Pharmacological Predictors of Morbidity and Mortality in COVID‐19

Oddy, Christopher; McCaul, James; Keeling, Polly; Allington, Jonathan; Senn, Dhanuja; Soni, Neesha; Morrison, Hannah; Mawella, Ruwani; Samuel, Thomas; Dixon, John

The interaction of COVID‐19 with the majority of common prescriptions is broadly unknown. The purpose of this study is to identify medications associated with altered disease outcomes in COVID‐19. A retrospective cohort comprised of all adult inpatient admissions to our centre with COVID‐19 was analysed. Data concerning all antecedent prescriptions were collected and agents brought forward for analysis if prescribed to at least 20 patients in our cohort. Forty‐two medications and 22 classes of medication were examined. Groups were propensity score matched and analysed by logistic and linear regression. The majority of medications did not show a statistically significant relationship with altered disease outcomes. Lower mortality was associated with use of pregabalin (p = 0.049, HR = 0.10 [0.01‐0.92]), inhalers of any type (p = 0.015, HR = 0.33 [0.14‐0.80]) and specifically beclomethasone (p = 0.032, HR = 0.10 [0.01‐0.82]), tiotropium (p = 0.035, HR = 0.07 [0.01‐0.83]) and steroid containing inhalers (p = 0.013, HR = 0.35 [0.15‐0.79]). Gliclazide (p = 0.020, HR = 4.37 [1.26‐15.18]) and proton pump inhibitor (p = 0.028, HR = 1.72 [1.06‐2.79]) use was associated with greater mortality. Diuretic (p = 0.002, HR = 0.07 [0.01‐0.37]) and statin (p = 0.006, HR = 0.35 [0.17‐0.73]) use was associated with lower rates of critical care admission. Our data lends confidence to observing usual practice in COVID‐19 patients by continuing antecedent prescriptions in the absence of an alternative acute contraindication. We highlight potential benefits in investigation of diuretics, inhalers, pregabalin and statins as therapeutic agents for COVID‐19 and support further assessment of the safety of gliclazide and PPIs in the acute illness. This article is protected by copyright. All rights reserved