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?:abstract
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BACKGROUND: It may take months to years until drugs specifically designed to treat COVID-19 are available. Until then, it is crucial to identify whether existing medications could have a protective effect against severe disease. This is the objective of this large population study performed in Clalit Health Services (CHS), the largest healthcare provider in Israel. METHODS: CHS centrally manages electronic health records (EHRs) including medication purchases for over 4.5 million members. Two case-control matched cohorts were assembled to assess systematically which drugs affected the risk of COVID-19 hospitalization: in both cohorts, case patients were hospitalized for COVID-19; matched control patients were taken from the general population in the first cohort, and non-hospitalized SARS-CoV-2 positive patients in the second cohort. For each medication anatomical-therapeutic-chemical (ATC) class acquired during the last month before the index-date, we computed the 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: Several drugs and pharmacy sold items were associated with significantly reduced odds for SARS-CoV-2 hospitalization, notably ubiquinone (OR=0.185, 95% CI [0.058,0.458], p<0.001), ezetimibe (OR=0.513, 95% CI [0.375,0.688], P<0.001), rosuvastatin (OR=0.746, 95% CI [0.645,0.858], p<0.001) and flecainide (OR=0.303, 95% CI [0.080,0.813], p<0.01). Additionally, acquisition of surgical masks, latex gloves and several ophthalmological products were associated with decreased risk for hospitalization. CONCLUSION: Ubiquinone, ezetimibe and rosuvastatin, all related to the cholesterol synthesis pathway were associated with reduced hospitalization risk. These findings suggest a promising protective effect which should be further investigated.
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