The Risk of Infective Endocarditis among COVID-19 Patients with Non-Medical Opioid Use

Patients with opioid use disorder are more likely to get coronavirus disease 2019 (COVID-19). Cardiovascular diseases frequently present in COVID-19 patients and can increase their susceptibility to invasive infectious diseases, such as infective endocarditis (IE). This study examines the difference in IE incidence following COVID-19 diagnosis between individuals with and without non-medical opioid use. De-identified electronic medical records data were retrieved from TriNetX, a web-based database. Patients in the U.S., aged 18-60 years, with a diagnosis of COVID-19 during January 2020 - January 2021 were included in this study. Development of IE was determined within three months after COVID-19 diagnosis. Logistic regression was conducted to estimate the risk of developing IE between COVID-19 patients with and without opioid use after propensity score matching. COVID-19 patients with non-medical opioid use had 6.8 times the risk of developing IE compared with COVID-19 patients without opioid use (95% CI: 5.44, 8.56; p<0.0001) after propensity score matching. Findings suggest a significant risk of IE among COVID-19 patients with a history of non-medical opioid use. It provides objective evidence to account for baseline opioid use in the risk assessment of IE among COVID-19 patients.