COVID-19 Infection Rates Research Articles

Hypopituitarism and COVID-19.

This review aims to collect and examine recent research findings regarding hypopituitarism and COVID-19, focusing on the virus's impact on the pituitary gland and the outcomes for infected patients with hormonal deficiencies. Literature review using PubMed (pubmed.ncbi.nlm.nih.gov). The search included the following terms: "COVID19" in combination with "Pituitary" and "Hypopituitarism". Many studies have aimed to evaluate the function of the pituitary gland in infected patients, revealing variable degrees of deficiencies. The results are very heterogenous mostly because many different tests and hormonal cut-off have been adopted. It is unclear whether primary virus damage or the inflammatory response is responsible for these hormonal alterations. Interestingly, pituitary defects may persist long after the initial infection, possibly contributing to the "Long COVID syndrome". However, data on the recovery of pituitary function and long-term follow-up are not yet available. On the other hand, although findings are not consistent, patients with hypopituitarism may be at a higher risk for COVID-19 infection rate, complications, and mortality. The COVID-19 pandemic presented challenges for endocrinologists. The endocrine system appears to be involved in both the acute phase of infection and the recovery period. Hypopituitarism can be a consequence of SARS-COV-2 infection, and patients with existing hypopituitarism may face higher risks of complications. It is advisable to educate these patients on how to adjust their replacement therapies. Long-term follow-up data on pituitary function after recovery from COVID-19 are needed.

Self-poisoning in young Australians: The impact of COVID-19 and recent trends following easing of restrictions

Introduction: Self-poisoning is the most common form of hospitalised self-harm in young people and has been increasing over the last decade. The COVID-19 pandemic was associated with further increases in self-harm in adolescents. There are limited data on changes after pandemic restrictions ended. This study aimed to describe recent trends in self-poisoning in young people. Setting: Australia 2018–2023. Methods: A retrospective analysis of self-poisoning calls to Australia’s poisons information centres. Intentional poisoning exposures in people aged 5–19 years were included in the main analysis. We also examined intentional poisonings in people aged 20 and over for comparison. We used interrupted time-series analysis to estimate the impact of COVID-19 (March 2020) and ‘re-opening’ (December 2021), when many restrictions were lifted in Australia. We compared effects in the jurisdictions with most disruptions and lockdowns with other jurisdictions. Results: There were 201,755 self-poisonings documented, 64% female, with 19,946 children (aged 5–14, 9.9%) and 44,388 adolescents (aged 15–19, 22.0%). There was a steep increase in the rate of poisoning in female children and adolescents – with the annual increase being 1.361 (95% confidence interval = [1.074, 1.735]) and 1.154 (95% confidence interval = [1.049, 1.283]) times faster than pre-pandemic trends in these two groups between March 2020 and December 2021. Following relaxation of restrictions, there was a sudden drop and then slow decline in self-poisonings (despite rising COVID-19 infection rates). There was an overall 29.6% increase in intentional poisonings in young people over the study period. This is markedly more pronounced among young females (37.0%) vs males (11.2%). There were substantial jurisdictional variations, with larger increases in Victoria, Tasmania and the Australian Capital Territory. Conclusion: There has been a marked increase in child and adolescent female self-poisonings over the last 6 years, with increases strongly associated with COVID-19 pandemic restrictions but persisting after their removal.

The connection of COVID-19 infection rate to a healthy diet

Abstract. In today's post-epidemic era, small-scale infections occur from time to time. While more research is focused on tackling COVID-19, before finding a way to eliminate its threat, it's even more important that ordinary people take simple steps to reduce their chances of getting infected in their daily lives. This paper focuses on the relationship between the infection rate of COVID-19 and diet and tries to find a nutrient intake way for people to prevent them from being infected by COVID-19. Through the analysis of the database, the Chi-square test, and the linear and logistical relationship between the infection rate and various nutrient intake ways are obtained. By eliminating the effects of obesity and undernourished rate, by analyzing nutrient intake ways, vegetal and animal products are two major parts of nutrient intake ways, and they are considered able to provide better resistance to infection. For more specific components, milk, meats, and cereals are beneficial for the resistance of infection.

