CO-MORBID PAIN SUBSTANCE USE DISORDERS SECTION: Evaluating chronic pain as a risk factor for COVID-19 complications among New York State Medicaid beneficiaries: a retrospective claims analysis

• Published in: Pain medicine (Malden, Mass.) Vol. 24; no. 12; p. 1296
• Main Authors: Perry, Allison, Wheeler-Ma, Terlizzi, Kelly, Krawczyk, Noa, Jent, Victoria, Hasin, Deborah S, Neighbors, Charles, Mannes, Zachary L, Doan, Lisa V, Pamplin, John R., II, Townsend, Tarlise N, Crystal, Stephen, Ma, Cerda, Magdalena
• Format: Journal Article
• Language: English
• Published: Oxford University Press 01.12.2023
• Subjects: Chronic pain; Comorbidity; Complications and side effects; Substance abuse; United States
• ISSN: 1526-2375
• DOI: 10.1093/pm/pnad121

Objective: To assess whether chronic pain increases the risk of COVID-19 complications and whether opioid use disorder (OUD) differentiates this risk among New York State Medicaid beneficiaries. Design, Setting, and Subjects: This was a retrospective cohort study of New York State Medicaid claims data. We evaluated Medicaid claims from March 2019 through December 2020 to determine whether chronic pain increased the risk of COVID-19 emergency department (ED) visits, hospitalizations, and complications and whether this relationship differed by OUD status. We included beneficiaries 18-64years of age with 10months of prior enrollment. Patients with chronic pain were propensity score-matched to those without chronic pain on demographics, utilization, and comorbidities to control for confounders and were stratified by OUD. Complementary log-log regressions estimated hazard ratios (HRs) of COVID-19 ED visits and hospitalizations; logistic regressions estimated odds ratios (ORs) of hospital complications and readmissions within 0-30, 31-60, and 61-90 days. Results: Among 773880 adults, chronic pain was associated with greater hazards of COVID-related ED visits (HR = 1.22 [95% CI: 1.16-1.29]) and hospitalizations (HR = 1.19 [95% CI: 1.12-1.27]). Patients with chronic pain and OUD had even greater hazards of hospitalization (HR = 1.25 [95% CI: 1.07-1.47]) and increased odds of hepatic- and cardiac-related events (OR = 1.74 [95% CI: 1.10-2.74]). Conclusions: Chronic pain increased the risk of COVID-19 ED visits and hospitalizations. Presence of OUD further increased the risk of COVID-19 hospitalizations and the odds of hepatic- and cardiac-related events. Results highlight intersecting risks among a vulnerable population and can inform tailored COVID-19 management. Keywords: chronic pain; COVID-19; Medicaid; claims.