Endocarditis in patients with cocaine or opioid use disorders increased significantly between 2011 and 2022

news release

Tuesday, December 13, 2022

A recent sharp increase indicates that COVID-19 is associated with a higher risk of endocarditis, an NIH-sponsored study has found.

The incidence of infective endocarditis (a rare but often fatal inflammation of heart valves) in patients with cocaine use disorder or opioid use disorder increased from 2011 to 2022, and by 2021 from 2020 to 2022, a new study reports. It further indicates that risks have exacerbated during the COVID-19 pandemic.

Among patients with any substance use disorder, those with a clinical diagnosis of COVID-19 were more likely to have a new endocarditis diagnosis and hospitalization after this diagnosis than those without COVID-19. increased risk. Over 12 years, patients with opioid and cocaine use disorders had a 3- to 8-fold higher incidence of endocarditis than those without.

Findings also showed that black and Hispanic people face a higher risk of COVID-19-related endocarditis than non-Hispanic whites. The authors note that this is consistent with higher rates of injectable drug use in non-Hispanic white populations compared to black or Hispanic populations.Research published today molecular psychiatryfunded by agencies across the National Institutes of Health and led by the National Institute on Drug Abuse (NIDA).

“People with substance use disorders already face significant barriers to adequate health care due to lack of access and stigma,” said Nora D. Volkow, MD, director of NIDA and co-study author. increase. Infection from reused or shared injection equipment can help prevent this often fatal and costly condition. “

One in ten hospitalizations for endocarditis are related to injection drug use, and these numbers continue to rise. Many drugs can be injected, including cocaine, methamphetamine, and opioids such as heroin and fentanyl. Improper access to sterile injecting equipment is common and dramatically increases the risk of infection for people who use drugs. HIV and hepatitis can also be transmitted through re-use of injection equipment and pose a health risk.

Dr. Volkow of NIDA and a team of scientists from Case Western Reserve University in Cleveland, Ohio, analyzed electronic medical record data for more than 109 million unique patients collected between January 2011 and August 2022. Did. Patient data were obtained from 77 hospitals nationwide. It covers various geographic locations, age groups, racial and ethnic groups, income levels, and insurance types. Electronic medical records are anonymized to ensure privacy.

Researchers found that in 2011, there were four cases of endocarditis per day for every million people with opioid use disorders. By 2022, this rate has increased to 30 cases per million people with opioid use disorder per day. For people with cocaine use disorders, the number of people with cocaine use disorders increased from 5 per million in 2011 to 23 in 2022.

A clinical diagnosis of COVID-19 more than doubled the risk of a new diagnosis of endocarditis in patients with cocaine or opioid use disorders. Among these patients, the risk of hospitalization within 180 days after diagnosis of endocarditis was about 68% for the COVID-19 patient, compared to 59% for him without it. Additionally, the risk of death within 180 days of a new diagnosis of endocarditis was 9% for patients with COVID-19 compared to 8% for those without.

“As our long-term scientific understanding of COVID has advanced, we are now able to include endocarditis as one of the long-term effects on critical organ systems in injecting drug users. is one of the first studies to show this,” said Rong Xu, Ph.D., professor of biomedical informatics at Case Western University and co-author of the study. “It is important that we continue to monitor the long-term and widespread effects of COVID-19 on drug users.”

For more information about substance and mental health treatment programs in your area, please contact us via a free and confidential phone call. national helpline 1-800-662-HELP (4357) or visit www.FindTreatment.gov.

About the National Institute on Drug Abuse (NIDA): NIDA is a component of the National Institutes of Health, US Department of Health and Human Services. NIDA supports most of the world’s research into the health aspects of drug use and addiction. The Institute conducts a wide variety of programs to inform policy, improve practice, and advance addiction science. For more information about NIDA and its programs, please visit: https://www.nida.nih.gov/.

About the National Institutes of Health (NIH):NIH, the United States medical research agency, has 27 laboratories and centers and is part of the US Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.

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