[LINK] O/t: Marijuana Associated with Lower COVID-19 Severity

[Stephen Loosley]

B57 CUTTING EDGE COVID RESEARCH

“Marijuana Consumption Is Associated with Lower COVID-19 Severity Among Hospitalized
Patients”

By P. Yan, C. Shover, N. J. Jackson, R. Buhr, R. Nguyen, D. P. Tashkin, I. Barjaktarevic; UCLA
David Geffen School of Medicine, Los Angeles, CA, United States, Offsite Care, Santa Rosa, CA, United States, Department of Medicine Statistics Core, UCLA, Los Angeles, CA, United States, Division of Pulmonary, Critical Care and Sleep Medicine, UCLA, Los Angeles, CA, United States, UCLA, Los Angeles, CA, United States.


RATIONALE: While marijuana is known to have immunomodulatory properties, clinical consequences of its chronic use on outcomes in COVID-19 have not been extensively evaluated. We aimed to assess whether current marijuana users hospitalized for COVID-19 had different outcomes compared to non-users.

METHODS: We conducted a retrospective analysis of 1831 patients admitted to UCLA between February 2020 and February 2021 with a diagnosis of COVID-19. We evaluated outcomes including NIH COVID-19 severity score, need for supplemental oxygen, ICU admission, mechanical ventilation, length of hospitalization, and in-hospital death for self-reported current marijuana users (use of edible or inhalant marijuana within one month of admission) and non-users (includes former marijuana users and never users). Propensity matching was used to account for differences in age, body mass index, sex, tobacco smoking history, and comorbidities known to be risk factors for COVID-19 mortality (diabetes, chronic kidney disease, congestive heart failure, and liver disease) between marijuana users and non-users.

RESULTS: Of 1831 patients admitted with COVID-19, 69 patients reported active marijuana use (4% of the overall cohort). Active users were younger (44 years vs. 62 years, p<0.001), less often diabetic (23.2% vs. 37.2%, p<0.021), and more frequently active tobacco smokers (20.3% vs. 4.1%, p<0.001) compared to non-users. Notably, active users had lower levels of inflammatory markers upon admission than non-users — CRP (3.7mg/L vs. 7.6mg/L, p<0.001), ferritin (282ug/L vs. 622ug/L, p<0.001), D-dimer (468ng/mL vs. 1140ng/mL, p=0.017), and procalcitonin (0.10ng/mL vs. 0.15ng/mL, p=0.001). Based on univariate analysis, marijuana users had significantly better outcomes compared to non-users as reflected in lower NIH scores (5.1 vs. 6.0, p<0.001), shorter hospitalization (4 days vs. 6 days, p<0.001), lower ICU admission rates (12% vs. 31%, p<0.001), and less need for mechanical ventilation (6% vs. 17%, p=0.027). Using propensity matching, differences in overall survival were not statistically significant between marijuana users and non-users, nevertheless ICU admission was 12 percentage points lower (p=0.018) and intubation rates were 6 percentage points lower (p=0.017) in marijuana users after adjusting for covariates.

CONCLUSION: This retrospective cohort study suggests that active marijuana users hospitalized with COVID-19 had better clinical outcomes compared with non-users, including decreased need for ICU admission or mechanical ventilation. However, our results need to be interpreted with caution given the limitations of a retrospective analysis. Prospective and observational studies will better help elucidate the effects of marijuana use in COVID-19 patients.

Ref: https://www.atsjournals.org/doi/pdf/10.1164/ajrccm-conference.2022.205.1_MeetingAbstracts.A3174