AUTHOR=Li Shilong , Jun Tomi , Tyler Jonathan , Schadt Emilio , Kao Yu-Han , Wang Zichen , Konig Maximilian F. , Bettegowda Chetan , Vogelstein Joshua T. , Papadopoulos Nickolas , Parsons Ramon E. , Chen Rong , Schadt Eric E. , Li Li , Oh William K. 

TITLE=Inpatient Administration of Alpha-1-Adrenergic Receptor Blocking Agents Reduces Mortality in Male COVID-19 Patients

JOURNAL=Frontiers in Medicine

VOLUME=Volume 9 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2022.849222

DOI=10.3389/fmed.2022.849222

ISSN=2296-858X

ABSTRACT=<p>Apha-1-adrenergic receptor antagonists (α<sub>1</sub>-blockers) can suppress pro-inflammatory cytokines, thereby potentially improving outcomes among patients with COVID-19. Accordingly, we evaluated the association between α<sub>1</sub>-blocker exposure (before or during hospitalization) and COVID-19 in-hospital mortality. We identified 2,627 men aged 45 or older who were admitted to Mount Sinai hospitals with COVID-19 between February 24 and May 31, 2020, in New York. Men exposed to α<sub>1</sub>-blockers (<italic>N</italic> = 436) were older (median age 73 vs. 64 years, <italic>P</italic> &lt; 0.001) and more likely to have comorbidities than unexposed men (<italic>N</italic> = 2,191). Overall, 777 (29.6%) patients died in hospital, and 1,850 (70.4%) were discharged. Notably, we found that α<sub>1</sub>-blocker exposure was independently associated with improved in-hospital mortality in a multivariable logistic analysis (OR 0.699; 95% CI, 0.498-0.982; <italic>P</italic> = 0.039) after adjusting for patient demographics, comorbidities, and baseline vitals and labs. The protective effect of α<sub>1</sub>-blockers was stronger among patients with documented inpatient exposure to α<sub>1</sub>-blockers (OR 0.624; 95% CI 0.431-0.903; <italic>P</italic> = 0.012). Finally, age-stratified analyses suggested variable benefit from inpatient α<sub>1</sub>-blocker across age groups: Age 45-65 OR 0.483, 95% CI 0.216-1.081 (<italic>P</italic> = 0.077); Age 55-75 OR 0.535, 95% CI 0.323-0.885 (<italic>P</italic> = 0.015); Age 65-89 OR 0.727, 95% CI 0.484-1.092 (<italic>P</italic> = 0.124). Taken together, clinical trials to assess the therapeutic value of α<sub>1</sub>-blockers for COVID-19 complications are warranted.</p>