Evaluation of rate and severity of COVID-19 infection after vaccination in the age group of 18–25-year population: A questionnaire-based study

Objectives: Covid-19 has been a challenging and challenging pandemic for mankind, with the introduction of the novel coronavirus, SARSCov-2, in late December 2019. Vaccination has proven to be a boon in these challenging times, with the study aiming to determine the efficacy of vaccination against the novel coronavirus in terms of the number of cases affected before and after vaccination and the severity of illness in post-vaccinated Covid-affected individuals. The study aims to learn from the lessons learned during this challenging period. Material and Methods: Students between age group of 18 to 25, from Nashik District, Maharashtra State, India, were the subject of a questionnaire-based study. Using Google Form, a survey was created. Results: It was found that vaccination has reduced the number of positive Covid 19 cases and we have seen a statistically significant decrease in the number of Covid-19-affected individuals. Conclusion: In the present study, we found that the severity is reduced and a smaller number of severe cases are seen after vaccination however the sample was small so this finding was not statically significant.

Migration behaviors leaving metropolitan areas: assessing the impacts of health risks and teleworking in the COVID-19 context

An increase in the number of people leaving metropolitan areas (MAs) was observed in various countries in the early years of the COVID-19 pandemic. While considerable attention has been paid to the impacts of health risks and teleworking, two prominent topics related to health-crisis-led migration, empirical evidence remains inadequate. This study aims to empirically investigate the impacts and temporal changes of these two factors on migration leaving MAs (LMA migration). It utilizes survey data from the Japanese government and employs fixed effects logit models. (1) By using infection rates in a more accurate measurement than previous studies, this study confirms the health-risk-aversion motives in LMA migration. (2) Teleworking’s influence on LMA migration is found to be insignificant over the long term. Nevertheless, it increases the likelihood of formal employees staying in MAs and strengthens the tendency of the self-employed to leave for local areas. (3) Temporally, the significant impact of lower COVID-19 infection rates attracting metropolitan residents persisted beyond the pandemic stringency and continued for several months afterward, though it eventually reversed. Teleworking shows a positive influence on LMA migration only in the later stage of COVID-19. These findings suggest a tendency of ‘deferred decisions’ in LMA migration due to people’s unfamiliarity with an unprecedented health crisis. However, the negative impact of infection risks emerges sooner than the significant effect of teleworking, indicating that safety is a pressing priority for LMA migration in the early stages of a major health crisis. (4) Self-employed individuals, homeworkers, and the unemployed are more likely to engage in LMA migration, while employees (whether formal or informal) are less likely, highlighting the role of opportunity costs. Policy implications suggest that local governments should focus on attracting the self-employed from MAs during health crises and on enhancing the teleworking environment for the long term.

Evaluating the impact of the Public Health Wales Winter Respiratory Vaccines Communication Campaign 2022–23 on vaccination uptake in Wales: an investigation using controlled interrupted time series methods

