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Folic acid and methotrexate use and their association with COVID-19 diagnosis and mortality: a case-control analysis

Ruth Topless1, Ralph Green2, Sarah L Morgan3

  • 1Department of Biochemistry, University of Otago, Dunedin, New Zealand.

BMJ Open
|August 24, 2022
PubMed

Insights

Folic acid supplementation was linked to a higher risk of COVID-19 diagnosis and death. Methotrexate prescription did not increase COVID-19 risk and may reduce associated mortality risks.

Area of Science:

  • Epidemiology
  • Pharmacology
  • Infectious Diseases

Background:

  • Folic acid and methotrexate are commonly prescribed medications.
  • Their potential impact on COVID-19 risk and outcomes is not fully understood.

Purpose of the Study:

  • To investigate the association between folic acid or methotrexate prescription and the risk of COVID-19 diagnosis and mortality.

Main Methods:

  • A case-control study using UK Biobank data from over 380,000 participants.
  • Multivariable logistic regression analyzed COVID-19 diagnosis and mortality, adjusting for numerous covariates.

Main Results:

  • Folic acid supplementation was associated with increased COVID-19 diagnosis (OR 1.51) and COVID-19-related death (OR 2.64).
  • Methotrexate prescription, with or without folic acid, was not significantly associated with COVID-19 diagnosis or mortality.

Conclusions:

  • Folic acid supplementation is associated with higher risks of COVID-19 diagnosis and mortality.
  • Methotrexate may potentially mitigate these risks, warranting further investigation.
Abstract

Keywords:
COVID-19epidemiologyrheumatology

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