Association of previous medications with the risk of COVID-19: a nationwide claims-based study from South Korea
Kyungmin Huh, Wonjun Ji, Minsun Kang, Jinwook Hong, Gi Hwan Bae, Rugyeom Lee, Yewon Na, Hyoseon Choi, Seon Yeong Gong, MD Jaehun Jung
doi:10.1101/2020.05.04.20089904
Background. Identifying the association between medications taken prior to the infection of coronavirus disease (COVID-19) might be useful during the current pandemic until a proven treatment is developed. We aimed to determine whether the risk of developing COVID-19 was associated with the use of various drugs that may increase or decrease susceptibility to severe acute respiratory syndrome coronavirus 2 infection and COVID-19.
Methods and Findings: A case-control study was performed using a nationwide claims database of South Korea, where a large testing capacity has been available throughout the pandemic. Exposure was defined as the prescription of study drugs that would have been continued until ≤7 days before the testing for COVID-19. Adults were considered eligible if they were ≥18 years old and tested for COVID-19. Among the 65,149 eligible subjects (mean age, 48.3 years; 49.4% male), 5,172 (7.9%) were diagnosed with COVID-19. Hydroxychloroquine was not significantly associated with the risk of COVID-19 (adjusted odds ratio [aOR], 1.48; 95% CI, 0.95-2.31). In the overall population, lower risks of COVID-19 were associated with the use of camostat (aOR, 0.45; 95% CI, 0.20-1.02) and amiodarone (aOR, 0.54; 95% CI, 0.33-0.89), although the differences were not significant in the subgroup analyses. Angiotensin receptor blockers were also associated with a slightly increased risk of COVID-19 (aOR, 1.13; 95% CI, 1.01-1.26), which was also not observed in the subgroup analysis. The study limitations include potential bias regarding the controls' characteristics, inability to determine prescription compliance, and a lack of information regarding the severity of underlying conditions.
Conclusions. No medications were consistently associated with increased or decreased risks of COVID-19. These findings suggest that a more cautious approach is warranted for the clinical use of re-purposed drugs until the results are available from clinical trials. .
Author contributions. Drs Huh and Jung had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Concept and design: Huh, Ji, Jung. Acquisition, analysis or interpretation of data: Huh, Ji, Kang, Hong, Bae, Lee, Na, Choi, Gong, Jung. Drafting of the manuscript: Huh, Ji, Jung. Funding. This work was supported by grants from the Gachon University Gil Medical Center (grant nos. 2018-17 and 2019-11) . The sponsor of the study was not involved in the study design, analysis, and interpretation of data; writing of the report; or the decision to submit the study results for publication. .
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'abstract': '<jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>Identifying '
'the association between medications taken prior to the infection of coronavirus disease '
'(COVID-19) might be useful during the current pandemic until a proven treatment is developed. '
'We aimed to determine whether the risk of developing COVID-19 was associated with the use of '
'various drugs that may increase or decrease susceptibility to severe acute respiratory '
'syndrome coronavirus 2 infection and '
'COVID-19.</jats:p></jats:sec><jats:sec><jats:title>Methods and Findings</jats:title><jats:p>A '
'case-control study was performed using a nationwide claims database of South Korea, where a '
'large testing capacity has been available throughout the pandemic. Exposure was defined as '
'the prescription of study drugs that would have been continued until ≤7 days before the '
'testing for COVID-19. Adults were considered eligible if they were ≥18 years old and tested '
'for COVID-19. Among the 65,149 eligible subjects (mean age, 48.3 years; 49.4% male), 5,172 '
'(7.9%) were diagnosed with COVID-19. Hydroxychloroquine was not significantly associated with '
'the risk of COVID-19 (adjusted odds ratio [aOR], 1.48; 95% CI, 0.95–2.31). In the overall '
'population, lower risks of COVID-19 were associated with the use of camostat (aOR, 0.45; 95% '
'CI, 0.20–1.02) and amiodarone (aOR, 0.54; 95% CI, 0.33–0.89), although the differences were '
'not significant in the subgroup analyses. Angiotensin receptor blockers were also associated '
'with a slightly increased risk of COVID-19 (aOR, 1.13; 95% CI, 1.01–1.26), which was also not '
'observed in the subgroup analysis. The study limitations include potential bias regarding the '
'controls’ characteristics, inability to determine prescription compliance, and a lack of '
'information regarding the severity of underlying '
'conditions.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>No '
'medications were consistently associated with increased or decreased risks of COVID-19. These '
'findings suggest that a more cautious approach is warranted for the clinical use of '
're-purposed drugs until the results are available from clinical trials.</jats:p></jats:sec>',
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