BackgroundClinically vulnerable groups are at greater risk of serious illness when seasonal flu and increased COVID-19 infection rates coincide. Public Health Wales ran a national Winter Respiratory Vaccines Communications Campaign in 2022-23, jointly targeting flu and COVID-19 vaccination uptake, tailoring messages towards low uptake groups, and eligible groups with underlying health conditions. We evaluated whether the campaign increased vaccination uptake in the clinically vulnerable using a natural experiments approach. MethodsThe study used a total population of patients registered with NHS Wales during Sept 1 to Dec 31, 2022, who were eligible for both flu and COVID19 vaccination. Anonymised data from the National Vaccination Registry in the SAIL databank was analysed using a controlled interrupted time series (CITS) to investigate the impact of the campaign on vaccine uptake. Due to the availability of data before the beginning of the campaign, COVID-19 daily rates of vaccination were used. The campaign intervention group contained respiratory clinically vulnerable patients aged 16–49 years (n=49 749) and the control group was patients not clinically vulnerable but eligible because of age ≥50 years. The preintervention time series was 1 to 26 September 2022 and post campaign data was examined in the initial weeks after campaign introduction. Modelling will take account of COVID-19 infections, vaccination invitation letters and consider demographics. FindingsDescriptive trends in vaccination uptake show age is a dominating factor over clinical risk for people taking up the vaccine offer, particularly as age rises towards 65+ years. Early findings from the CITS suggest an increase in vaccination uptake from the campaign. InterpretationWe outline the practical application of using novel methods to evaluate the impact of a national communications campaign on vaccine uptake. Confidently attributing the effect of the campaign is challenging due to the complex vaccination delivery landscape, with results requiring careful interpretation. FundingNone.

Risk of long COVID in migrants and the contribution of vaccinations, disease severity, social inequalities and preexisting health: A nationwide register study in Sweden

Abstract Background and aim A number of studies have found higher COVID-19 infection rates, hospitalizations and deaths in migrants and ethnic minorities throughout the Corona Pandemic. Some recent evidence also suggests higher risk of long COVID in migrants although less is known about the risk factors for long COVID in this population. The objective of our study is to examine the risk of long COVID in migrants and to examine whether preexisting health conditions, disease severity, social inequalities and vaccinations contribute to the association. Methods We used linked Swedish administrative registers to estimate the risk of a long COVID diagnosis in the population that had a confirmed COVID-19 infection. Poisson regressions were used to calculate incidence rate ratios between the Swedish born and migrant groups. Adjustments for preexisting health conditions, disease severity, vaccinations and social inequalities were separately introduced. Results Higher risks of long COVID were found among migrants from Africa, Asia, Eastern Europe, Finland, Middle-East and South America. While the contribution of vaccinations and social inequalities were modest, we found that disease severity (i.e. whether the person was hospitalized or treated in an intensive care unit) primarily contributed to the higher risk of long COVID found in migrants. Conclusions The greater exposure and impact of the COVID-19 virus among migrants during the pandemic also affected the longer-term consequences of infection in this at-risk population.

A Global Meta-Analysis of the Effects of Greenspaces on COVID-19 Infection and Mortality Rates.

The COVID-19 outbreak in 2020 resulted in rapidly rising infection rates with high associated mortality rates. In response, several epidemiological studies aimed to define ways in which the spread and severity of COVID-19 can be curbed. As a result, there is a steady increase in the evidence linking greenspaces and COVID-19 impact. However, the evidence of the benefits of greenspaces or greenness to human wellbeing in the context of COVID-19 is fragmented and sometimes contradictory. This calls for a meta-analysis of existing studies to clarify the matter. Here, we identified 621 studies across the world on the matter, which were then filtered down to 13 relevant studies for meta-analysis, covering Africa, Asia, Europe, and the USA. These studies were meta-analyzed, with the impacts of greenness on COVID-19 infection rate quantified using regression estimates whereas impacts on mortality rates were measured using mortality rate ratios. We found evidence of significant negative correlations between greenness and both COVID-19 infection and mortality rates. We further found that the impacts on COVID-19 infection and related mortality are moderated by year of publication, greenness metrics, sample size, health and political covariates. This clarification has far-reaching implications for policy development toward the establishment and management of green infrastructure for the benefit of human wellbeing.

Coronavirus disease 2019 vaccination effectiveness based on the 2021 Japanese dialysis registry.

