Eagleton, Marie ORCID: https://orcid.org/0000-0002-4347-8122, Stokes, Siobhán ORCID: https://orcid.org/0000-0003-2406-0879, Fenton, Fiona ORCID: https://orcid.org/0000-0001-6187-974X and Keenan, Eamon ORCID: https://orcid.org/0000-0002-3395-3831 (2021) Therapeutic potential of long-acting opioids and opioid antagonists for SARS CoV-2 infection. British Journal of Anaesthesia, 127, (6), e212-e214. https://dx.doi.org/10.1016%2Fj.bja.2021.08.022.
External website: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC84189...
Editor
Aware of few reports of COVID-19 in patients undergoing opioid substitution treatment, we proposed that OST may have a protective effect on clinical manifestations of COVID-191 based on a publication proposing an interaction between opioids and SARS-CoV-2 pathology.1a We have not observed significant clusters of COVID-19 in the cohort of opioid substitution-treated patients, including attendees at our centre.2 Establishing incidence of COVID-19 in people who use drugs is confounded by the tendency of many authors to aggregate all people who use drugs together although effects of individual drugs on immune function and viral infection differ.3, 4 Recent UK and US studies indicate a low incidence of COVID-19 in people who use drugs including, but not confined to, patients treated with opioid substitution treatment.5, 6, 7 A US retrospective study concluded that patients with recent opioid use disorder were at higher risk for COVID-19 and that methadone, buprenorphine and naltrexone did not alter that risk.8 However, detailed examination of this study does not provide strong evidence for this. The study was based on a small SARS-CoV-2-positive population, i.e. 210 (0.04%) of 471,520 patients with lifetime opioid use disorder and 90 (0.21%) of 43,160 patients with recent opioid use disorder. The majority had multiple co-morbidities and a third of those with lifetime opioid use disorder were over 65 yr of age. The opioid used was not stated, and patients with opioid use disorder who tested negative or were asymptomatic for COVID-19 were excluded as were those dispensed methadone in methadone clinics.
B Substances > Opioids (opiates) > Opioid product > Naltrexone
B Substances > Opioids (opiates) > Opioid product > Methadone
G Health and disease > Disease by cause (Aetiology) > Communicable / infectious disease > Viral disease / infection > Coronavirus (COVID-19)
HJ Treatment or recovery method > Substance disorder treatment method > Substance replacement method (substitution) > Opioid agonist treatment (methadone maintenance / buprenorphine)
T Demographic characteristics > Person who injects drugs (Intravenous / injecting)
VA Geographic area > Europe > Ireland
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