PDF(Pubmed)
Abstract：
BACKGROUND: Prior reports indicate that modulation of the endocannabinoid system (ECS) may have a protective benefit for Covid-19 patients. However, associations between cannabis use (CU) or CU not in remission (active cannabis use (ACU)), and Covid-19-related outcomes among hospitalized patients is unknown.
METHODS: In this multicenter retrospective observational cohort analysis of adults (≥ 18 years-old) identified from 2020 National Inpatient Sample database, we utilize multivariable regression analyses and propensity score matching analysis (PSM) to analyze trends and outcomes among Covid-19-related hospitalizations with CU and without CU (N-CU) for primary outcome of interest: Covid-19-related mortality; and secondary outcomes: Covid-19-related hospitalization, mechanical ventilation (MV), and acute pulmonary embolism (PE) compared to all-cause admissions; for CU vs N-CU; and for ACU vs N-ACU.
RESULTS: There were 1,698,560 Covid-19-related hospitalizations which were associated with higher mortality (13.44% vs 2.53%, p ≤ 0.001) and worse secondary outcomes generally. Among all-cause hospitalizations, 1.56% of CU and 6.29% of N-CU were hospitalized with Covid-19 (p ≤ 0.001). ACU was associated with lower odds of MV, PE, and death among the Covid-19 population. On PSM, ACU(N(unweighted) = 2,382) was associated with 83.97% lower odds of death compared to others(N(unweighted) = 282,085) (2.77% vs 3.95%, respectively; aOR:0.16, [0.10-0.25], p ≤ 0.001).
CONCLUSIONS: These findings suggest that the ECS may represent a viable target for modulation of Covid-19. Additional studies are needed to further explore these findings.
METHODS: In this multicenter retrospective observational cohort analysis of adults (≥ 18 years-old) identified from 2020 National Inpatient Sample database, we utilize multivariable regression analyses and propensity score matching analysis (PSM) to analyze trends and outcomes among Covid-19-related hospitalizations with CU and without CU (N-CU) for primary outcome of interest: Covid-19-related mortality; and secondary outcomes: Covid-19-related hospitalization, mechanical ventilation (MV), and acute pulmonary embolism (PE) compared to all-cause admissions; for CU vs N-CU; and for ACU vs N-ACU.
RESULTS: There were 1,698,560 Covid-19-related hospitalizations which were associated with higher mortality (13.44% vs 2.53%, p ≤ 0.001) and worse secondary outcomes generally. Among all-cause hospitalizations, 1.56% of CU and 6.29% of N-CU were hospitalized with Covid-19 (p ≤ 0.001). ACU was associated with lower odds of MV, PE, and death among the Covid-19 population. On PSM, ACU(N(unweighted) = 2,382) was associated with 83.97% lower odds of death compared to others(N(unweighted) = 282,085) (2.77% vs 3.95%, respectively; aOR:0.16, [0.10-0.25], p ≤ 0.001).
CONCLUSIONS: These findings suggest that the ECS may represent a viable target for modulation of Covid-19. Additional studies are needed to further explore these findings.
摘要：
背景：先前的报道表明，内源性大麻素系统（ECS）的调节可能对Covid-19患者具有保护性益处。然而,大麻使用(CU)或未缓解的CU(活跃大麻使用(ACU))之间的关联，住院患者中Covid-19相关结局未知。
方法：在2020年全国住院患者样本数据库中确定的成人（≥18岁）的多中心回顾性观察队列分析中，我们利用多变量回归分析和倾向评分匹配分析(PSM)来分析合并CU和不合并CU(N-CU)的Covid-19相关住院的趋势和结果，主要结果：Covid-19相关死亡率；次要结果：Covid-19相关住院，机械通气(MV),与全因入院相比，急性肺栓塞（PE）；CUvsN-CU；ACUvsN-ACU。
结果：有1,698,560例与Covid-19相关的住院治疗与更高的死亡率相关(13.44%vs2.53%，p≤0.001)和一般较差的次要结果。在所有原因的住院治疗中，1.56%的CU和6.29%的N-CU因Covid-19住院（p≤0.001）。ACU与较低的MV几率相关，PE,以及Covid-19人口中的死亡。在PSM上,ACU（N（未加权）=2,382）与其他（N（未加权）=282,085）（2.77％vs3.95％，分别为：0.16，[0.10-0.25]，p≤0.001)。
结论：这些发现表明，ECS可能是新冠肺炎调制的可行靶标。需要更多的研究来进一步探索这些发现。
方法：在2020年全国住院患者样本数据库中确定的成人（≥18岁）的多中心回顾性观察队列分析中，我们利用多变量回归分析和倾向评分匹配分析(PSM)来分析合并CU和不合并CU(N-CU)的Covid-19相关住院的趋势和结果，主要结果：Covid-19相关死亡率；次要结果：Covid-19相关住院，机械通气(MV),与全因入院相比，急性肺栓塞（PE）；CUvsN-CU；ACUvsN-ACU。
结果：有1,698,560例与Covid-19相关的住院治疗与更高的死亡率相关(13.44%vs2.53%，p≤0.001)和一般较差的次要结果。在所有原因的住院治疗中，1.56%的CU和6.29%的N-CU因Covid-19住院（p≤0.001）。ACU与较低的MV几率相关，PE,以及Covid-19人口中的死亡。在PSM上,ACU（N（未加权）=2,382）与其他（N（未加权）=282,085）（2.77％vs3.95％，分别为：0.16，[0.10-0.25]，p≤0.001)。
结论：这些发现表明，ECS可能是新冠肺炎调制的可行靶标。需要更多的研究来进一步探索这些发现。
