TY - JOUR
T1 - Susceptibility to and severity of SARS-CoV-2 infection according to prescription drug use-an observational study of 46,506 Danish healthcare workers
AU - Eiken, Aleksander
AU - Bliddal, Sofie
AU - Villumsen, Marie
AU - Iversen, Kasper K
AU - Bundgaard, Henning
AU - Hasselbach, Rasmus B
AU - Kristensen, Jonas H
AU - Nielsen, Pernille B
AU - Pries-Heje, Mia M
AU - Knudsen, Andreas D
AU - Fogh, Kamille
AU - Norsk, Jakob B
AU - Andersen, Ove
AU - Fischer, Thea K
AU - Dessau, Ram B
AU - Ostrowski, Sisse R
AU - Torp-Pedersen, Christian
AU - Ditlev, Sisse B
AU - Gybel-Brask, Mikkel
AU - Sørensen, Erik
AU - Harritshøj, Lene H
AU - Folke, Fredrik
AU - Benfield, Thomas
AU - Engsig, Frederik N
AU - Poulsen, Henrik E
AU - Ullum, Henrik
AU - Feldt-Rasmussen, Ulla
AU - Nielsen, Susanne D
AU - Rungby, Jørgen
N1 - Copyright: © 2024 Eiken et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2024
Y1 - 2024
N2 - It is not well investigated whether exposure to specific drug classes is associated with COVID-19. We investigated the risk of SARS-CoV-2 infection and severe COVID-19 among healthcare workers according to prescription drug use. We conducted an observational study among Danish healthcare workers. SARS-CoV-2 positivity was defined as a positive PCR/ELISA test throughout 2020 and severe COVID-19 as any above 48-hour hospitalization within 14 days after infection. Patient characteristics came from online surveys while data on SARS-CoV-2, drugs and hospitalizations came from Danish Health Registers. Infected individuals were matched with uninfected controls based on age, sex, and chronic diseases. Drug exposure was defined as any prescription redemption in the past six and one month(s) before infection for each drug class. Models assessing the risk of infection (conditional logistic regression) and severe COVID-19 (logistic regressions) versus drug usage were adjusted for BMI, smoking, alcohol, education, region, and patient contact when possible. We matched 5,710 SARS-CoV-2-infected cases with 57,021 controls. The odds of infection were reduced by calcium channel blocker (adjusted odds ratio (aOR) 0.81, 95% Confidence Interval (CI): 0.66-1.00) and vasoprotective drug (aOR 0.77, CI: 0.62-0.95) usage during the six months before infection compared to no usage. Exposure to antibacterials in the past month increased the odds of infection (aOR 1.27, CI: 1.09-1.48). Among infected participants, the odds of severe COVID-19 were higher with usage of almost any investigated drug, especially, diuretics (crude odds radio (OR) 4.82, CI:2.15-10.83), obstructive airway disease drugs (OR 4.49, CI: 2.49-8.08), and antibacterials (OR 2.74 CI:1.62-4.61). In conclusion, antibacterials were associated with more SARS-CoV-2 infections and calcium channel blockers with less. Once infected, users of prescription drugs had higher odds of developing severe COVID-19. These findings suggest a need for studies to clarify interactions between specific drug groups, behaviour, known risk factors, and disease susceptibility/severity.
AB - It is not well investigated whether exposure to specific drug classes is associated with COVID-19. We investigated the risk of SARS-CoV-2 infection and severe COVID-19 among healthcare workers according to prescription drug use. We conducted an observational study among Danish healthcare workers. SARS-CoV-2 positivity was defined as a positive PCR/ELISA test throughout 2020 and severe COVID-19 as any above 48-hour hospitalization within 14 days after infection. Patient characteristics came from online surveys while data on SARS-CoV-2, drugs and hospitalizations came from Danish Health Registers. Infected individuals were matched with uninfected controls based on age, sex, and chronic diseases. Drug exposure was defined as any prescription redemption in the past six and one month(s) before infection for each drug class. Models assessing the risk of infection (conditional logistic regression) and severe COVID-19 (logistic regressions) versus drug usage were adjusted for BMI, smoking, alcohol, education, region, and patient contact when possible. We matched 5,710 SARS-CoV-2-infected cases with 57,021 controls. The odds of infection were reduced by calcium channel blocker (adjusted odds ratio (aOR) 0.81, 95% Confidence Interval (CI): 0.66-1.00) and vasoprotective drug (aOR 0.77, CI: 0.62-0.95) usage during the six months before infection compared to no usage. Exposure to antibacterials in the past month increased the odds of infection (aOR 1.27, CI: 1.09-1.48). Among infected participants, the odds of severe COVID-19 were higher with usage of almost any investigated drug, especially, diuretics (crude odds radio (OR) 4.82, CI:2.15-10.83), obstructive airway disease drugs (OR 4.49, CI: 2.49-8.08), and antibacterials (OR 2.74 CI:1.62-4.61). In conclusion, antibacterials were associated with more SARS-CoV-2 infections and calcium channel blockers with less. Once infected, users of prescription drugs had higher odds of developing severe COVID-19. These findings suggest a need for studies to clarify interactions between specific drug groups, behaviour, known risk factors, and disease susceptibility/severity.
KW - Humans
KW - COVID-19/epidemiology
KW - Male
KW - Female
KW - Health Personnel
KW - Middle Aged
KW - Adult
KW - Denmark/epidemiology
KW - SARS-CoV-2/isolation & purification
KW - Prescription Drugs/therapeutic use
KW - Severity of Illness Index
KW - Risk Factors
KW - Calcium Channel Blockers/therapeutic use
KW - Disease Susceptibility
KW - Case-Control Studies
U2 - 10.1371/journal.pone.0311260
DO - 10.1371/journal.pone.0311260
M3 - Journal article
C2 - 39602471
SN - 1932-6203
VL - 19
SP - e0311260
JO - PLOS ONE
JF - PLOS ONE
IS - 11
ER -