# Association Between Pre-hospital Medication Use and Outcomes in Patients Hospitalized for COVID-19 Pneumonia: A Multicenter Observational Study in the Netherlands

## TL;DR

This study examines how pre-hospital medications affect outcomes for patients with COVID-19 pneumonia in Dutch hospitals.

## Contribution

It identifies specific medications associated with ICU admission and in-hospital mortality in hospitalized COVID-19 patients.

## Key findings

- Anticoagulants, aspirin, and corticosteroids were linked to lower odds of ICU admission.
- Hydroxychloroquine use was associated with increased ICU admission risk.
- Heparin-related medications were tied to higher in-hospital mortality.

## Abstract

Background

Home medication use may influence the clinical trajectory of COVID‑19, yet its association with adverse outcomes such as intensive care unit (ICU) admission and in‑hospital death remains unclear. We aim to explore whether pre-admission use of commonly prescribed medication - anticoagulants, antiplatelet agents, renin-angiotensin-aldosterone system (RAAS) inhibitors, corticosteroids, nonsteroidal anti-inflammatory drugs (NSAIDs), immunosuppressants, hydroxychloroquine, and statins - is associated with ICU admission and in-hospital mortality among adults hospitalized with COVID-19 across three Dutch hospitals.

Methods

We conducted a retrospective analysis using data from three Dutch hospitals containing variables including 22 medications. After recoding variables as factors, we performed descriptive analyses to assess basic associations. We then fitted multivariate logistic regression models correcting for patients' characteristics (age, gender) and disease status (diabetes, hypertension) to identify which medications were significantly associated with ICU admission and death.

Results

Composite variables representing anticoagulants, aspirin, and corticosteroids were independently associated with reduced odds of ICU admission, whereas hydroxychloroquine use was linked to increased risk. In contrast, for in-hospital mortality as an outcome, the use of heparin‑related medications was associated with increased odds of death.

Conclusion

Our observational analysis indicates that pre‑hospitalization medication patterns are significantly associated with COVID‑19 outcomes. While some medication groupings appear protective with respect to ICU admission, others are linked with increased mortality. These findings underscore the importance of further research to disentangle correlation from causation and to guide therapeutic decision‑making in COVID‑19 management.