Abstract
Introduction: With the sequelae of the COVID-19 pandemic, many concerns remain about reinfection and waning immunity against the virus and its variants.
Objective: This study aimed to assess the risk of COVID-19 reinfection and its severe complications in adults treated with long-term opioid therapy (LTOT) for chronic non-cancer pain.
Methods: A retrospective cohort study was conducted using the TriNetX database of over 2,120,701 adults infected by COVID-19 between January 2020 and June 2022. The reinfection was defined as a new COVID-19 infection recorded after at least 30 days after the initial one. Logistic regression was applied to evaluate the probability of reinfection and severe COVID-19 illness (measured by emergence department (ED) visits, hospitalization, intensive care unit (ICU) care, or death) within 30 days of the reinfection, controlled for baseline demographic and comorbid conditions.
Results: The study included 36,265 adults treated with LTOT. Adults on LTOT, compared to those without LTOT, were 2.8 times more likely to have a COVID-19 reinfection, and, after re-infected, were 1.4-1.6 times more likely to be admitted to ED, hospital, and ICU, though no impact was found on a 30-day mortality.
Conclusion: the study findings can help guide clinical decisions about the level of monitoring and care for adults treated with LTOT for chronic non-cancer pain who experience a COVID-19 reinfection. Future prospective research is needed to fully understand the components of risk and optimal risk mitigation strategies of COVID-19 reinfection in adults on LTOT.