The effectiveness of the coronavirus disease (COVID-19) vaccine in Japanese patients undergoing haemodialysis has previously not been evaluated on a large scale. We analyzed data from the Japanese Society for Dialysis Therapy Renal Data Registry (JRDR), covering nearly all Japanese patients undergoing dialysis (~95% coverage), to examine the association between COVID-19 vaccination and infection or mortality. We used data from the JRDR end-of-year surveys conducted in 2020 and 2021, including information on the COVID-19 vaccination and infection months. COVID-19 infection incidence and its associated mortality rates based on vaccination status (time updated) and odds ratio (OR) (vaccinated vs. unvaccinated) were estimated monthly from April 2021, when vaccination commenced in Japan. COVID-19 infection analysis included 228 865 patients (215 941 vaccinated and 12 924 unvaccinated patients at the end of 2021). The age- and sex-adjusted ORs (aORs) were significantly lower in August, September, October and November 2021, especially in September (aOR [95% confidence interval (CI)]: 0.25 [0.18-0.36]). Additional adjustments for past medical history and laboratory results rarely affected these results. Similarly, in the COVID-19-related mortality analysis with 228 731 patients, including 216 781 vaccinated and 11 950 unvaccinated at the end of 2021, COVID-19-related mortality risk was significantly lower in the vaccinated group in August, September, October and November (aOR [95% CI]: August, 0.32 [0.12-0.84], September, 0.04 [0.01-0.11]; October, 0.10 [0.01-0.81]; November, 0.05 [0.00-0.79]). In Japanese patients undergoing haemodialysis, the first or second COVID-19 vaccine dose was significantly associated with decreased COVID-19 infection and mortality rates, suggesting its effectiveness in this population.

'Is It Safe? Is it not?' A Youth-Led Photovoice Study of Youth Perspectives of COVID-19 Vaccine Confidence.

Youth have been uniquely affected by the COVID-19 pandemic. Despite high rates of COVID-19 infection, youth had one of the lowest vaccine uptake rates. Certain characteristics can affect vaccine uptake, such as mental health and substance use, but it is important to understand uptake for an effective response to pandemics. This study examined the perspectives of youth with mental health or substance use concerns on COVID-19 vaccine confidence, hesitancy and overall COVID-19 vaccine perspectives. Using photovoice, a community-based participatory research method, a sample of 27 youth aged 14-24 years participated in a series of photography workshops and focus groups. Participants submitted final photographs for discussion. Focus groups were recorded, transcribed and thematically analysed. Four themes were generated: (1) Youth deciphered the vaccine discourse in a changing information landscape; (2) mixed perspectives of families, friends and loved ones influenced the vaccine journey; (3) complex societal influences affected views and decisions around the COVID-19 vaccine; and (4) youth navigated their vaccine journeys through first- and second-hand experiences. The four themes and subthemes highlight the evolution of youth's journeys with the COVID-19 vaccine over the course of the pandemic and into the late-pandemic period. Youth with mental health or substance use challenges navigated a complex environment during the COVID-19 pandemic. The wide variety of factors influencing vaccine perspectives should be taken into account in public health messaging and future research on youth vaccine uptake. Youth-led and youth-engaged research can help solicit rich and meaningful perspectives of young people on important public health issues. This was a youth-led study. A youth research analyst conducted the study activities together with the support of a youth advisory group, an adult photographer with lived experience, and a scientific team.

Decline in and recovery of fertility rates after COVID-19-related state of emergency in Japan

IntroductionThe COVID-19 pandemic led to a decline in fertility rates worldwide. Although many regions have experienced a temporary drop in fertility rates with the spread of the infection, subsequent recovery...

The Painful Double-Knock on Food Prices: 2008 Financial Crises and COVID-19 Pandemic

