%0 Journal Article
%A Hoertel, N.
%A Sánchez Rico, M.
%A Gulbins, E.
%A Kornhuber, J.
%A Vernet, R.
%A Beeker, N.
%A Neuraz, A.
%A Blanco, C.
%A Olfson, M.
%A Airagnes, G.
%A Lemogne, C.
%A Alvarado Izquierdo, Jesús María
%A Arnaout, M.
%A Cougoule, C.
%A Meneton, P.
%A Limosin, F.
%T Association between benzodiazepine receptor agonist use and mortality in patients hospitalised for COVID-19: a multicentre observational study
%D 2022
%@ 2045-7960
%U https://hdl.handle.net/20.500.14352/71571
%X AimsTo examine the association between benzodiazepine receptor agonist (BZRA) use and mortality in patients hospitalised for coronavirus disease 2019 (COVID-19).MethodsA multicentre observational study was performed at Greater Paris University hospitals. The sample involved 14 381 patients hospitalised for COVID-19. A total of 686 (4.8%) inpatients received a BZRA at hospital admission at a mean daily diazepam-equivalent dose of 19.7 mg (standard deviation (S.D.) = 25.4). The study baseline was the date of admission, and the primary endpoint was death. We compared this endpoint between patients who received BZRAs and those who did not in time-to-event analyses adjusted for sociodemographic characteristics, medical comorbidities and other medications. The primary analysis was a Cox regression model with inverse probability weighting (IPW).ResultsOver a mean follow-up of 14.5 days (S.D. = 18.1), the primary endpoint occurred in 186 patients (27.1%) who received BZRAs and in 1134 patients (8.3%) who did not. There was a significant association between BZRA use and increased mortality both in the crude analysis (hazard ratio (HR) = 3.20; 95% confidence interval (CI) = 2.74–3.74; p < 0.01) and in the IPW analysis (HR = 1.61; 95% CI = 1.31–1.98, p < 0.01), with a significant dose-dependent relationship (HR = 1.55; 95% CI = 1.08–2.22; p = 0.02). This association remained significant in sensitivity analyses. Exploratory analyses indicate that most BZRAs may be associated with an increased mortality among patients hospitalised for COVID-19, except for diazepam, which may be associated with a reduced mortality compared with any other BZRA treatment.ConclusionsBZRA use may be associated with an increased mortality among patients hospitalised for COVID-19, suggesting the potential benefit of decreasing dose or tapering off gradually these medications when possible.
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