The Association of Opium Abuse with Mortality Amongst Hospitalized COVID-19 Patients in Iranian Population

Abstract

Opioid abuse is a serious problem in the society. Since the first months of COVID-19 pandemic, several myths, rumors and misconceptions have been spread about the benefits of opium consumption for COVID-19 outcome. In addition, data are limited on the relationship between opium abuse and COVID-19 mortality amongst hospitalized COVID-19 patients. In this historical cohort study, we assessed the risks of several variables for mortality amongst all hospitalized COVID-19 patients from the beginning of COVID-19 pandemic in South of Iran from March 15th, 2021 to October 14th, 2021. Data was acquired from the Medical Care Monitoring Center (MCMC), affiliated to Shiraz University of Medical Sciences. A total of 64,427 hospitalized COVID-19 patients were included into the analysis. The mortality rate was 10.59% ( n = 6756). Of all, 2030 (3.15%) patients—1702 males and 328 females—reported the positive history of opium abuse with a mean age of 57 ± 17.21 years. The results of multivariable risk showed that the positive history of opium abuse had a significant association with mortality (adjusted RR: 1.173; p = 0.007). Other significant predictive risk factors were male gender, elder ages, and comorbidities such as pulmonary diseases, cardiovascular disease, cancer, nephrological diseases, neurological diseases, and diabetes. However, being a health care worker and having thyroid gland diseases were protective factors amongst hospitalized COVID-19 patients (adjusted RR: 0.650 and 0.642; p = 0.040 and < .0001, respectively). Opium abuse is a risk factor for mortality amongst hospitalized COVID-19 patients. It is vital to educate societies about the consequences of unauthorized opium consumption.

The effects of opium consumption on severity of disease on hospitalized COVID-19 patients in East of Iran, a prospective cohort study

“…It’s crucial to acknowledge that, in our study, while these trends were observed, they did not attain statistical significance. A prior study demonstrated a noteworthy association between opium consumption and mortality in hospitalized COVID-19 patients (relative risk, 1.173) [ 22 ]. Additionally, earlier investigations highlighted notable variations in cytokine levels among opium users, with lower levels of interleukin (IL)-4 and interferon gamma, and higher levels of IL-6 and transforming growth factor-beta compared to controls [ 33 ].…”

“…The onset of COVID-19, along with disruptions in healthcare and social safety nets, compounded by social and economic stressors, intensified the opioid epidemic [ 18 19 20 21 ]. Recognizing factors associated with COVID-19 mortality is pivotal for risk reduction and appropriate interventions [ 22 ]. Hence, comprehensive studies are essential to elucidate the relationship between opium user and mortality in COVID-19 patients.…”

Patterns of Opioid and Non-Opioid Analgesic Consumption in Patients with Post-COVID-19 Conditions

“…Similarly, opioid consumption increased from 19.79 DHD (defined daily dose/1000 inhabitants per day) in 2019 to 20.88 DHD in 2021 [20], whereas nonopioid analgesic consumption has risen from 32.90 DHD in 2019 to 40.05 DHD in 2021 [21] according to data reported by the Spanish Agency of Medicines and Health Products. An uncontrolled increase in opioid consumption could lead to opium abuse, which has been associated with higher mortality in hospitalized COVID-19 patients [22].…”