Acute COVID-19 Infection Impact on Patients Receiving Opiate Agonist Treatment with Methadone

Abstract

Background: During the COVID-19 epidemic in Georgia, to control the infection and prevent further spread of the SARS-CoV-2 virus among methadone replacement therapy (MRT) users, the State program with methadone for opioid drug addiction has been implemented since 2009, and in March 2020, switched to the take-home dose regimen countrywide. Objectives: This study aimed to determine the morbidity and mortality rates of COVID-19 in MRT recipients from March 2020 to July 2022. Methods: A case series study was conducted in the country. A retrospective analysis of COVID-19 surveillance data was performed. Study subjects were selected based on the following criteria: age between 21 and 65, male gender, MRT recipient for at least three months, and laboratory-confirmed (positive PCR test for SARS-CoV-2 virus antigen) COVID-19 infection. Descriptive statistics were applied to the study results. Results: The study results showed that the incidence of COVID-19 was increasing among MRT recipients over the pandemic years, ranging from 58.6 per 10,000 in 2020 to 30.6 per 10,000 in 2022; however, the number of death cases was rare. By contrast, during the epidemic years, 22 cases of death were reported in MRT users, while in the general population, death cases were frequent, exceeding 2,200. The mortality rate was 1.5 times lower in the study subjects than in the general population. Conclusions: The study findings indicate a high incidence of SARS-CoV-2 viral infection in MRT recipients; however, cases of reinfection, case fatality rates, and mortality rates were lower compared to those in the general population during the COVID-19 pandemic. Further research is required to understand the mechanism of interaction between COVID-19 and methadone, to maintain MRT efficacy and control and manage COVID-19 and similar severe respiratory infections in MRT recipients.