Large population study identifies drugs associated with reduced COVID-19 severity

  

View ORCID ProfileAriel Israel, Alejandro A. Schäffer,  View ORCID ProfileAssi Cicurel, Ilan Feldhamer, Ameer Tal,  View ORCID ProfileKuoyuan Cheng, Sanju Sinha, Eyal Schiff, Gil Lavie,  View ORCID ProfileEytan Ruppin

doi: https://doi.org/10.1101/2020.10.13.20211953

This article is a preprint and has not been peer-reviewed [what does this mean?]. It reports new medical research that has yet to be evaluated and so should not be used to guide clinical practice.

PDF: https://www.medrxiv.org/content/10.1101/2020.10.13.20211953v2.full.pdf

Abstract

BACKGROUND It may take months to years until drugs specifically designed to treat COVID-19 are available. Until then, it is crucial to identify whether existing medications could have a protective effect against severe disease. This is the objective of this large population study performed in Clalit Health Services (CHS), the largest healthcare provider in Israel.

METHODS CHS centrally manages electronic health records (EHRs) including medication purchases for over 4.5 million members. Two case-control matched cohorts were assembled to assess systematically which drugs affected the risk of COVID-19 hospitalization: in both cohorts, case patients were hospitalized for COVID-19; matched control patients were taken from the general population in the first cohort, and non-hospitalized SARS-CoV-2 positive patients in the second cohort. For each medication anatomical-therapeutic-chemical (ATC) class acquired during the last month before the index-date, we computed the odds ratio (OR) for hospitalization, 95% confidence interval (CI), and the p-value, using Fisher’s exact test. False discovery rate was used to adjust for multiple testing.

RESULTS Several drugs and pharmacy sold items were associated with significantly reduced odds for SARS-CoV-2 hospitalization, notably ubiquinone (OR=0.185, 95% CI [0.058,0.458], p<0.001), ezetimibe (OR=0.513, 95% CI [0.375,0.688], P<0.001), rosuvastatin (OR=0.746, 95% CI [0.645,0.858], p<0.001) and flecainide (OR=0.303, 95% CI [0.080,0.813], p<0.01). Additionally, acquisition of surgical masks, latex gloves and several ophthalmological products were associated with decreased risk for hospitalization.

CONCLUSION Ubiquinone, ezetimibe and rosuvastatin, all related to the cholesterol synthesis pathway were associated with reduced hospitalization risk. These findings suggest a promising protective effect which should be further investigated.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

This research was supported in part by the Intramural Research Program of the National Institutes of Health, NCI.

https://www.medrxiv.org/content/10.1101/2020.10.13.20211953v2