Food supply and demand chains are susceptible to global shocks. Unstable and sudden food price hikes cause serious malnutrition problems and increase the number of food-insecure people, especially in developing countries. Using the FAO Food Price Index (FFPI), this study makes one of the first attempts to utilize monthly observations of the FFPI in dynamic time series ARDL and ARX settings to identify the effects of food prices on COVID-19 infection rates and the 2008 global financial crisis. Our empirical findings confirm that the financial crisis significantly increased the FFPI, although its effects decreased as markets equilibrated between 2007 and 2009. The pandemic has had a mild impact on food prices in the short run compared to the 2008 crisis, but in the long run, the COVID-19 outbreak has a larger impact, with 1 million new COVID-19 infections associated with an increase of between 0.0464 and 0.0509 points in the FFPI. Food price volatility and hikes, even if short-term, increase poverty, malnutrition, and food insecurity, foster social unrest, and lower people’s living standards. This research implies that food prices are globally sensitive to both pandemics and financial crises, and the severity of the pandemic can drive global food prices higher, depending on the number of infections. Over the long run, the impact of the outbreak surpasses that of the financial crisis. The latter tends to have a major impact on food prices in the short run but subsequently declines as markets begin to equilibrate, reflecting asymmetries between the two phenomena in their effects on food prices. Overall, the results indicate that the financial crisis and the COVID-19 pandemic had a short-run, immediate, augmenting impact on food prices. However, while the 2008 crisis affected the supply side only, COVID-19 had impacts on both the demand and supply sides.

Assessing access: Texting hotline app provides mental health crisis care for economically deprived youth

BackgroundDue to rapidly increasing youth suicides in the U.S state of Utah, the legislature funded creation of a 24/7 texting-based smartphone app in Spanish and English targeting Utah's school aged population. Recent research elsewhere (in the Netherlands) suggests cost inhibits help seeking among the economically disadvantaged. We evaluate the relationship between poverty and app usage during the onset of the COVID-19. MethodLocal demographics, social determinants of health and COVID-19 infection rates were modeled using a Bayesian spatio-temporal approach examining usage rates. ResultsWhen controlling for generally researched suicide crisis covariates, app usage is shown to vary depending on economic status of the population, with the largest relative increases in use among disadvantaged youth. DiscussionThis bilingual Spanish/English, texting (SMS) based, smart phone app crisis hotline proved effective at providing adolescents from certain populations access to mental health care. The groups discussed are in Census Block Groups (CBGs – neighborhoods) with higher poverty, and/or lower population density (rural areas). The usage of the crisis hotline by these populations increased relative to the overall population as the COVID-19 pandemic unfolded. However, adolescents from areas of higher mobility (our proxy for housing insecure) and those in areas with larger non-White populations had a relative decrease in usage.

Factors That Impact Effective Public Health Communication With Michigan’s Latinx Population in the Context of COVID-19

The far-reaching impact of the COVID-19 pandemic on Latinx communities is well-documented. This population has higher rates of COVID-19 infection and death compared with non-Latinx White Americans mainly due to long-standing problems related to Social Determinants of Health. Communication about issues such as health threats and safety measures are a vital part of public health, and need to be appropriate to the population of focus. To understand the effectiveness of public health communication to Latinx communities in Michigan during the COVID-19 pandemic, semi-structured interviews ( n = 16) and three focus groups ( n = 24 participants) were conducted virtually in 2021 across counties in Michigan deeply impacted by COVID-19: Washtenaw, Kent, Genesee, and Wayne. Participants shared some facilitating factors that supported effective health communication during the pandemic for their communities. For instance, in their experiences, religious and community leaders were especially effective in communicating information about the pandemic. They also expressed issues with English often being the only language of official communication; the need for bilingual options; and, the need for multiple channels of communication to reach as many people as possible. Participants also highlighted their concerns about inconsistent government communication and politicizing messages as a hindering factor that impacted effective health communication within their communities. Lessons from successes and failures experienced during the COVID-19 pandemic are vital to improving health outcomes for marginalized communities during public health crises. Future responses must ensure that public health communication is appropriate and effective for Latinx communities to better protect them.

Validation of Saliva as the Clinical Specimen Type for a University-Wide COVID-19 Surveillance Program.

