Reduced Mortality With Ondansetron Use in SARS-CoV-2-Infected Inpatients

Area of Science:

• Infectious Diseases
• Clinical Pharmacology
• Epidemiology

Background:

• The COVID-19 pandemic spurred extensive clinical trials for various drugs.
• Retrospective analysis of drug use in hospitalized COVID-19 patients is crucial for identifying treatments impacting outcomes.
• Understanding drug effects on mortality and morbidity in COVID-19 is a key research area.

Purpose of the Study:

• To investigate the association between ondansetron use and 30-day all-cause mortality in hospitalized COVID-19 patients.
• To evaluate the impact of ondansetron on length of hospital stay and adverse events.
• To assess if ondansetron influences subsequent SARS-CoV-2 test positivity.

Main Methods:

• A retrospective cohort study included 10,741 patients with SARS-CoV-2 infection.
• Multivariate Cox proportional hazard models were used to compare mortality risk in patients receiving ondansetron.
• Key outcomes measured included 30-day all-cause mortality, hospital stay duration, and adverse events.

Main Results:

• Ondansetron (≥8 mg within 48 hours of admission) was associated with a significantly reduced adjusted hazard ratio for 30-day mortality (0.55 overall, 0.52 in ICU patients).
• Patients receiving ondansetron had shorter hospital stays (9.2 vs 11.6 days) and lower rates of subsequent positive SARS-CoV-2 tests (53.6% vs 75.0%).
• A reduced risk of ischemic cerebral ischemia was also observed in the ondansetron group (3.2% vs 6.1%).

Conclusions:

• Ondansetron use in COVID-19 patients showed a significant association with decreased 30-day mortality and morbidity.
• The findings suggest ondansetron could be a valuable therapeutic option for reducing adverse outcomes in at-risk COVID-19 populations.
• Further confirmation through prospective clinical trials is recommended to validate these promising results.