AUTHOR=Rose Liam , Graham Laura , Koenecke Allison , Powell Michael , Xiong Ruoxuan , Shen Zhu , Mench Brett , Kinzler Kenneth W. , Bettegowda Chetan , Vogelstein Bert , Athey Susan , Vogelstein Joshua T. , Konig Maximilian F. , Wagner Todd H. 

TITLE=The Association Between Alpha-1 Adrenergic Receptor Antagonists and In-Hospital Mortality From COVID-19

JOURNAL=Frontiers in Medicine

VOLUME=Volume 8 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2021.637647

DOI=10.3389/fmed.2021.637647

ISSN=2296-858X

ABSTRACT=Effective therapies for coronavirus disease 2019 (COVID-19) are urgently needed, and preclinical data suggest alpha-1 adrenergic receptor antagonists (⍺1-AR antagonists) may be effective in reducing mortality related to hyperinflammation. Using a retrospective cohort design with patients in the Department of Veterans Affairs healthcare system, we use doubly robust regression and matching to estimate the association between use of ⍺1-AR antagonists at time of hospitalization and likelihood of death due to COVID-19 during an inpatient stay. Having an active prescription for an ⍺1-AR antagonist (tamsulosin, silodosin, prazosin, terazosin, doxazosin, or alfuzosin) at the time of admission had a significant negative association with in-hospital mortality (relative risk reduction 14%; odds ratio 0.75; 95% CI 0.66 to 0.86; p < 0.001). These effects were also found in an expanded cohort of suspected COVID-19 patients, supporting the need for clinical trials.