A Retrospective Cohort Study of SARS-CoV-2 Mortality Rate in Individuals with Opioid Use Disorder in Ilam (Southwest of Iran)

 Individuals with opioid use disorder are a marginalized population in any society. They commonly have a weaker immune system, greater stress vulnerability, poorer health, more high-risk behaviors, and less access to healthcare services compared to the general population, which can expose them to a risk of severe COVID-19 complications. This study aimed to evaluate the effects of opioid use disorder on mortality in patients with SARS-CoV-2.

 This registry-based retrospective cohort study was conducted on 2362 consecutive inpatients with a confirmed diagnosis of SARS-CoV-2 between March 5, 2020 and March 21, 2021, presenting to a university hospital in Ilam in the southwest of Iran. Forty-five patients with opioid use disorder were identified in this study and matched to 100 patients without opium addiction. All patients with a history of opium addiction were included in the study group, and age- and sex-matched patients without opioid use disorder were randomly recruited as the controls. After adjusting for the effects of age and comorbidities, data were analyzed in STATA version 10, using logistic regression models.

 The mortality of patients with opioid use disorder increased following COVID-19 (adjusted OR: 6.59; 95% CI: 1.84–23.59; P=0.004). Hypertension (adjusted OR: 8.17; 95% CI: 2.21–30.15; P=0.002) and advancing age (OR: 1.06; 95% CI: 1.01–1.11; P=0.01) were significantly associated with increased COVID-19 mortality.

 Based on the present findings, opioid use disorder is a possible risk factor for mortality following COVID-19. The findings of the present study can be applied in the implementation of preventive measures and policies and prioritization of COVID-19 vaccination. However, further relevant research is recommended.