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All Studies   Meta Analysis    Recent:   

Identification of drugs associated with reduced severity of COVID-19: A case-control study in a large population

Israel et al., Epidemiology and Global Health Microbiology and Infectious Disease, doi:10.7554/eLife.68165
Jul 2021  
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Hospitalization 38% Improvement Relative Risk Dutasteride for COVID-19  Israel et al.  Prophylaxis Is prophylaxis with antiandrogens beneficial for COVID-19? Retrospective 39,180 patients in Israel Lower hospitalization with antiandrogens (p=0.014) c19early.org Israel et al., Epidemiology and Global.., Jul 2021 Favorsdutasteride Favorscontrol 0 0.5 1 1.5 2+
7th treatment shown to reduce risk in September 2020
 
*, now with p = 0.000000056 from 49 studies.
No treatment is 100% effective. Protocols combine treatments. * >10% efficacy, ≥3 studies.
4,800+ studies for 102 treatments. c19early.org
Case control study examining medication usage with a healthcare database in Israel, showing lower risk of hospitalization with dutasteride.
Study covers vitamin D and zinc.
risk of hospitalization, 37.7% lower, OR 0.62, p = 0.01, treatment 30 of 6,530 (0.5%) cases, 240 of 32,650 (0.7%) controls, NNT 18, case control OR.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Israel et al., 27 Jul 2021, retrospective, Israel, peer-reviewed, 10 authors.
This PaperAntiandrogensAll
Identification of drugs associated with reduced severity of COVID-19 – a case-control study in a large population
Ariel Israel, Alejandro A Schäffer, Assi Cicurel, Kuoyuan Cheng, Sanju Sinha, Eyal Schiff, Ilan Feldhamer, Ameer Tal, Gil Lavie, Eytan Ruppin
eLife, doi:10.7554/elife.68165
Background: Until coronavirus disease 2019 (COVID-19) drugs specifically developed to treat COVID-19 become more widely accessible, it is crucial to identify whether existing medications have a protective effect against severe disease. Toward this objective, we conducted a large population study in Clalit Health Services (CHS), the largest healthcare provider in Israel, insuring over 4.7 million members. Methods: Two case-control matched cohorts were assembled to assess which medications, acquired in the last month, decreased the risk of COVID-19 hospitalization. Case patients were adults aged 18 to 95 hospitalized for COVID-19. In the first cohort, five control patients, from the general population, were matched to each case (n=6202); in the second cohort, two nonhospitalized SARS-CoV-2 positive control patients were matched to each case (n=6919). The outcome measures for a medication were: odds ratio (OR) for hospitalization, 95% confidence interval (CI), and the p-value, using Fisher's exact test. False discovery rate was used to adjust for multiple testing. Results: Medications associated with most significantly reduced odds for COVID-19 hospitalization include: ubiquinone (OR=0.185, 95% CI [0.058 to 0.458], p<0.001), ezetimibe (OR=0.488, 95% CI [0.377 to 0.622], p<0.001), rosuvastatin (OR=0.673, 95% CI [0.596 to 0.758], p<0.001), flecainide (OR=0.301, 95% CI [0.118 to 0.641], p<0.001), and vitamin D (OR=0.869, 95% CI [0.792 to 0.954], p<0.003). Remarkably, acquisition of artificial tears, eye care wipes, and several ophthalmological products were also associated with decreased risk for hospitalization. Conclusions: Ubiquinone, ezetimibe, and rosuvastatin, all related to the cholesterol synthesis pathway were associated with reduced hospitalization risk. These findings point to a promising protective effect which should be further investigated in controlled, prospective studies.
The funders had no role in study design, data collection and interpretation, or the decision to submit the work for publication. Additional files Author contributions Supplementary files . Source code 1. R source code, producing Figure 1 . . Supplementary file 1. Supplementary tables and figures. Suppl Tab 1 Multivariable logistic regression for hospitalization status according to ethnicity and medication consumption in Cohort 1. Suppl Tab 2 Multivariable logistic regression for hospitalization status according to ethnicity and medication consumption in Cohort 2. Figure supplements Forest plot showing association between drug use and hospitalization risk in each of the cohorts, divided by body mass index (BMI) category. Data availability Data were obtained from patients' electronic health records, and IRB approval restrains its use to researchers inside Clalit Health Services. For further information regarding data availability, researchers may contact Dr. Lavie gillav@clalit.org.il. This study is based on real-world patient drug purchases, and it cannot be made available due to patient privacy concerns. R code used to produce Figure 1 is available as a supplementary file named 'Source code 1'.
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Toward this objective, we conducted a large population study in Clalit Health ' 'Services (CHS), the largest healthcare provider in Israel, insuring over 4.7 million ' 'members.</jats:p></jats:sec><jats:sec id="abs2"><jats:title>Methods:</jats:title><jats:p>Two ' 'case-control matched cohorts were assembled to assess which medications, acquired in the last ' 'month, decreased the risk of COVID-19 hospitalization. Case patients were adults aged 18 to ' '95 hospitalized for COVID-19. In the first cohort, five control patients, from the general ' 'population, were matched to each case (n=6202); in the second cohort, two non-hospitalized ' 'SARS-CoV-2 positive control patients were matched to each case (n=6919). The outcome measures ' 'for a medication were: odds ratio (OR) for hospitalization, 95% confidence interval (CI), and ' 'the p-value, using Fisher’s exact test. False discovery rate was used to adjust for multiple ' 'testing.</jats:p></jats:sec><jats:sec ' 'id="abs3"><jats:title>Results:</jats:title><jats:p>Medications associated with most ' 'significantly reduced odds for COVID-19 hospitalization include: ubiquinone (OR=0.185, 95% CI ' '[0.058 to 0.458], p&lt;0.001), ezetimibe (OR=0.488, 95% CI [0.377 to 0.622], p&lt;0.001), ' 'rosuvastatin (OR=0.673, 95% CI [0.596 to 0.758], p&lt;0.001), flecainide (OR=0.301, 95% CI ' '[0.118 to 0.641], p&lt;0.001), and vitamin D (OR=0.869, 95% CI [0.792 to 0.954], p&lt;0.003). ' 'Remarkably, acquisition of artificial tears, eye care wipes, and several ophthalmological ' 'products were also associated with decreased risk for ' 'hospitalization.</jats:p></jats:sec><jats:sec ' 'id="abs4"><jats:title>Conclusions:</jats:title><jats:p>Ubiquinone, ezetimibe, and ' 'rosuvastatin, all related to the cholesterol synthesis pathway were associated with reduced ' 'hospitalization risk. 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Please send us corrections, updates, or comments. c19early involves the extraction of 100,000+ datapoints from thousands of papers. Community updates help ensure high accuracy. Treatments and other interventions are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment 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 and WCH provide treatment protocols.
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