J Clin Pharmacol. 2021 Apr 28. doi: 10.1002/jcph.1878. Online ahead of print.
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.