Skip to main navigation menu Skip to main content Skip to site footer
##common.pageHeaderLogo.altText##

Original article

Vol. 152 No. 0102 (2022)

High SARS-CoV-2 seroprevalence but no severe course of COVID-19 disease among people on opioid agonist treatment in Zurich: a cross-sectional study

  • Philip Bruggmann
  • Oliver Senn
  • Anja Frei
  • Milo A. Puhan
  • Jan Fehr
  • Luis Falcato
DOI
https://doi.org/10.4414/SMW.2022.w30122
Cite this as:
Swiss Med Wkly. 2022;152:w30122
Published
12.01.2022

Summary

BACKGROUND AND AIMS: Among people on opioid agonist treatment (OAT), social-environmental and behavioural risk factors may promote the spread of SARS-CoV-2, and somatic comorbidities are highly prevalent. Thus, this population is considered at elevated risk for being infected as well as for developing a more severe course of COVID-19 disease. The aim was to assess the SARS-CoV-2 seroprevalence among people in ongoing OAT, to explore whether the antibody positive group differed from the antibody negative group, and to compare the SARS-CoV-2 seroprevalence among OAT patients with the prevalence in the regional general population.

METHODS: The nationwide Corona Immunitas study assessed the participants’ Sars-CoV-2 antibody status, social characteristics and behavioural data after the first wave of the corona pandemic in Switzerland, between the end of June and beginning of September 2020. We analysed the subsample of OAT patients (n = 122) and the subsample from the general population of the canton of Zurich (n = 472).

RESULTS: SARS-CoV-2 seroprevalence in the general population (mean age ± standard deviation 44.7 ± 11.7 years; 50.9% female) was 3.5% (95% confidence interval [CI] 2.2–4.8%) vs 9.8% (5.1–17.2%) in the OAT population age 44.3 ± 9.4 years; 30.3% female), corresponding to a prevalence ratio of 2.9 (95% CI 1.37–5.94; p = 0.004). OAT patients had a significantly worse health status than the general population. In the OAT group, we found no significant difference between seropositive and seronegative individuals regarding socioeconomic status, risk behaviour, COVID-19-related symptoms or comorbidity. None of the OAT patients who tested positive had a severe course of COVID-19.

CONCLUSION: The 3-fold higher seroprevalence suggests a higher than average viral exposure in the OAT group. Nevertheless, no severe COVID-19 course occurred, although the number of study participants was relatively small. One possible reason for this could be possible cross-immunity to SARS-CoV-2 due to frequent viral contacts in OAT patients. 

ISRCTN Registry: http://www.isrctn.com/ISRCTN18181860

References

  1. Gmel G, Labhart F, Maffli E. Heroingestützte Behandlung in der Schweiz – Resultate der Erhebung 2018 (Forschungsbericht Nr. 108). Lausanne: Sucht Schweiz; 2019.
  2. Labhart FK, Maffli E. Nationale Statistik der Substitutionsbehandlungen mit Opioid-Agonisten – Ergebnisse 2018. Lausanne: Sucht Schweiz; 2019.
  3. Maffli EE, Delgrande Jordan M, Labhart F, Gmel G, Kretschmann A. act-info Jahresbericht 2018: Suchtberatung und Suchtbehandlung in der Schweiz. Ergebnisse des Monitoringsystems. Bern: Bundesamt für Gesundheit; 2020.
  4. Wang QQ, Kaelber DC, Xu R, Volkow ND. COVID-19 risk and outcomes in patients with substance use disorders: analyses from electronic health records in the United States. Mol Psychiatry. 2021 Jan;26(1):30–9. https://doi.org/10.1038/s41380-020-00880-7
  5. Bech AB, Clausen T, Waal H, Šaltytė Benth J, Skeie I. Mortality and causes of death among patients with opioid use disorder receiving opioid agonist treatment: a national register study. BMC Health Serv Res. 2019 Jul;19(1):440. https://doi.org/10.1186/s12913-019-4282-z
  6. Wittchen HU, Rehm J, Soyka M, Träder A, Mark K, Trautmann S. Der Verlauf und Ausgang von Substitutionspatienten unter den aktuellen Bedingungen der deutschen Substitutionsversorgung nach 6 Jahren. Suchtmed. 2011;13(5):232–46.
  7. Grischott T, Falcato L, Senn O, Puhan MA, Bruggmann P. Chronic obstructive pulmonary disease (COPD) among opioid-dependent patients in agonist treatment. A diagnostic study. Addiction. 2019 May;114(5):868–76. https://doi.org/10.1111/add.14559
  8. Lambert DG. Opioids and the COVID-19 pandemic: does chronic opioid use or misuse increase clinical vulnerability? Br J Anaesth. 2020 Oct;125(4):e382–3. https://doi.org/10.1016/j.bja.2020.07.004
  9. Bruggmann PK, Meyer F, Bäni S, Beck T. Massnahmen zur COVID-19-Prävention in suchtmedizinischen Einrichtungen in Zürich. Suchtmed. 2020;22(4):182–6.
  10. West EA, Anker D, Amati R, Richard A, Wisniak A, Butty A, et al.; Corona Immunitas Research Group. Corona Immunitas: study protocol of a nationwide program of SARS-CoV-2 seroprevalence and seroepidemiologic studies in Switzerland. Int J Public Health. 2020 Dec;65(9):1529–48. https://doi.org/10.1007/s00038-020-01494-0
  11. Health SSoP. What is Corona Immunitas? 2020Available from: https://www.corona-immunitas.ch/en/program/research-program/
  12. Fenwick C, Croxatto A, Coste AT, Pojer F, André C, Pellaton C, et al. Changes in SARS-CoV-2 Antibody Responses Impact the Estimates of Infections in Population-Based Seroprevalence Studies. medRxiv. 2020:2020.07.14.20153536. https://doi.org/10.1101/2020.07.14.20153536
  13. Daly LE. Confidence limits made easy: interval estimation using a substitution method. Am J Epidemiol. 1998 Apr;147(8):783–90. https://doi.org/10.1093/oxfordjournals.aje.a009523
  14. Eagleton M, Stokes S, Fenton F, Keenan E. Does opioid substitution treatment have a protective effect on the clinical manifestations of COVID-19? Comment on Br J Anaesth 2020; 125: e382-3. Br J Anaesth. 2021 Mar;126(3):e114–6. https://doi.org/10.1016/j.bja.2020.11.027
  15. Fenton F, Stokes S, Eagleton M. A cross-section observational study on the seroprevalence of antibodies to COVID-19 in patients receiving opiate agonist treatment. Ir J Med Sci. 2021 Jul; https://doi.org/10.1007/s11845-021-02660-w

Most read articles by the same author(s)

<< < 1 2 3 4 5 > >>