Musculoskeletal Disorders, Pain Medication, and in-Hospital Mortality among Patients with COVID-19 in South Korea: A Population-Based Cohort Study

• Published in: International journal of environmental research and public health 2021-06, Vol.18 (13), p.6804
• Main Authors: Oh, Tak-Kyu, Song, In-Ae, Lee, Joon, Eom, Woosik, Jeon, Young-Tae
• Format: Article
• Language: English
• Subjects: Analgesics; Anti-inflammatory agents; Arthritis; Back pain; Benzodiazepines; Biomedical materials; Cancer therapies; Chronic illnesses; Cohort analysis; Comorbidity; Confidence intervals; Coronaviruses; COVID-19; COVID-19 vaccines; Disability; Disease; Gabapentin; Glucocorticoids; Hospitals; Infections; Inflammation; Low back pain; Mortality; Musculoskeletal diseases; Narcotics; Neck pain; Nonsteroidal anti-inflammatory drugs; Opioids; Osteoarthritis; Pain; Paracetamol; Patients; Population; Population studies; Population-based studies; Prescription drugs; Regression analysis; Rheumatoid arthritis; Software; Statistical analysis; Variables
• ISSN: 1660-4601; 1661-7827; 1660-4601
• DOI: 10.3390/ijerph18136804

We aimed to investigate whether comorbid musculoskeletal disorders (MSD)s and pain medication use was associated with in-hospital mortality among patients with coronavirus disease 2019 (COVID-19). Adult patients (≥20 years old) with a positive COVID-19 diagnosis until 5 June 2020 were included in this study, based on the National Health Insurance COVID-19 database in South Korea. MSDs included osteoarthritis, neck pain, lower back pain, rheumatoid arthritis, and others, while pain medication included paracetamol, gabapentin, pregabalin, glucocorticoid, nonsteroidal anti-inflammatory drugs (NSAIDs), opioids (strong and weak opioids), and benzodiazepine. Primary endpoint was in-hospital mortality. A total of 7713 patients with COVID-19 were included, and in-hospital mortality was observed in 248 (3.2%) patients. In multivariate logistic regression analysis, no MSDs (p > 0.05) were significantly associated with in-hospital mortality. However, in-hospital mortality was 12.73 times higher in users of strong opioids (odds ratio: 12.73, 95% confidence interval: 2.44–16.64; p = 0.002), while use of paracetamol (p = 0.973), gabapentin or pregabalin (p = 0.424), glucocorticoid (p = 0.673), NSAIDs (p = 0.979), weak opioids (p = 0.876), and benzodiazepine (p = 0.324) was not associated with in-hospital mortality. In South Korea, underlying MSDs were not associated with increased in-hospital mortality among patients with COVID-19. However, use of strong opioids was significantly associated with increased in-hospital mortality among the patients.