Opioid usage and COVID-19 prognosis: A systematic review and meta-analysis
The COVID-19 pandemic continues to have profound health, social, psychological, and economic ramifications. Infection by COVID-19 has been of concern in people who use opioids, as opioid use has been known to mediate immunosuppression and is associated with respiratory depression and end-organ damag...
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| Veröffentlicht in: | The American journal of emergency medicine 2022-06, Vol.56, p.51-56 |
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| creator | Ao, Guangyu Li, Anthony Wang, Yushu Li, Jing Tran, Carolyn Chen, Min Qi, Xin |
| description | The COVID-19 pandemic continues to have profound health, social, psychological, and economic ramifications. Infection by COVID-19 has been of concern in people who use opioids, as opioid use has been known to mediate immunosuppression and is associated with respiratory depression and end-organ damage. With differing modalities of opioid usage, the association between opioids and COVID-19 outcomes is not well understood.
We performed a comprehensive systematic search of seven health science databases, including PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), and Wanfang Data, up to December 15, 2021. We identified a total of five related articles, which were included in this study.
The meta-analysis showed that opioids have a significant association with ICU admission for COVID-19 patients (OR = 5.41, 95%CI: 1.85 to 15.79, P = 0.002). Use of opioids was also associated with higher mortality among patients with COVID-19 compared to non-users (OR = 2.74, 95%CI: 1.34 to 5.62, P = 0.034), while use of opioids was not significantly associated with need for mechanical ventilation (OR = 3.68, 95%CI: 0.85 to 15.90, P = 0.081). Furthermore, the adjusted analysis indicated that COVID-19 patients with a history of opioid use were more likely to be admitted to the ICU (OR = 3.57, 95%CI: 3.05 to 4.17, P |
| doi_str_mv | 10.1016/j.ajem.2022.03.048 |
| format | Article |
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We performed a comprehensive systematic search of seven health science databases, including PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), and Wanfang Data, up to December 15, 2021. We identified a total of five related articles, which were included in this study.
The meta-analysis showed that opioids have a significant association with ICU admission for COVID-19 patients (OR = 5.41, 95%CI: 1.85 to 15.79, P = 0.002). Use of opioids was also associated with higher mortality among patients with COVID-19 compared to non-users (OR = 2.74, 95%CI: 1.34 to 5.62, P = 0.034), while use of opioids was not significantly associated with need for mechanical ventilation (OR = 3.68, 95%CI: 0.85 to 15.90, P = 0.081). Furthermore, the adjusted analysis indicated that COVID-19 patients with a history of opioid use were more likely to be admitted to the ICU (OR = 3.57, 95%CI: 3.05 to 4.17, P<0.001) and have higher mortality rates (OR = 1.72, 95%CI: 1.09 to 2.72, P = 0.02), while there was no significant association with need for mechanical ventilation (OR = 2.09, 95%CI: 0.77 to 5.64, P = 0.146). Significant heterogeneity existed across the included studies.
Patients using opioids with COVID-19 were at higher risk of ICU admission and mortality. Prospective studies are required to confirm these findings.</description><identifier>ISSN: 0735-6757</identifier><identifier>EISSN: 1532-8171</identifier><identifier>DOI: 10.1016/j.ajem.2022.03.048</identifier><identifier>PMID: 35366438</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Analgesics, Opioid - therapeutic use ; Clinical outcomes ; Coronaviruses ; COVID-19 ; Emergency medical care ; Fentanyl ; Heterogeneity ; Humans ; Immunosuppression ; Investigations ; Mechanical ventilation ; Medical prognosis ; Meta-analysis ; Morphine ; Mortality ; Narcotics ; Opioid ; Opioids ; Palliative care ; Pandemics ; Respiration, Artificial ; SARS-CoV-2 ; Severe ; Severe acute respiratory syndrome coronavirus 2 ; Systematic review ; Ventilation ; Ventilators</subject><ispartof>The American journal of emergency medicine, 2022-06, Vol.56, p.51-56</ispartof><rights>2022 Elsevier Inc.</rights><rights>Copyright © 2022 Elsevier Inc. All rights reserved.</rights><rights>2022. Elsevier Inc.</rights><rights>2022 Elsevier Inc. All rights reserved. 2022 Elsevier Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c483t-e4df70313dc3350b10a01f80a788e3d7fa20709b137760c72f953f233d7fef5a3</citedby><cites>FETCH-LOGICAL-c483t-e4df70313dc3350b10a01f80a788e3d7fa20709b137760c72f953f233d7fef5a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/2664418305?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>230,314,780,784,885,3550,27924,27925,45995,64385,64387,64389,72469</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35366438$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ao, Guangyu</creatorcontrib><creatorcontrib>Li, Anthony</creatorcontrib><creatorcontrib>Wang, Yushu</creatorcontrib><creatorcontrib>Li, Jing</creatorcontrib><creatorcontrib>Tran, Carolyn</creatorcontrib><creatorcontrib>Chen, Min</creatorcontrib><creatorcontrib>Qi, Xin</creatorcontrib><title>Opioid usage and COVID-19 prognosis: A systematic review and meta-analysis</title><title>The American journal of emergency medicine</title><addtitle>Am J Emerg Med</addtitle><description>The COVID-19 pandemic continues to have profound health, social, psychological, and economic ramifications. Infection by COVID-19 has been of concern in people who use opioids, as opioid use has been known to mediate immunosuppression and is associated with respiratory depression and end-organ damage. With differing modalities of opioid usage, the association between opioids and COVID-19 outcomes is not well understood.
We performed a comprehensive systematic search of seven health science databases, including PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), and Wanfang Data, up to December 15, 2021. We identified a total of five related articles, which were included in this study.
