16]
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