Researchers have found that people with substance use disorders (SUDs) -- tobacco, alcohol, opioid, cannabis, and cocaine, are more susceptible to COVID-19 and its complications.
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The study, published in the journal Molecular Psychiatry, suggests that health care providers should closely monitor patients with SUDs and develop action plans to help shield them from infection and severe outcomes. By analysing the non-identifiable electronic health records (EHR) of millions of patients in the US, the research team revealed that individuals with a 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. "The lungs and cardiovascular system are often compromised in people with SUD, which may partially explain their heightened susceptibility to COVID-19," said study author Nora D Volkow from the National Institute on Drug Abuse (NIDA) in the US.
For the findings, the research team analysed EHR data collected until June 15, 2020, from 360 hospitals nationwide. The study population consisted of over 73 million patients, of which over 7.5 million had been diagnosed with a SUD at some point in their lives. Slightly more than 12,000 were diagnosed with COVID-19, and about 1,880 had both a 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. According to the study, hospitalisations and death rates of COVID-19 patients were all elevated in people with recorded SUDs compared to those without (41.0 percent versus 30.1 percent and 9.6 percent versus 6.6 percent, respectively). The 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," the team noted.