Dataset Information

Association of ?1-Blocker Receipt With 30-Day Mortality and Risk of Intensive Care Unit Admission Among Adults Hospitalized With Influenza or Pneumonia in Denmark.

ABSTRACT:

Importance

Alpha 1-adrenergic receptor blocking agents (?1-blockers) have been reported to have protective benefits against hyperinflammation and cytokine storm syndrome, conditions that are associated with mortality in patients with coronavirus disease 2019 and other severe respiratory tract infections. However, studies of the association of ?1-blockers with outcomes among human participants with respiratory tract infections are scarce.

Objective

To examine the association between the receipt of ?1-blockers and outcomes among adult patients hospitalized with influenza or pneumonia.

Design, setting, and participants

This population-based cohort study used data from Danish national registries to identify individuals 40 years and older who were hospitalized with influenza or pneumonia between January 1, 2005, and November 30, 2018, with follow-up through December 31, 2018. In the main analyses, patients currently receiving ?1-blockers were compared with those not receiving ?1-blockers (defined as patients with no prescription for an ?1-blocker filled within 365 days before the index date) and those currently receiving 5?-reductase inhibitors. Propensity scores were used to address confounding factors and to compute weighted risks, absolute risk differences, and risk ratios. Data were analyzed from April 21 to December 21, 2020.

Exposures

Current receipt of ?1-blockers compared with nonreceipt of ?1-blockers and with current receipt of 5?-reductase inhibitors.

Main outcomes and measures

Death within 30 days of hospital admission and risk of intensive care unit (ICU) admission.

Results

A total of 528?467 adult patients (median age, 75.0 years; interquartile range, 64.4-83.6 years; 273?005 men [51.7%]) were hospitalized with influenza or pneumonia in Denmark between 2005 and 2018. Of those, 21?772 patients (4.1%) were currently receiving ?1-blockers compared with a population of 22?117 patients not receiving ?1-blockers who were weighted to the propensity score distribution of those receiving ?1-blockers. In the propensity score-weighted analyses, patients receiving ?1-blockers had lower 30-day mortality (15.9%) compared with patients not receiving ?1-blockers (18.5%), with a corresponding risk difference of -2.7% (95% CI, -3.2% to -2.2%) and a risk ratio (RR) of 0.85 (95% CI, 0.83-0.88). The risk of ICU admission was 7.3% among patients receiving ?1-blockers and 7.7% among those not receiving ?1-blockers (risk difference, -0.4% [95% CI, -0.8% to 0%]; RR, 0.95 [95% CI, 0.90-1.00]). A comparison between 18?280 male patients currently receiving ?1-blockers and 18?228 propensity score-weighted male patients currently receiving 5?-reductase inhibitors indicated that those receiving ?1-blockers had lower 30-day mortality (risk difference, -2.0% [95% CI, -3.4% to -0.6%]; RR, 0.89 [95% CI, 0.82-0.96]) and a similar risk of ICU admission (risk difference, -0.3% [95% CI, -1.4% to 0.7%]; RR, 0.96 [95% CI, 0.83-1.10]).

Conclusions and relevance

This cohort study's findings suggest that the receipt of ?1-blockers is associated with protective benefits among adult patients hospitalized with influenza or pneumonia.

SUBMITTER: Thomsen RW

PROVIDER: S-EPMC7876591 | biostudies-literature | 2021 Feb

REPOSITORIES: biostudies-literature

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Publications

Association of α1-Blocker Receipt With 30-Day Mortality and Risk of Intensive Care Unit Admission Among Adults Hospitalized With Influenza or Pneumonia in Denmark.

Thomsen Reimar W RW Christiansen Christian Fynbo CF Heide-Jørgensen Uffe U Vogelstein Joshua T JT Vogelstein Bert B Bettegowda Chetan C Tamang Suzanne S Athey Susan S Sørensen Henrik Toft HT

JAMA network open 20210201 2

<h4>Importance</h4>Alpha 1-adrenergic receptor blocking agents (α1-blockers) have been reported to have protective benefits against hyperinflammation and cytokine storm syndrome, conditions that are associated with mortality in patients with coronavirus disease 2019 and other severe respiratory tract infections. However, studies of the association of α1-blockers with outcomes among human participants with respiratory tract infections are scarce.<h4>Objective</h4>To examine the association betwee ...[more]

PMID: 33566109

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