The meta-analysis showed that opioids have a significant association with ICU admission for COVID-19 patients (OR = 5.41, 95%CI: 1.85 to 15.79, P = 0.002). Use of opioids was also associated with higher mortality among patients with COVID-19 compared to non-users (OR = 2.74, 95%CI: 1.34 to 5.62, P = 0.034), while use of opioids was not significantly associated with need for mechanical ventilation (OR = 3.68, 95%CI: 0.85 to 15.90, P = 0.081). Furthermore, the adjusted analysis indicated that COVID-19 patients with a history of opioid use were more likely to be admitted to the ICU (OR = 3.57, 95%CI: 3.05 to 4.17, P<0.001) and have higher mortality rates (OR = 1.72, 95%CI: 1.09 to 2.72, P = 0.02), while there was no significant association with need for mechanical ventilation (OR = 2.09, 95%CI: 0.77 to 5.64, P = 0.146). Significant heterogeneity existed across the included studies.
Patients using opioids with COVID-19 were at higher risk of ICU admission and mortality. Prospective studies are required to confirm these findings.</description><subject>Analgesics, Opioid - therapeutic use</subject><subject>Clinical outcomes</subject><subject>Coronaviruses</subject><subject>COVID-19</subject><subject>Emergency medical care</subject><subject>Fentanyl</subject><subject>Heterogeneity</subject><subject>Humans</subject><subject>Immunosuppression</subject><subject>Investigations</subject><subject>Mechanical ventilation</subject><subject>Medical prognosis</subject><subject>Meta-analysis</subject><subject>Morphine</subject><subject>Mortality</subject><subject>Narcotics</subject><subject>Opioid</subject><subject>Opioids</subject><subject>Palliative care</subject><subject>Pandemics</subject><subject>Respiration, Artificial</subject><subject>SARS-CoV-2</subject><subject>Severe</subject><subject>Severe acute respiratory syndrome coronavirus 2</subject><subject>Systematic review</subject><subject>Ventilation</subject><subject>Ventilators</subject><issn>0735-6757</issn><issn>1532-8171</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kU1v1DAQhi0EotvCH-CAInHhkjD-ir0IIVVbPooq7QW4Wl5nsjhK4sVOivbf47ClAg6c5jDPvJqZh5BnFCoKtH7VVbbDoWLAWAW8AqEfkBWVnJWaKvqQrEBxWdZKqjNynlIHQKmQ4jE545LXteB6RT5tDz74ppiT3WNhx6bYbL9eX5V0XRxi2I8h-fS6uCzSMU042Mm7IuKtxx-_2AEnW9rR9seMPSGPWtsnfHpXL8iX9-8-bz6WN9sP15vLm9IJzacSRdMq4JQ3jnMJOwoWaKvBKq2RN6q1DBSsd5QrVYNTrF1L3jK-tLCVll-Qt6fcw7wbsHE4TtH25hD9YOPRBOvN353RfzP7cGv0Wiq95jng5V1ADN9nTJMZfHLY93bEMCfDalErJpWoM_riH7QLc8wHL1QtBNUcZKbYiXIxpBSxvV-GgllUmc4sqsyiygA3WVUeev7nGfcjv91k4M0JwPzM_PJokvM4Omx8RDeZJvj_5f8E9eajug</recordid><startdate>20220601</startdate><enddate>20220601</enddate><creator>Ao, Guangyu</creator><creator>Li, Anthony</creator><creator>Wang, Yushu</creator><creator>Li, Jing</creator><creator>Tran, Carolyn</creator><creator>Chen, Min</creator><creator>Qi, Xin</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20220601</creationdate><title>Opioid usage and COVID-19 prognosis: A systematic review and meta-analysis</title><author>Ao, Guangyu ; 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Infection by COVID-19 has been of concern in people who use opioids, as opioid use has been known to mediate immunosuppression and is associated with respiratory depression and end-organ damage. With differing modalities of opioid usage, the association between opioids and COVID-19 outcomes is not well understood.
We performed a comprehensive systematic search of seven health science databases, including PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), and Wanfang Data, up to December 15, 2021. We identified a total of five related articles, which were included in this study.
The meta-analysis showed that opioids have a significant association with ICU admission for COVID-19 patients (OR = 5.41, 95%CI: 1.85 to 15.79, P = 0.002). Use of opioids was also associated with higher mortality among patients with COVID-19 compared to non-users (OR = 2.74, 95%CI: 1.34 to 5.62, P = 0.034), while use of opioids was not significantly associated with need for mechanical ventilation (OR = 3.68, 95%CI: 0.85 to 15.90, P = 0.081). Furthermore, the adjusted analysis indicated that COVID-19 patients with a history of opioid use were more likely to be admitted to the ICU (OR = 3.57, 95%CI: 3.05 to 4.17, P<0.001) and have higher mortality rates (OR = 1.72, 95%CI: 1.09 to 2.72, P = 0.02), while there was no significant association with need for mechanical ventilation (OR = 2.09, 95%CI: 0.77 to 5.64, P = 0.146). Significant heterogeneity existed across the included studies.
Patients using opioids with COVID-19 were at higher risk of ICU admission and mortality. Prospective studies are required to confirm these findings.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>35366438</pmid><doi>10.1016/j.ajem.2022.03.048</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Analgesics, Opioid - therapeutic use Clinical outcomes Coronaviruses COVID-19 Emergency medical care Fentanyl Heterogeneity Humans Immunosuppression Investigations Mechanical ventilation Medical prognosis Meta-analysis Morphine Mortality Narcotics Opioid Opioids Palliative care Pandemics Respiration, Artificial SARS-CoV-2 Severe Severe acute respiratory syndrome coronavirus 2 Systematic review Ventilation Ventilators |
| title | Opioid usage and COVID-19 prognosis: A systematic review and meta-analysis |
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