Substance use disorders linked to COVID-19 susceptibility
Research finds higher risk and worse outcomes for those with addiction


Date:
September 14, 2020
Source:
NIH/National Institute on Drug Abuse
Summary:
A recent study found that people with substance use disorders
(SUDs) are more susceptible to COVID-19 and its complications. The
findings suggest that health care providers should closely monitor
patients with SUDs and develop action plans to help shield them
from infection and severe outcomes.



FULL STORY ==========================================================================
A National Institutes of Health-funded study found that people with
substance use disorders (SUDs) are more susceptible to COVID-19 and
its complications.

The research, published today in Molecular Psychiatry, was co-authored by
Nora D. Volkow, M.D., director of the National Institute on Drug Abuse
(NIDA). The findings suggest that health care providers should closely
monitor patients with SUDs and develop action plans to help shield them
from infection and severe outcomes.


==========================================================================
By analyzing the non-identifiable electronic health records (EHR) of
millions of patients in the United States, the team of investigators
revealed that while individuals with an SUD constituted 10.3% of
the total study population, they represented 15.6% of the COVID-19
cases. The analysis revealed that those with a recent SUD diagnosis
on record were more likely than those without to develop COVID-19, an
effect that was strongest for opioid use disorder, followed by tobacco
use disorder. Individuals with an SUD diagnosis were also more likely
to experience worse COVID-19 outcomes (hospitalization, death), than
people without an SUD.

"The lungs and cardiovascular system are often compromised in people
with SUD, which may partially explain their heightened susceptibility
to COVID-19," said Dr. Volkow. "Another contributing factor is the marginalization of people with addiction, which makes it harder for
them to access health care services. It is incumbent upon clinicians to
meet the unique challenges of caring for this vulnerable population,
just as they would any other high-risk group." NIDA's Dr. Volkow and
Rong Xu, Ph.D., of Case Western Reserve University in Cleveland, Ohio,
analyzed EHR data collected until June 15, 2020, from 360 hospitals
nationwide. The EHRs were de-identified to ensure privacy.

The study population consisted of over 73 million patients, of which
over 7.5 million had been diagnosed with an SUD at some point in their
lives. Slightly more than 12,000 were diagnosed with COVID-19, and about
1,880 had both an SUD and a COVID-19 diagnosis on record. The types of
SUDs investigated in the study were tobacco, alcohol, opioid, cannabis,
and cocaine.

The complicating effects of SUD were visible in increased adverse
consequences of COVID-19. Hospitalizations and death rates of COVID-19
patients were all elevated in people with recorded SUDs compared to
those without (41.0% versus 30.1% and 9.6% versus 6.6%, respectively).

Additionally, African Americans with a recent opioid use disorder
diagnosis were over four times more likely to develop COVID-19, compared
to whites.

Results showed that hypertension, diabetes, cardiovascular diseases,
and renal diseases, which are risk factors for COVID-19, were more
prevalent among African Americans than whites with opioid use disorder.

According to the authors, the study findings underscore the need to screen
for, and treat, SUDs as part of the strategy for controlling the pandemic.

Additional research needs to be done to better understand how best to
treat those with SUDs who are at risk for COVID-19 and counsel on how
to avoid the risk of infection.

This research was funded by NIDA, the Eunice Kennedy Shriver National
Institute of Child Health and Human Development and the National Institute
on Aging, all parts of NIH, as well as the American Cancer Society and
The Clinical and Translational Science Collaborative of Cleveland.


========================================================================== Story Source: Materials provided by
NIH/National_Institute_on_Drug_Abuse. Note: Content may be edited for
style and length.


========================================================================== Journal Reference:
1. Quan Qiu Wang, David C. Kaelber, Rong Xu, Nora D. Volkow. COVID-19
risk
and outcomes in patients with substance use disorders: analyses
from electronic health records in the United States. Molecular
Psychiatry, 2020; DOI: 10.1038/s41380-020-00880-7 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2020/09/200914115900.htm

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