At the beginning of the COVID-19 pandemic, the Georgia Institute of Technology made the decision to keep the university doors open for on-campus attendance. To manage COVID-19 infection rates, internal resources were applied to develop and implement a mass asymptomatic surveillance program. The objective was to identify infections early for proper follow-on verification testing, contact tracing, and quarantine/isolation as needed. Program success depended on frequent and voluntary sample collection from over 40,000 students, faculty, and staff personnel. At that time, the nasopharyngeal (NP) swab, not saliva, was the main accepted sample type for COVID-19 testing. However, due to collection discomfort and the inability to be self-collected, the NP swab was not feasible for voluntary and frequent self-collection. Therefore, saliva was selected as the clinical sample type and validated. A saliva collection kit and a sample processing and analysis workflow were developed. The results of a clinical sample-type comparison study between co-collected and matched NP swabs and saliva samples showed 96.7% positive agreement and 100% negative agreement. During the Fall 2020 and Spring 2021 semesters, 319,988 samples were collected and tested. The program resulted in maintaining a low overall mean positivity rate of 0.78% and 0.54% for the Fall 2020 and Spring 2021 semesters, respectively. For this high-throughput asymptomatic COVID-19 screening application, saliva was an exceptionally good sample type.

White privilege, ethnic disadvantage, and stigmatized linguistic capital: COVID-19 infection rates and lockdown law enforcement in Hong Kong

The COVID-19 pandemic has exposed and exacerbated existing disparities in various societies. This study investigates disparities among racial, ethnic, and linguistic groups in Hong Kong's society in COVID-19 infection rates and lockdown enforcement practices that was imposed 545 times from January 2021 to September 2022 and affected 9% of the population. It is found that neighborhoods with more white individuals had lower infection rates than the overall population, while those with more ethnically minoritized groups had higher infection rates. Furthermore, hit rate tests reveal that the government targeted more neighborhoods with a higher share of individuals from linguistically minoritized groups. This novel finding suggests that not only race, but linguistic difference of the same ethnicity can cause bias. The study highlights the positive impact of providing ethnic support services on health outcomes in neighborhoods with a higher share of individuals from ethnically minoritized groups.

COVID-19 Policy Decisions in Manitoba and the Experiences of the Red River Métis: A partnership-based, whole-population linked administrative data study

Systematically marginalized populations, like Red River Métis, have been greatly affected by COVID-19. Manitoba’s Indigenous COVID-19 vaccine policy initially delayed prioritization of Métis. Our research team, which included Métis partners, examined the consequences of these decisions (COVID-19 infections, health service use, vaccine uptake) among Métis, and how earlier prioritization could have improved outcomes. This retrospective cohort study linked data from the Métis Population Database to whole-population COVID testing and vaccination data, and administrative data on health service use. Restricted mean survival time models tested whether vaccination uptake differed between Métis and all other Manitobans (AOM), adjusting for sociodemographic characteristics and comorbidities. A Bayesian model will simulate how prioritization of Métis for vaccination two weeks earlier could have impacted infections. Cumulative prevalence of COVID-19 infection rates were similar among Métis and AOM until May 2021 when rates became higher among Métis. Between May and December 2021, rates of first vaccination were lower among Metis than AOM, as were second vaccination rates between July and November 2021. Métis were more likely than AOM to be hospitalized due to Covid-19 between March and August 2021 and visit physicians for COVID related reasons from October 2020 to Feb 2021 and November 2021 to March 2022. Our analyses simulated what would have occurred had Métis been prioritized for vaccination two weeks before AOM, alongside other Indigenous peoples. Understanding the experiences of Métis relative to AOM is critical to identifying public health strategies which close gaps in vaccine uptake and infections.

