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

eLife ◽  
2021 ◽  
Vol 10 ◽  
Ariel Israel ◽  
Alejandro A Schäffer ◽  
Assi Cicurel ◽  
Ilan Feldhamer ◽  
Ameer Tal ◽  

Background: Until 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. Towards 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 18-95 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. 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. Funding: This research was supported in part by the Intramural Research Program of the National Institutes of Health, NCI.

2003 ◽  
Vol 108 (1) ◽  
pp. 130-135 ◽  
Le Jian ◽  
Li Ping Xie ◽  
Andy H. Lee ◽  
Colin W. Binns

2015 ◽  
Vol 2015 ◽  
pp. 1-10 ◽  
Joaquim C. V. D. Van-Dunem ◽  
Laura C. Rodrigues ◽  
Luiz Claudio Arraes Alencar ◽  
Maria de Fátima Pessoa Militão-Albuquerque ◽  
Ricardo Arraes de Alencar Ximenes

The objective of this study was to estimate the protective effect of Bacille Calmette-Guérin (BCG) vaccine against tuberculosis among (predominantly immunodeficient) HIV-infected children in Angola. A hospital-based case-control study was conducted with 230 cases, children coinfected with tuberculosis, and 672 controls, HIV-infected children from the same hospital, aged 18 months to 13 years. The presence of a vaccination scar was taken as a proxy marker for BCG vaccination. The crude effectiveness was 8% (95% CI: −26 to 32) and the adjusted effectiveness was 30% (95% CI: −75 to 72). The present study suggests that BCG does not have a protective effect against tuberculosis among immunodeficient HIV-infected children. Since BCG is no longer given to HIV-infected children, the study may not be replicated. Accepting that these findings should be considered with caution, they are nonetheless likely to be the last estimate of BCG efficacy in a sufficiently powered study.

2003 ◽  
Vol 19 (6) ◽  
pp. 1593-1601 ◽  
Sérgio Tessaro ◽  
Jorge U. Béria ◽  
Elaine Tomasi ◽  
Cesar G. Victora

To investigate the relationship between breastfeeding and breast cancer in Southern Brazil, a case-control design was employed, with two age-matched control groups. A total of 250 cases of breast cancer were identified in women from 20 to 60 years of age, with 1,020 hospital and community controls. The main study variables were occurrence of breastfeeding and duration of breastfeeding. A multivariate conditional logistic regression analysis was employed. According to the results, breastfeeding did not have a protective effect against breast cancer. The odds ratio (OR) for women who breastfed was 0.9 (95% CI: 0.8-1.2) compared to women who did not breastfeed. For women who breastfed for six months or less, the OR was 1.0 (95% CI: 0.6-1.8). In pre-menopausal women who breastfed for more than 25 months, the OR was 0.95 (95% CI: 0.5-3.5), and in post-menopausal women OR was 1.27 (95% CI: 0.5-3.1), compared to women who had not breastfeed.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 2594-2594
Karine Lacut ◽  
Gregoire Le Gal ◽  
Emmanuel Oger ◽  
Dominique Mottier

Abstract Background: Previous studies of selected patients have suggested a reduction in the risk of venous thromboembolism (VTE) with the use of statins, and no effect of fibrates. Objective: To evaluate the influence of statin and fibrate use on the risk of venous thromboembolic events. Design: Case-control study (EDITH) designed to investigate genetic and environmental risk factors of VTE. Setting: Brest University Hospital. Participants: 857 patients consecutively hospitalized for a documented venous thromboembolic event were included between May 2000 and May 2004. Controls were matched on age, sex and the main risk factors of VTE (cancer, surgery, pregnancy…). Results: The mean age of patients was 67.7 year. No significant difference was found between cases and controls concerning the main characteristics, except for smocking and body mass index. Controls had more often previous vascular events (coronary heart disease, stroke or arteriopathy of the lower limbs) than cases but the difference was no significant. Statin use was associated with a significant decreased risk of VTE (odds ratio (OR) = 0.58; 95% confidence interval (CI), 0.41–0.82), whereas fibrate use was associated with a significant increased risk of VTE (OR = 1.60; 95% CI, 1.09–2.34). After adjustment on the main confounding factors including aspirin use and cardiovascular disease, these associations remained significant. Among pleiotropic effects of statins, some antithrombotic mechanisms could be proposed to explain their possible protective effect. Concerning the possible negative effect of fibrates, some authors found that the most prescribed fibrates, but not statins, caused hyperhomocysteinemia. In our study, analyses of homocysteinemia are ongoing. Conclusion: In this case-control study of hospitalized patients, statin use was associated with a significant decreased risk of VTE, whereas fibrate use was associated with a significant increased risk. Homocysteinemia may be involved in the difference between the effects of these two categories of lipid-lowering drugs on VTE. Because our study was observational, the protective effect of statins as regards the risk of VTE remains questionable and further prospective studies are needed.

