Effect of common maintenance drugs on the risk and severity of COVID-19 in elderly patients
Fung et al.
, Effect of common maintenance drugs on the risk and severity of COVID-19 in elderly patients
, PLoS ONE, doi:10.1371/journal.pone.0266922 (date from earlier preprint)
Retrospective database analysis of 374,229 patients in the USA, showing higher cases, lower hospitalizations, and no change in mortality with famotidine use.
This study is excluded in the after exclusion results of meta
not fully adjusting for the different baseline risk of systemic autoimmune patients.
risk of death, no change, HR 1.00, p = 1.00, vs. never used.
risk of hospitalization, 6.0% lower, HR 0.94, p < 0.001, vs. never used.
risk of case, 12.0% higher, HR 1.12, p < 0.001, vs. never used.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Fung et al., 1 Oct 2021, retrospective, population-based cohort, USA, peer-reviewed, 6 authors.
Abstract: PLOS ONE
Effect of common maintenance drugs on the
risk and severity of COVID-19 in elderly
Kin Wah Fung ID*, Seo H. Baik, Fitsum Baye, Zhaonian Zheng, Vojtech Huser, Clement
Lister Hill National Center for Biomedical Communications, National Library of Medicine, National Institutes of
Health, Bethesda, Maryland, United States of America
Citation: Fung KW, Baik SH, Baye F, Zheng Z,
Huser V, McDonald CJ (2022) Effect of common
maintenance drugs on the risk and severity of
COVID-19 in elderly patients. PLoS ONE 17(4):
Editor: Masaki Mogi, Ehime University Graduate
School of Medicine, JAPAN
Received: October 1, 2021
Accepted: March 29, 2022
Published: April 18, 2022
Peer Review History: PLOS recognizes the
benefits of transparency in the peer review
process; therefore, we enable the publication of
all of the content of peer review and author
responses alongside final, published articles. The
editorial history of this article is available here:
Copyright: This is an open access article, free of all
copyright, and may be freely reproduced,
distributed, transmitted, modified, built upon, or
otherwise used by anyone for any lawful purpose.
The work is made available under the Creative
Commons CC0 public domain dedication.
Data Availability Statement: The minimal data set
relevant to this study is included in the Supporting
information. All data in Supporting information can
be used without restriction. As for raw data, CMS
Maintenance drugs are used to treat chronic conditions. Several classes of maintenance
drugs have attracted attention because of their potential to affect susceptibility to and severity of COVID-19.
Using claims data on 20% random sample of Part D Medicare enrollees from April to
December 2020, we identified patients diagnosed with COVID-19. Using a nested case-control design, non-COVID-19 controls were identified by 1:5 matching on age, race, sex, dualeligibility status, and geographical region. We identified usage of angiotensin-converting
enzyme inhibitors (ACEI), angiotensin-receptor blockers (ARB), statins, warfarin, direct factor Xa inhibitors, P2Y12 inhibitors, famotidine and hydroxychloroquine based on Medicare
prescription claims data. Using extended Cox regression models with time-varying propensity score adjustment we examined the independent effect of each study drug on contracting
COVID-19. For severity of COVID-19, we performed extended Cox regressions on all
COVID-19 patients, using COVID-19-related hospitalization and all-cause mortality as outcomes. Covariates included gender, age, race, geographic region, low-income indicator,
and co-morbidities. To compensate for indication bias related to the use of hydroxychloroquine for the prophylaxis or treatment of COVID-19, we censored patients who only started
on hydroxychloroquine in 2020.
Up to December 2020, our sample contained 374,229 Medicare patients over 65 who
were diagnosed with COVID-19. Among the COVID-19 patients, 278,912 (74.6%) were on
at least one study drug. The three most common study drugs among COVID-19 patients
were statins 187,374 (50.1%), ACEI 97,843 (26.2%) and ARB 83,290 (22.3%). For all
three outcomes (diagnosis, hospitalization and death), current users of ACEI,..
Please send us corrections, updates, or comments. Vaccines and
treatments are complementary. All practical, effective, and safe means should
be used based on risk/benefit analysis. No treatment, vaccine, or intervention
is 100% available and effective for all current and future variants. We do not
provide medical advice. Before taking any medication, consult a qualified
physician who can provide personalized advice and details of risks and
benefits based on your medical history and situation. FLCCC
provide treatment protocols.