Association between Functional Inhibitors of Acid Sphingomyelinase (FIASMAs) and Reduced Risk of Death in COVID-19 Patients: A Retrospective Cohort Study

Gil Darquennes; Pascal Le Corre; Olivier Le Moine; Gwenolé Loas

doi:10.3390/ph14030226

Association between Functional Inhibitors of Acid Sphingomyelinase (FIASMAs) and Reduced Risk of Death in COVID-19 Patients: A Retrospective Cohort Study

Pharmaceuticals (Basel). 2021 Mar 7;14(3):226. doi: 10.3390/ph14030226.

Authors

Gil Darquennes^{1

2}, Pascal Le Corre^{3

4

5}, Olivier Le Moine⁶, Gwenolé Loas^{1

2}

Affiliations

¹ Department of Psychiatry, Hôpital Erasme, Université libre de Bruxelles (ULB), 1050 Brussels, Belgium.
² Research Unit (ULB 266), Hôpital Erasme, Université libre de Bruxelles (ULB), 1050 Brussels, Belgium.
³ Pôle Pharmacie, Service Hospitalo-Universitaire de Pharmacie, CHU de Rennes, 35033 Rennes, France.
⁴ Irset (Institut de Recherche en Santé, Environnement et Travail)-UMR_S 1085, University of Rennes, CHU Rennes, INSERM, EHESP, 35000 Rennes, France.
⁵ Laboratoire de Biopharmacie et Pharmacie Clinique, Faculté de Pharmacie, Université de Rennes 1, 35043 Rennes, France.
⁶ Department of Medical Gastro-Enterology, Hôpital Erasme, Université libre de Bruxelles (ULB), 1050 Brussels, Belgium.

Abstract

Given the current scarcity of curative treatment of COVID-19, the search for an effective treatment modality among all available medications has become a priority. This study aimed at investigating the role of functional inhibitors of acid sphingomyelinase (FIASMAs) on in-hospital COVID-19 mortality. In this retrospective cohort study, we included adult in-patients with laboratory-confirmed COVID-19 between 1 March 2020 and 31 August 2020 with definite outcomes (discharged hospital or deceased) from Erasme Hospital (Brussels, Belgium). We used univariate and multivariate logistic regression models to explore the risk factors associated with in-hospital mortality. We included 350 patients (205 males, 145 females) with a mean age of 63.24 years (SD = 17.4, range: 21-96 years). Seventy-two patients died in the hospital and 278 were discharged. The four most common comorbidities were hypertension (184, 52.6%), chronic cardiac disease (110, 31.4%), obesity (96, 27.8%) and diabetes (95, 27.1%). Ninety-three participants (26.6%) received a long-term prescription for FIASMAs. Among these, 60 (64.5%) received amlodipine. For FIASMAs status, multivariable regression showed increasing odds ratio (OR) for in-hospital deaths associated with older age (OR 1.05, 95% CI: 1.02-1.07; p = 0.00015), and higher prevalence of malignant neoplasm (OR 2.09, 95% CI: 1.03-4.22; p = 0.039). Nonsignificant decreasing OR (0.53, 95% CI: 0.27-1.04; p = 0.064) was reported for FIASMA status. For amlodipine status, multivariable regression revealed increasing OR of in-hospital deaths associated with older age (OR 1.04, 95% CI: 1.02-1.07; p = 0.0009), higher prevalence of hypertension (OR 2.78, 95% CI: 1.33-5.79; p = 0.0062) and higher prevalence of malignant neoplasm (OR 2.71, 95% CI: 1.23-5.97; p = 0.013), then secondarily decreasing OR of in-hospital death associated with long-term treatment with amlodipine (OR 0.24, 95% CI: 0.09-0.62; p = 0.0031). Chronic treatment with amlodipine could be significantly associated with low mortality of COVID-19 in-patients.

Keywords: SARS-CoV-2; amlodipine; functional inhibitors of acid sphingomyelinase (FIASMAs), COVID-19; mortality.