“PURPOSE: Marijuana use is becoming increasingly prevalent worldwide, yet the full spectrum of its effects largely remains unknown. Although cannabinoids have immunomodulatory properties, there remains a significant gap in our understanding of the potential impact of marijuana use on COVID-19 outcomes. The purpose of the study is to compare the outcomes of COVID-19 infection on individuals who use marijuana and those who do not.
METHODS: National Inpatient Sample Database was used to sample individuals admitted with the diagnosis of COVID-19. Patients were divided into two groups based on marijuana use. Baseline demographics and comorbidities were collected using ICD-10 codes. Patients with missing data or age under 18 were excluded. Greedy propensity matching using R was performed to match marijuana users to non-users 1:1 on age, race, gender, and 17 other comorbidities including chronic lung disease. Univariate analysis pre- and post-match were performed. Binary logistic regression was performed post-match. A p-value of <0.05 was considered statistically significant.
RESULTS: Out of 322,214 patients included in the study, 2,603 were marijuana users. Marijuana users were younger and had higher prevalence of tobacco use. However, other comorbidities including obstructive sleep apnea, obesity, hypertension, and diabetes mellitus were more prevalent in marijuana non-users. On univariate analysis, marijuana users had significantly lower rates of intubation (6.8% vs 12%), acute respiratory distress syndrome (ARDS) (2.1% vs 6%), acute respiratory failure (25% vs 52.9%) and severe sepsis with multiorgan failure (5.8% vs 12%). They also had lower in-hospital cardiac arrest (1.2% vs 2.7%) and mortality (2.9% vs 13.5%). After 1:1 matching, marijuana users had lower rates of intubation (OR: 0.64 [0.51-0.81]; p<0.01), ARDS (OR: 0.39 [0.26-0.58]; p<0.01), acute respiratory failure (OR: 0.53 [0.47-0.61]; p<0.01), severe sepsis with multiorgan failure (OR: 0.68 [0.52-0.89]; p<0.01) and lower mortality (OR: 0.48 [0.33-0.69]; p<0.01)
CONCLUSIONS: Marijuana smokers had better outcomes and mortality compared to non-users. The beneficial effect of marijuana use may be attributed to its potential to inhibit viral entry into cells and prevent the release of proinflammatory cytokines, thus mitigating cytokine release syndrome.
CLINICAL IMPLICATIONS: The significant decrease in mortality and complications warrants further investigation of the association between marijuana use and COVID-19. Our study highlights a topic of future research for larger trials especially considering the widespread use of marijuana.”
https://journal.chestnet.org/article/S0012-3692(23)02201-8/fulltext