UH Med Now

By Paula Bender, JABSOM News

Early this year, a researcher with the John A. Burns School of Medicine (JABSOM) collaborated with a colleague at the Tianyou Hospital of the Wuhan University of Science and Technology to seek associations between treatments and clinical outcomes with the Corona Virus Disease of 2019 (COVID-19). This may be the first report of the beneficial effect of hypnotics on clinical outcomes in the management of COVID-19 patients.

The study was published on March 25, 2020, in MedRxiv: (https://doi.org/10.1101/2020.03.25.20037721). 

Dr. Youping Deng, Department of Quantitative Health Sciences, JABSOM.

Twenty researchers in teams led by JABSOM’s Dr. Youping Deng and Dr. Ling Hu of Tianyou Hospital reviewed the charts of 323 hospitalized COVID-19 patients admitted from January 8, 2020, through February 20, 20202. 

“Of those 323 patients, 82 or 25% were prescribed Zopiclone, a hypnotic drug used to treat insomnia, at a daily dose of 1mg for the duration of their hospital stay,” Dr. Deng said. 

Of those 82 patients, 77 had better clinical outcomes and were discharged. Of the five patients receiving hypnotics who had unfavorable outcomes, only one died. 

“Favorable outcomes were more prevalent among the patients on hypnotics versus non-hypnotics at the same disease stage,” Dr. Deng added. “For patients in the more severe disease groups, the improvement effect was even more pronounced.” 

In their report, the teams noted that the patients usually showed strong anxiety, sleep deficiency, and oxygen insufficiency with disease progression. These findings suggest that better sleep quality and stress reduction may enhance the immune system and benefit admitted COVID-19 patients receiving hypnotics. 

Aside from treating insomnia, Zopiclone helps the body by promoting autophagy activation, which promotes protection against infections. However, since only about 25% of patients in the study received hypnotics, the investigators note that self-healing may occur without medical intervention in many COVID-19 patients. 

More about the study: 

In analyzing the effect of hypnotics on rRT-PCR*-positive versus rRT-PCR-negative patients (with typical chest CT findings) at the time of diagnosis, hypnotics had a stronger association with improved outcome in the rRT-PCR-positive patients. Moreover, hypnotics were identified as an independent factor in the risk model that contributed to better clinical outcomes (P<0.001), including a better survival rate. 

*rRT-PCR (Real Time Reverse Transcription-Polymerase Chain Reaction) amplifies a specific target sequence in the sample, then monitors the amplification progress using fluorescent technology.