tetano
Editor, Senior Moderator
Open Forum Infect Dis
. 2022 Mar 29;9(5)
fac156.
doi: 10.1093/ofid/ofac156. eCollection 2022 May.
Screening Large Population Health Databases for Potential Coronavirus Disease 2019 Therapeutics: A Pharmacopeia-Wide Association Study of Commonly Prescribed Medications
Derek R MacFadden[SUP] 1 2 [/SUP], Kevin Brown[SUP] 2 3 4 [/SUP], Sarah A Buchan[SUP] 2 3 4 [/SUP], Hannah Chung[SUP] 2 [/SUP], Rob Kozak[SUP] 5 6 [/SUP], Jeffrey C Kwong[SUP] 2 3 4 7 [/SUP], Doug Manuel[SUP] 1 2 [/SUP], Samira Mubareka[SUP] 5 6 [/SUP], Nick Daneman[SUP] 2 4 5 6 [/SUP]
Affiliations
Abstract
Background: For both the current and future pandemics, there is a need for high-throughput drug screening methods to identify existing drugs with potential preventive and/or therapeutic activity. Epidemiologic studies could complement laboratory-focused efforts to identify possible therapeutic agents.
Methods: We performed a pharmacopeia-wide association study (PWAS) to identify commonly prescribed medications and medication classes that are associated with the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in older individuals (≥65 years) in long-term care homes (LTCHs) and the community, between 15 January 2020 and 31 December 2020, across the province of Ontario, Canada.
Results: A total of 26 121 cases and 2 369 020 controls from LTCHs and the community were included in this analysis. Many of the drugs and drug classes evaluated did not yield significant associations with SARS-CoV-2 detection. However, some drugs and drug classes appeared to be significantly associated with reduced SARS-CoV-2 detection, including cardioprotective drug classes such as statins (weighted odds ratio [OR], 0.91; standard P < .01, adjusted P < .01) and β-blockers (weighted OR, 0.87; standard P < .01, adjusted P = .01), along with individual agents ranging from levetiracetam (weighted OR, 0.70; standard P < .01, adjusted P < .01) to fluoxetine (weighted OR, 0.86; standard P = .013, adjusted P = .198) to digoxin (weighted OR, 0.89; standard P < .01, adjusted P = .02).
Conclusions: Using this epidemiologic approach, which can be applied to current and future pandemics, we have identified a variety of target drugs and drug classes that could offer therapeutic benefit in coronavirus disease 2019 (COVID-19) and may warrant further validation. Some of these agents (eg, fluoxetine) have already been identified for their therapeutic potential.
Keywords: COVID-19; SARS-CoV-2; case-control; drug screening; epidemiology.
. 2022 Mar 29;9(5)
fac156.doi: 10.1093/ofid/ofac156. eCollection 2022 May.
Screening Large Population Health Databases for Potential Coronavirus Disease 2019 Therapeutics: A Pharmacopeia-Wide Association Study of Commonly Prescribed Medications
Derek R MacFadden[SUP] 1 2 [/SUP], Kevin Brown[SUP] 2 3 4 [/SUP], Sarah A Buchan[SUP] 2 3 4 [/SUP], Hannah Chung[SUP] 2 [/SUP], Rob Kozak[SUP] 5 6 [/SUP], Jeffrey C Kwong[SUP] 2 3 4 7 [/SUP], Doug Manuel[SUP] 1 2 [/SUP], Samira Mubareka[SUP] 5 6 [/SUP], Nick Daneman[SUP] 2 4 5 6 [/SUP]
Affiliations
- PMID: 35531374
- PMCID: PMC8992242
- DOI: 10.1093/ofid/ofac156
Abstract
Background: For both the current and future pandemics, there is a need for high-throughput drug screening methods to identify existing drugs with potential preventive and/or therapeutic activity. Epidemiologic studies could complement laboratory-focused efforts to identify possible therapeutic agents.
Methods: We performed a pharmacopeia-wide association study (PWAS) to identify commonly prescribed medications and medication classes that are associated with the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in older individuals (≥65 years) in long-term care homes (LTCHs) and the community, between 15 January 2020 and 31 December 2020, across the province of Ontario, Canada.
Results: A total of 26 121 cases and 2 369 020 controls from LTCHs and the community were included in this analysis. Many of the drugs and drug classes evaluated did not yield significant associations with SARS-CoV-2 detection. However, some drugs and drug classes appeared to be significantly associated with reduced SARS-CoV-2 detection, including cardioprotective drug classes such as statins (weighted odds ratio [OR], 0.91; standard P < .01, adjusted P < .01) and β-blockers (weighted OR, 0.87; standard P < .01, adjusted P = .01), along with individual agents ranging from levetiracetam (weighted OR, 0.70; standard P < .01, adjusted P < .01) to fluoxetine (weighted OR, 0.86; standard P = .013, adjusted P = .198) to digoxin (weighted OR, 0.89; standard P < .01, adjusted P = .02).
Conclusions: Using this epidemiologic approach, which can be applied to current and future pandemics, we have identified a variety of target drugs and drug classes that could offer therapeutic benefit in coronavirus disease 2019 (COVID-19) and may warrant further validation. Some of these agents (eg, fluoxetine) have already been identified for their therapeutic potential.
Keywords: COVID-19; SARS-CoV-2; case-control; drug screening; epidemiology.