Randomized trial of influence of vitamin D on the prevention and improvement of symptomatic COVID-19

We aimed to investigate the preventive effect of vitamin D2 on COVID-19 and the improvement of symptoms after COVID-19 infection. The study recruited 228 health care workers who tested negative PCR or antigen for COVID-19. Subjects were randomly allocated to vitamin D2 or non-intervention at a ratio 1:1. Subjects recorded PCR or antigen tests and the symptoms of COVID-19 twice a week during the follow-up visit. The concentration of serum 25-hydroxyvitamin D (25(OH)D), C-reaction protein (CRP), complement component C1q and inflammatory cytokines were measured. The rates of COVID-19 infection were 50.5% in the vitamin D2 group and 52.4% in the non-intervention group (P = 0.785). There was no difference in the COVID-19 symptoms between the two groups. The mean 25(OH)D level significantly increased from 14.1 to 31.1 ng/mL after administration (P < 0.001). The difference between the two groups was not significant for the concentrations of CRP, C1q and inflammatory cytokines on the thirtieth day of the trial. According to the second level of vitamin D, there was a 14.3% difference in positive infection rates between the vitamin D adequate (> 30 ng/mL) and deficient groups (< 20 ng/mL). Adequate vitamin D had a tendency to prevent COVID-19.Trial registration: ClinicalTrials.gov NCT05673980, dated: 12/2022.

Spatial nonstationarity and the role of environmental metal exposures on COVID-19 mortality in New Mexico

Worldwide, the COVID-19 pandemic has been influenced by a combination of environmental and sociodemographic drivers. To date, population studies have overwhelmingly focused on the impact of societal factors. In New Mexico, the rate of COVID-19 infection and mortality varied significantly among the state's geographically dispersed, and racially and ethnically diverse populations who are exposed to unique environmental contaminants related to resource extraction industries (e.g. fracking, mining, oil and gas exploration). By looking at local patterns of COVID-19 disease severity, we sought to uncover the spatially varying factors underlying the pandemic. We further explored the compounding role of potential long-term exposures to various environmental contaminants on COVID-19 mortality prior to widespread applications of vaccinations. To illustrate the spatial heterogeneity of these complex associations, we leveraged multiple modeling approaches to account for spatial non-stationarity in model terms. Multiscale geographically weighted regression (MGWR) results indicate that increased potential exposure to fugitive mine waste is significantly associated with COVID-19 mortality in areas of the state where socioeconomically disadvantaged populations were among the hardest hit in the early months of the pandemic. This relationship is paradoxically reversed in global models, which fail to account for spatial relationships between variables. This work contributes both to environmental health sciences and the growing body of literature exploring the implications of spatial nonstationarity in health research.

Exploring the Relationship Between Cannabis Use And COVID-19 Outcomes.

Background: Cannabis use is becoming increasingly prevalent worldwide, yet the full spectrum of its effects largely remain unknown. Although cannabis have immunomodulatory properties, there remains a significant gap in our understanding of the potential impact of marijuana use on COVID-19 outcomes. The purpose of this study is to evaluate the effect of chronic cannabis use on severe COVID-19. Materials and Methods: National Inpatient Sample Database was used to sample individuals admitted with the diagnosis of COVID-19. Patients were divided into two groups based on cannabis use. Baseline demographics and comorbidities were collected using ICD-10 codes. Patients with missing data or age under 18 were excluded. Propensity matching using R was performed to match cannabis users to non-cannabis users 1:1 on age, race, gender, and 17 other comorbidities. The primary outcome was severe COVID-19 infection, defined as a composite of acute respiratory failure, intubation, acute respiratory distress syndrome (ARDS), or severe sepsis with multiorgan failure. Results: Out of 322,214 patients included in the study, 2,603 were cannabis users. Cannabis users were younger and had higher prevalence of tobacco use. On initial analysis, cannabis users had significantly lower rates of severe COVID-19 infection, intubation, ARDS, acute respiratory failure, severe sepsis with multiorgan failure, mortality, and shorter length of hospital stay. After 1:1 matching, cannabis use was associated with lower rates of severe COVID-19 infection, intubation, ARDS, acute respiratory failure, severe sepsis with multiorgan failure, mortality, and shorter length of hospital stay. Conclusion: Cannabis users had better outcomes and mortality compared with non-users. The beneficial effect of cannabis use may be attributed to its immunomodulatory effects.