- Published
- 25 June 2024
- Journal article
Factors associated with SARS-CoV-2 testing, diagnosis and COVID-19 disease among individuals prescribed opioid-agonist treatment: a nationwide retrospective cohort study
- Authors
- Source
- Clinical Microbiology and Infection
Abstract
Objectives
Among people receiving opioid-agonist treatment (OAT), the risk of COVID-19 infection and disease may be higher owing to underlying health problems and vulnerable social circumstances. We aimed to determine whether recent OAT, compared to past exposure, affected risk of (i) testing for SARS-CoV-2, (ii) testing positive for SARS-CoV-2 and (iii) being hospitalized/dying with COVID-19 disease.
Methods
We included individuals prescribed OAT in Scotland between 2015 and 2020. We performed record linkage to SARS-CoV-2 PCR testing, vaccination, hospitalization, and mortality data, and followed up from March-2020 to December-2021. We used proportional hazards analysis and multivariate logistic regression to estimate associations between recent OAT prescription (in the previous two months), compared to past exposure (off treatment for over a year), and COVID-19 outcomes. Models were adjusted for confounders.
Results
Among 36,093 individuals prescribed OAT, 19,071 (52.9%) were tested for SARS-CoV-2, 2,896 (8.3%) tested positive and 552 (1.5%) were hospitalized/died with COVID-19. Recent OAT, compared to past exposure, was associated with lower odds of testing positive among those tested (aOR, 0.63; 95% CI, 0.57, 0.69). However, among those testing positive, recent OAT was associated with two-fold higher odds of hospitalization/death (aOR, 2.04; 95% CI, 1.60, 2.59).
Conclusion
We found that recent OAT was associated with lower odds of SARS-CoV-2 infection, but with higher odds of disease once diagnosed. Clinical studies are needed to unravel the role of OAT in these associations. Enhanced effort is warranted to increase vaccine coverage among OAT patients to mitigate severe consequences of COVID-19.
Cite as
Glancy, M., Yeung, A., McAuley, A., Palmateer, N., Bishop, J., Taylor, B., Lang, J., Barnsdale, L., Priyadarshi, S. & Hutchinson, S. 2024, 'Factors associated with SARS-CoV-2 testing, diagnosis and COVID-19 disease among individuals prescribed opioid-agonist treatment: a nationwide retrospective cohort study', Clinical Microbiology and Infection. https://doi.org/10.1016/j.cmi.2024.06.019