Outcomes of patients with COVID-19 in the setting of chronic opioid use disorder

Heather F. Thiesset, PhD, MPH; Michael Newman, MS; Joseph E. Tonna, MD, MS; Ray M. Merrill, PhD, MPH

doi:10.5055/jom.2022.0747

Authors

Heather F. Thiesset, PhD, MPH https://orcid.org/0000-0002-5484-5303
Michael Newman, MS
Joseph E. Tonna, MD, MS
Ray M. Merrill, PhD, MPH

DOI:

https://doi.org/10.5055/jom.2022.0747

Keywords:

COVID-19, opioid use disorder, substance abuse

Abstract

Background: There are limited studies regarding the effects of COVID-19 in patients with a concurrent diagnosis of opioid use disorder (OUD). Due to the rapidly developing nature and consequences of this disease, it is important to identify patients at an increased risk for serious illness. The aim of this study was to identify whether COVID-19 patients with OUD are at an increased risk of hospitalization and other adverse outcomes.

Methods: This retrospective chart review compared clinical parameters from patients with positive COVID-19 status as identified by a positive SARS-CoV-2 PCR test and diagnosed OUD at the University of Utah Health. The primary outcome variables were hospitalization for COVID-19, length of hospital stay, and the presence of comorbidities in the OUD patient population. Descriptive statistics and prevalence ratios (PRs) were generated. Log binomial models generated PRs adjusted by age, sex, and race, and comorbidities of asthma, pneumonia, hypertension, cardiovascular disease, and diabetes.

Results: COVID-19 patients with OUD were significantly more likely than patients without OUD to have asthma (p < 0.01), diabetes (p < 0.01), hypertension (p < 0.01), cardiovascular disease (p < 0.01), and chronic pneumonia (p < 0.01), and to be hospitalized (27.9 percent vs 3.6 percent; p < 0.01), admitted to the intensive care unit (11.5 percent vs 1.5 percent; p < 0.01), and receive mechanical ventilation (30.5 percent vs 0.1 percent; p < 0.01). After adjusting for age, sex, race, asthma, pneumonia, cardiovascular disease, hypertension, and diabetes, patients with OUD continued to be at increased risk for inpatient hospitalization (aPR = 4.27, 95 percent confidence interval [CI] = 1.66-10.94). Patients with OUD also averaged longer stays in the hospital than those without OUD (9.53 days vs 0.70 days, p < 0.001).

Conclusion: Patients with a diagnosis of OUD in the presence of COVID-19 are more likely to be hospitalized, have underlying health issues, and have longer hospital inpatient stays compared to patients without OUD.

Author Biographies

Heather F. Thiesset, PhD, MPH

Department of Surgery, Department of Family and Preventive Medicine, Division of Public Health, University of Utah Health, Salt Lake City; Department of Public Health, Brigham Young University, Provo, Utah

Michael Newman, MS

Department of Family and Preventive Medicine, Division of Public Health, University of Utah Health, Salt Lake City, Utah

Joseph E. Tonna, MD, MS

Department of Surgery, University of Utah Health, Salt Lake City, Utah

Ray M. Merrill, PhD, MPH

Department of Family and Preventive Medicine, Division of Public Health, University of Utah Health, Salt Lake City; Department of Public Health, Brigham Young University, Provo, Utah

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