2012 ◽  
Vol 107 ◽  
pp. S15-S16 ◽  
Prasad Iyer ◽  
Herbert Heien ◽  
Bijan Borah ◽  
Gregory Cooper ◽  
Ananya Das ◽  

2019 ◽  
Vol 20 (1) ◽  
Sana Mahjoub ◽  
Vera Chayeb ◽  
Hedia Zitouni ◽  
Rabeb M. Ghali ◽  
Haifa Regaieg ◽  

Abstract Background Associations between IKZF1 gene variants and Acute Lymphoblastic Leukemia (ALL) was recently reported. We examined whether the common IKZF1 polymorphisms rs4132601 T/G and rs111978267 A/G are associated with ALL among a Tunisian pediatric cohort. Methods This case-control study involved 170 patients with ALL and 150 control subjects. SNP genotyping was performed by TaqMan® SNP Genotyping Assay. Results The minor allele G of IKZF1 gene polymorphism rs4132601 T/G was significantly higher in ALL cases than in control subjects (P = 0.029), with 1.54-fold increased risk of ALL. The association of rs4132601 with ALL was seen under co-dominant (P = 0.009), recessive (P = 0.006), and additive (P = 0.027) genetic models, of which the co-dominant (P = 0.027) and recessive (P = 0.027) association remained significant after adjusting for covariates, and False Discovery Rate correction. In contrast, no association was noted for rs111978267 variant. Two-locus (rs4132601-rs11978267) IKZF1 haplotype analysis demonstrated association of GA (P = 0.053), with increased ALL risk [OR (95% CI) = 1.58 (1.00–2.51)], which remained significant after controlling for key covariates [aP = 0.046; aOR (95% CI) = 1.61 (1.01–2.57)]. Conclusion We demonstrated the association of IKZF1 polymorphism rs4132601 T/G with increased risk of ALL among Tunisian pediatric cohort, with altered phenotypic changes among ALL patients.

Jakob Skov ◽  
Henrik Falhammar ◽  
Jan Calissendorff ◽  
Jonatan D Lindh ◽  
Buster Mannheimer

Abstract Purpose Drug-induced hyponatremia is common, with medications from many drug-classes implicated. Lipid-lowering agents are among the most prescribed drugs. Limited evidence suggests an inverse association between statins and hyponatremia, while data on other lipid-lowering agents is absent. The objective of this investigation was to study the association between lipid-lowering drugs and hospitalization due to hyponatremia. Methods This was a register-based case–control study of the general Swedish population. Those hospitalized with a main diagnosis of hyponatremia (n = 11,213) were compared with matched controls (n = 44,801). Multivariable logistic regression adjusting for co-medication, diseases, previous hospitalizations, and socioeconomic factors was used to explore the association between severe hyponatremia and the use of lipid-lowering drugs. Results Unadjusted ORs (95% CI) for hospitalization due to hyponatremia were 1.28 (1.22–1.35) for statins, 1.09 (0.79–1.47) for ezetimibe, 1.38 (0.88–2.12) for fibrates, and 2.12 (1.31–3.35) for resins. After adjustment for confounding factors the adjusted odds ratios (95% CI) compared with controls were 0.69 (0.64–0.74) for statins, 0.60 (0.41–0.86) for ezetimibe, 0.87 (0.51–1.42) for fibrates, and 1.21 (0.69–2.06) for resins. Conclusions Use of statins and ezetimibe was inversely correlated with severe hyponatremia. Consequently, these drugs are unlikely culprits in patients with hyponatremia, and they appear safe to initiate in hyponatremic patients. A potential protective effect warrants further studies on how statins and other lipid-lowering drugs are linked to dysnatremias.

2020 ◽  
Vol 10 (1) ◽  
Israini Suriati ◽  
Nurliana Mansyur

Pendahuluan: Obesitas adalah suatu kondisi yang menggambarkan seseorang memiliki badan yang sangat gemuk dan mengandung banyak lemak pada tubuhnya, sebagai akibat dari penumpukan zat gizi terutama karbohidrat, lemak dan protein. Kondisi ini disebabkan oleh ketidak seimbangan konsumsi kalori dan kebutuhan energy. Obesitas dapat dipengaruhi oleh berbagai faktor.Faktor-faktor tersebut diantaranya adalah faktor genetik, kurang gerak / olahraga, emosi, Pola makan,kurang istirahat,suhu, hormonal Tujuan:  Mengetahui Faktor-faktor yang berhubungan dengan kejadian obesitas pada warga dusun sabbang paru desa salu paremang selatan Kabupaten Luwu Kecamatan Kamanre Provinsi Sulawesi SelatanMetode: Penelitian ini menggunakan studi komparatif dengan pendekatan case control study dilihat secara retrospektif. Desain ini dilakukan dengan melihat variabel dependen terlebih dahulu, sedangkan variabel independen ditelusuri secara retrospektif untuk menentukan ada tidaknya hubungan faktor faktor yang berperan. Populasi dalam penelitian ini adalah warga yang obesitas di Dusun sabbang paru desa salu paremang selatan kecamatan kamanre sulawesi selatan. Adapun pengambilan sampel dilakukan dengan cara Random sampling yakni dengan cara acak tanpa memperhatikan strata yang ada dalam anggota populasi yaitu sebanyak 40 responden.Hasil: Berdasarkan uji chi square dengan Fisher Exact test pada variabel genetika diperoleh nilai hitung p = 0,001 lebih kecil dari nilai α = 0,05, pada variabel pola makan diperoleh nilai hitung p = 0,002 lebih kecil dari nilai α = 0,05, dan pada variabel aktifitas fisik diperoleh nilai hitung p = 0,001 lebih kecil dari nilai α = 0,05 Simpulan: Dari analisis tersebut dapat diartikan bahwa Ha diterima atau ada hubungan genetika, pola makan dan aktivitas fisik dengan obesitas pada warga desa salu paremang selatan kecamatan kamanre sulawesi selatan. Kata kunci: Obesitas

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