부산대학교 도서관

Introduction: Literature has shown that calcium metabolism mediates the body’s defense against viral pathogens. In particular, studies have found SARS-CoV-2 to use calcium to assist entry and replication in host cells.Hypothesis: The use of CCBs are associated with decreased mortality and hospitalization in SARS-CoV-2 positive patients.Methods: A retrospective chart review of patients 18 years and older with a positive SARS-CoV-2 polymerase chain reaction test between March 2020 and April 2021. Patients were categorized based on their use and non-use of CCB. The primary outcomes were all-cause mortality and hospitalization. Secondary outcomes were acute kidney injury, hypotension, intubation, myocardial infarction, systolic heart failure, ventricular tachycardia (VT), and ventricular fibrillation (VF). Multivariate logistic regression was used to adjust for baseline characteristics.Results: We identified 1,402 patients taking CCB and 21,674 patients not taking CCB who tested positive for SARS- CoV-2. The baseline characteristic incidence was 370 (26.4%) for coronary artery disease, 262 (18.7%) for heart failure, 1402 (100%) for hypertension in patients taking CCBs. Secondary outcome incidence was 85 (6.1%) for myocardial infarction, 257 (18.3%) for hypotension, and 100 (7.1%) for systolic heart failure in patients taking CCBs. After adjusting for comorbidities using logistic regression, OR was 0.605 (95% Confidence Interval [CI]: 0.519-0.705; p < 0.001) for all-cause mortality, and 27.641 (95% CI: 24.396-31.319; p<0.001) for hospitalization rate. The CCB group had significantly decreased adjusted OR for all secondary outcomes (p<0.001) except for VT (p<0.425) and VF (p <1.00).Conclusions: The incidence of cardiovascular outcomes and baseline cardiovascular risk factors were significantly greater in SARS-CoV-2 positive patients taking CCB. SARS-CoV-2 positive patients in the CCB group were associated with decreased all-cause mortality, myocardial infarction, and systolic heart failure. However, the CCB group had a significantly increased association with hospitalization. Therefore, when indicated, clinicians should consider using CCB in SARS-CoV-2 patients, especially those with cardiovascular risk factors.