Keywords
The United Nations Office on Drugs and Crime (UNODC) has estimated that there are 16 million opioid users globally (1). Since December 2019, when coronavirus disease 2019 (COVID-19) emerged from Wuhan city and rapidly spread throughout China (2), this disease has many psychiatric aspects (3), and some false beliefs and rumors have been spread in social media and the community regarding the protective effect of opium consumption against COVID-19 (4).
In this regard, our pilot survey in a COVID-19 referral hospital shows that the rate of opium addiction in 93 hospitalized patients was 10.8%, and calculation of the odds ratio for mortality resulted in 3.59 (95% CI, 0.9 - 14.5). The mean age of patients was 56.3 ± 15.2 years old, and 54.8% of patients were male. There was no significant difference (P = 0.503) between addicted males (7 cases, 13.7%) and females (3 cases, 7.1%).
According to our findings, it seems that the rate of mortality in the opium-addicted population is higher than the normal population. In regard to opium consumption, the study of Noori et al. has indicated that 2.4% of 6,027 participants from the general population of Iran’s Capital, Tehran (1), were addicted to opium. Hence, it seems that such people are more susceptible to novel Coronavirus. All these would be due to the lack of personal hygiene, sharing personal accessories, and disregarding social distancing. Nevertheless, this effect on mortality in patients with COVID-19 addicted to opium needs more attention, considering a wide confidence interval.
Moreover, the etiology of mortality in patients with COVID-19 is related to cytokine storm due to elevated levels of Interleukin-6 (IL-6) in these patients (5), which has been investigated by Nabati et al. regarding the effects of opium on cytokine secretion. This study showed elevated levels of IL-6 in plasmas were taken from opium-addicted subjects (6). In conclusion, this claim needs more comprehensive research to be proven; however, society has to pay more attention, which will come true by the health system authorities.
References
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1.
Noori R, Farhoudian A, Naranjiha H, Farhadi MH, Dolan K, Khoddami-Vishteh H. Comparison of Characteristics of Methamphetamine Versus Opiate Users in Tehran, Iran. International Journal of High Risk Behaviors and Addiction. 2016;5(4). https://doi.org/10.5812/ijhrba.28815.
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2.
Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020. [PubMed ID: 32109013]. [PubMed Central ID: PMC7092819]. https://doi.org/10.1056/NEJMoa2002032.
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3.
Zarghami M. Psychiatric Aspects of Coronavirus (2019-nCoV) Infection. Iranian Journal of Psychiatry and Behavioral Sciences. 2020;14(1). https://doi.org/10.5812/ijpbs.102957.
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4.
Etemad. [Cigarettes and opium do not protect against coronavirus infection]. 2020. Persian. Available from: https://www.magiran.com/article/4018916.
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5.
Mehta P, McAuley DF, Brown M, Sanchez E, Tattersall RS, Manson JJ, et al. COVID-19: consider cytokine storm syndromes and immunosuppression. Lancet. 2020;395(10229):1033-4. [PubMed ID: 32192578]. https://doi.org/10.1016/S0140-6736(20)30628-0.
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6.
Nabati S, Asadikaram G, Arababadi MK, Shahabinejad G, Rezaeian M, Mahmoodi M, et al. The plasma levels of the cytokines in opium-addicts and the effects of opium on the cytokines secretion by their lymphocytes. Immunol Lett. 2013;152(1):42-6. [PubMed ID: 23603301]. https://doi.org/10.1016/j.imlet.2013.04.003.