ArticleBMC medicine2021
Relation of severe COVID-19 to polypharmacy and prescribing of psychotropic drugs: the REACT-SCOT case-control study.
Article in BMC medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 8 of them syntheses that pooled it.
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Who cites it
42 citing papers in PubMed, 8 syntheses or guidelines pooled it, 60 citations in OpenAlex.
- Clinical and immunological comparison of COVID-19 disease between critical and non-critical courses: a systematic review and meta-analysis.Frontiers in immunology · 2024Pooled it
- Psychotropic drug repurposing for COVID-19: A Systematic Review and Meta-Analysis.European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology · 2023Pooled it
- Prevalence of NSAID use among people with COVID-19 and the association with COVID-19-related outcomes: Systematic review and meta-analysis.British journal of clinical pharmacology · 2022Pooled it
- The effect of antidepressants on the severity of COVID-19 in hospitalized patients: A systematic review and meta-analysis.PloS one · 2022Pooled it
- Risk of SARS-CoV-2 Infection and COVID-19 Severity Associated With Exposure to Nonsteroidal Anti-Inflammatory Drugs: Systematic Review and Meta-Analysis.Journal of clinical pharmacology · 2021Pooled it
- Mental disorders and risk of COVID-19-related mortality, hospitalisation, and intensive care unit admission: a systematic review and meta-analysis.The lancet. Psychiatry · 2021Pooled it
- Proton pump inhibitor use is associated with increased risk of severity and mortality from coronavirus disease 2019 (COVID-19) infection.Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver · 2020Pooled it
- Polypharmacy among COVID-19 patients: A systematic review.Journal of the American Pharmacists Association : JAPhAPooled it
- Non-steroidal anti-inflammatory drugs and clinical outcomes in patients with COVID-19.Frontiers in cellular and infection microbiology · 2022Trial
- A Population-Based Cross-Sectional Investigation of COVID-19 Hospitalizations and Mortality Among Autistic People.Journal of autism and developmental disorders · 2026Article
- Adherence to Antipsychotics, COVID-19 and Stigma: A Rainbow After the Storm?Actas espanolas de psiquiatria · 2025Article
- COVID-19 in the years 2020 to 2022 in Germany: effects of comorbidities and co-medications based on a large-scale database analysis.BMC public health · 2025Article
- Association of Polypharmacy and Burden of Comorbidities on COVID-19 Adverse Outcomes in People with Type 1 or Type 2 Diabetes.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2025Article
- Polypharmacy or potentially inappropriate medications among older adults with COVID-19 in a secondary hospital in China and their association with mortality.Scientific reports · 2025Article
- Aripiprazole as protector against COVID-19 mortality.Scientific reports · 2024Article
- Article
- Understanding covid-19 outcomes among people with intellectual disabilities in England.BMC public health · 2023Article
- A retrospective analysis of clinical outcomes between hospitalized patients with COVID-19 who received famotidine or pantoprazole.JGH open : an open access journal of gastroenterology and hepatology · 2023Article
- Effect of Previous Anticoagulant Treatment on Risk of COVID-19.Drug safety · 2023Article
- The health informatics centre: a safe haven and trusted research environment enabling world-leading research.International journal of population data science · 2023Article
Corrections and comments
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Authors and funding
18 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe objective of this study was to investigate the relation of severe COVID-19 to prior drug prescribing.
methodsSevere cases were defined by entry to critical care or fatal outcome. For this matched case-control study (REACT-SCOT), all 4251 cases of severe COVID-19 in Scotland since the start of the epidemic were matched for age, sex and primary care practice to 36,738 controls from the population register. Records were linked to hospital discharges since June 2015 and dispensed prescriptions issued in primary care during the last 240 days.
resultsSevere COVID-19 was strongly associated with the number of non-cardiovascular drug classes dispensed. This association was strongest in those not resident in a care home, in whom the rate ratio (95% CI) associated with dispensing of 12 or more drug classes versus none was 10.8 (8.8, 13.3), and in those without any of the conditions designated as conferring increased risk of COVID-19. Of 17 drug classes postulated at the start of the epidemic to be "medications compromising COVID", all were associated with increased risk of severe COVID-19 and these associations were present in those without any of the designated risk conditions. The fraction of cases in the population attributable to exposure to these drug classes was 38%. The largest effect was for antipsychotic agents: rate ratio 4.18 (3.42, 5.11). Other drug classes with large effects included proton pump inhibitors (rate ratio 2.20 (1.72, 2.83) for = 2 defined daily doses/day), opioids (3.66 (2.68, 5.01) for = 50 mg morphine equivalent/day) and gabapentinoids. These associations persisted after adjusting for covariates and were stronger with recent than with non-recent exposure.
conclusionsSevere COVID-19 is associated with polypharmacy and with drugs that cause sedation, respiratory depression, or dyskinesia; have anticholinergic effects; or affect the gastrointestinal system. These associations are not easily explained by co-morbidity. Measures to reduce the burden of mortality and morbidity from COVID-19 should include reinforcing existing guidance on reducing overprescribing of these drug classes and limiting inappropriate polypharmacy. REGISTRATION: ENCEPP number EUPAS35558.
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