NEW YORK — The risk for hospitalization from COVID-19 is elevated for patients with substance use disorders (SUD), but the link between SUDs and mortality from SARS-CoV-2 isn’t as clear.
That’s why a study team led by researchers from Columbia University and New York State Psychiatric Institute sought to better explain the connection. Study authors were from the VA Puget Sound Healthcare System, the VA San Francisco Healthcare System and the VA New York Harbor Healthcare System, as well as other universities.
The report in Drug & Alcohol Dependence discussed a study including 5.6 million VHA patients treated in 2019 and evaluated in 2020 for COVID-19, of whom 62,303 (1.1%) tested positive for COVID-19 (COVID-19+). 1
Defined as the outcomes were COVID-19 positivity by Nov. 1, 2020, hospitalization, ICU admission or death within 60 days of a positive test. The focus was on the association with any ICD-10-CM SUDs; substance-specific SUDs such as cannabis, cocaine, opioid, stimulant, sedative were explored individually, the researchers noted.
The authors pointed out that, among COVID-19+ patients, 19.25% were hospitalized, 7.71% admitted to ICU, and 5.84% died. Results indicated that, In unadjusted models, any SUD and all substance-specific SUDs except cannabis-use disorder were associated with COVID-19+(ORs=1.06-1.85), with adjusted models producing similar results.
Researchers reported that any SUD and all substance-specific SUDs were associated with hospitalization (aORs: 1.24-1.91), as well as ICU admission in unadjusted but not adjusted models.
“Any SUD, cannabis, cocaine and stimulant disorders were inversely associated with mortality in unadjusted models (OR=0.27-0.46),” the study noted. “After adjustment, associations with mortality were no longer significant. In ad hoc analyses, adjusted odds of mortality were lower among the 49.9% of COVID-19+ patients with SUD who had SUD treatment in 2019, but not among those without such treatment.”
The authors concluded that, for VHA patients, SUDs are associated with COVID-19 hospitalization but not COVID-19 mortality. As to why that might be the case, they posited, “SUD treatment may provide closer monitoring of care, ensuring that these patients received needed medical attention, enabling them to ultimately survive serious illness.”
- Hasin DS, Fink DS, Olfson M, Saxon AJ, et. al. Substance use disorders and COVID-19: An analysis of nationwide Veterans Health Administration electronic health records. Drug Alcohol Depend. 2022 Mar 3;234:109383. doi: 10.1016/j.drugalcdep.2022.109383. Epub ahead of print. PMID: 35279457; PMCID: PMC8891118.