Study: Substance Use Disorders Do Not Increase Likelihood of COVID-19 Deaths


Increased risk for severe disease in individuals with SUD could be from co-occurring medical conditions, investigators from Boston Medical Center say.

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Substance use disorders (SUDs) were not associated with an increased likelihood of dying from COVID-19, according to the results of a study published in Substance Abuse: Research and Treatment.

Increased risk for severe COVID-19 in individuals with SUD could be from co-occurring medical conditions, investigators said.

“BMC is known for excellent clinical care and innovative research related to [SUD]. Since the early days of the pandemic, BMC has also been a leader in the treatment of individuals with COVID-19, including [individuals] with complex medical and social needs,” Angela McLaughlin, MD, MPH, an infectious disease fellow at BMC, said in a statement.

“These findings showing a similar likelihood of COVID-19-related complications in hospitalized patients with and without SUD helps expand knowledge of the infectious complications of SUD,” she said.

In the study, 14% of the study population had SUD, which exceeded the national average of 10.8% of adults.

Investigators reviewed medical records of 353 individuals without SUD and 56 with SUD who were admitted to BMC early in the COVID-19 pandemic. They compared the likelihood of COVID-19 related complications between individuals with and without SUD.

Additionally, they compared the relationship among COVID-19 and mortality, clinical complications, and resource utilization.

“Early in the pandemic, BMC developed protocols to closely monitor and quickly manage COVID-19-related complications in all hospitalized patients,” Sabrina Assoumou, MD, MPH, an infectious disease doctor at BMC and assistant professor of Medicine at Boston University Chobanian and Avedisian School of Medicine, said in the statement. “The current findings suggest that such an approach might have benefited many patients, including individuals with [SUD].”

In this retrospective cohort study, SUD was not associated with COVID-19-associated inpatient mortality, which was the primary outcome. The secondary analysis also showed that those with and without SUD had similar COVID-19-related clinical complications, which included acute liver injury, cardiac complications, renal failure that required dialysis, secondary infections, venous thromboembolism, and “any complications,” which was the composite.

Investigators also found that some clinical outcomes such as strokes were very uncommon. There was also no difference in resource utilization secondary outcomes between the 2 groups.

By contrast, investigators found the similar likelihood of mechanical ventilation and intensive care unit admission of individuals with and without SUD. Although individuals with SUD presented to the hospital earlier, their total number of hospitalizations was similar to individuals without SUD.

The clinical complications and resource utilization patterns of individuals with COVID-19 and SUD can help physicians with the trajectory of infection and determine health care needs of this group, investigators said.

Additional studies are needed to further evaluate the differential outcomes in this high-risk population, according to investigators.

Limitations of the study included that the cohort was from a single site, which could limit generalizability to other areas, even though the cohort was ethnically and racially diverse. The data were also from the earliest phase of the COVID-19 pandemic, so trends might be different over time.


Substance use disorders do not increase the likelihood of COVID-19 deaths. News release. EurekAlert. March 24, 2023. Accessed March 24, 2023.

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