Similar COVID-19 incidence to the general population in people with opioid use disorder receiving integrated outpatient clinical care

Gabriel Vallecillo; Francina Fonseca; Lina Oviedo; Xavier Durán; Ignacio Martinez; Alexandra García-Guix; Claudio Castillo; Marta Torrens; Santiago Llana; Albert Roquer; Maria de la Cabeza Martinez; Sandra Aguelo; Irene Canosa; COSG Group (COVID-19 and Opioids Study Group)

doi:10.1016/j.dadr.2022.100027

Similar COVID-19 incidence to the general population in people with opioid use disorder receiving integrated outpatient clinical care

Drug Alcohol Depend Rep. 2022 Mar:2:100027. doi: 10.1016/j.dadr.2022.100027. Epub 2022 Jan 15.

Authors

Gabriel Vallecillo^{1

2}, Francina Fonseca^{1

2

3}, Lina Oviedo^{1

2}, Xavier Durán², Ignacio Martinez⁴, Alexandra García-Guix^{1

2}, Claudio Castillo^{1

2}, Marta Torrens^{1

2

4}, Santiago Llana¹, Albert Roquer¹, Maria de la Cabeza Martinez¹, Sandra Aguelo¹, Irene Canosa¹; COSG Group (COVID-19 and Opioids Study Group)

Affiliations

¹ Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Barcelona, Spain.
² Addiction Research Group (GRAd), Neuroscience Research Program, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.
³ Universitat Pompeu Fabra, Barcelona, Spain.
⁴ Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallès, Spain.

Abstract

Introduction: During the COVID-19 pandemic, limited access to health care augmented COVID-19 risk in subjects with opioid use disorder (OUD). The aim of the study was to compare COVID-19 incidence in individuals with OUD receiving continuous clinical care with that of the general population.

Methods: A prospective cohort study was carried out from March 2020 to March 2021 comparing COVID-19 cumulative incidence of individuals presenting an OUD receiving integrated clinical care with that of an age-reference general population, in three public outpatient treatment centers for addiction in Barcelona, Spain.

Results: Over the study period, 366 individuals received clinical care. Mean age: 48.2±8.9 years, 280 (76.5%) were men and 283 (77.3%) native Spanish. All subjects were on opioid agonist therapy. Prevalence of communicable diseases were: HIV infection in 109 (29.8%) and hepatitis C in 46 (12.6%). Psychiatric comorbidity was present in 207 (56.6%), and 119 (32.5%) had >1 chronic medical disease.

Covid-19 was diagnosed in 10 patients: a cumulative incidence of 2,732 casesx100,000 people/year (C.I.95%: 1,318-4,967). There were no differences compared to the age-general population: 2,856 casesx100,000 people/year (C.I.95%: 2,830-2,880) (p=0.81). In the bivariate analysis, hypertension (5[50.0%] vs. 53[14.9%], p=0.01) and cardiovascular chronic diseases (2 [20.0%] vs. 8 [2.2%], p=0.03) were more prevalent in patients with OUD and COVID-19.

Conclusions: Individuals with OUD who received integrated clinical care had a COVID-19 incidence comparable to the general population. Ensuring comprehensive healthcare is essential to prevent the clinical impact of COVID-19 on individuals with OUD.