Prognostic Factors for In-hospital Mortality in Confirmed COVID-19 Patients with Opioid Combinations Consumption

Abstract

Background: At the onset of the COVID-19 pandemic, a misunderstanding emerged, suggesting that the consumption of opioid combinations might have a protective effect against COVID-19. Objectives: To identify prognostic factors associated with in-hospital mortality among confirmed COVID-19 patients with a history of opioid combination consumption in southern Iran. Methods: This retrospective cross-sectional study, conducted between September 2020 and March 2021, included patients over 14 years of age with a confirmed diagnosis of COVID-19 who were admitted to Shahid Faghihi Hospital in southern Iran (affiliated with Shiraz University of Medical Sciences). Patients with incomplete or unreadable medical records were excluded. Data were extracted from medical files and recorded in a structured data collection form comprising three main sections: (1) Demographic characteristics (e.g., age, gender, comorbidities, smoking status), (2) clinical and paraclinical findings, and (3) patient outcomes. Statistical analysis was subsequently performed. Results: Of 1,048 patients with confirmed COVID-19, 98 (8.55%) reported a history of opioid combination consumption. The mean ± SD age was 61.40 ± 14.50 years, and 81 (82.7%) were male. Thirty patients (30.6%) died in the hospital (P < 0.001). A comparison of survivors and non-survivors revealed that the mean age was significantly higher in non-survivors (P = 0.004). Non-survivors were more frequently admitted to the ICU (P = 0.001), and their mean length of ICU stay was significantly longer (P = 0.03). Multiple logistic regression analysis identified C-reactive protein (CRP) (OR = 0.92, P = 0.02) as the only independent predictor of mortality among opioid combination users with confirmed COVID-19. Conclusions: Among confirmed COVID-19 patients with a history of opioid combination consumption, the CRP level was the sole independent predictor of in-hospital mortality.