[Valproic Acid Could Help in the Fight Against COVID-19: a case-control study]

[Article in Spanish]

Oscar Moreno-Pérez^{1

2}, Esperanza Merino³, Jose Manuel Ramos^{4

2}, Juan Carlos Rodríguez^{5

6}, Carmina Diaz^{7

2}, Patricio Mas⁸, Sergio Reus^{3

2}, Rosario Sánchez-Martínez⁹, Vicente Boix^{3

2}, Pablo Chico-Sánchez¹⁰, José Sánchez-Payá¹⁰, Joaquín Portilla^{4

2}

Affiliations

¹ Endocrinology and Nutrition department, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain.
² Clinical Medicine department, Miguel Hernández University, Elche, Spain.
³ Unit of Infectious Diseases, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain.
⁴ Internal Medicine department, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain.
⁵ Microbiology department, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain.
⁶ Miguel Hernández University, Elche, Spain.
⁷ Neurology department, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain.
⁸ Pharmacy department, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain.
⁹ Internal Medicine department, Alicante General University Hospital - Alicante Institute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain.
¹⁰ Preventive department, Alicante General University Hospital - - Alicante Institute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain.

PMID: 35185237
PMCID: PMC8841207
DOI: 10.1016/j.nrl.2022.01.007

[Valproic Acid Could Help in the Fight Against COVID-19: a case-control study]

[Article in Spanish]

Oscar Moreno-Pérez et al. Neurologia. 2022.

. 2022 Feb 14.

doi: 10.1016/j.nrl.2022.01.007. Online ahead of print.

Authors

Affiliations

¹ Endocrinology and Nutrition department, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain.
² Clinical Medicine department, Miguel Hernández University, Elche, Spain.
³ Unit of Infectious Diseases, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain.
⁴ Internal Medicine department, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain.
⁵ Microbiology department, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain.
⁶ Miguel Hernández University, Elche, Spain.
⁷ Neurology department, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain.
⁸ Pharmacy department, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain.
⁹ Internal Medicine department, Alicante General University Hospital - Alicante Institute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain.
¹⁰ Preventive department, Alicante General University Hospital - - Alicante Institute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain.

PMID: 35185237
PMCID: PMC8841207
DOI: 10.1016/j.nrl.2022.01.007

Abstract

Objective: There is early evidence about Valproic acid (VPA) antiviral effect. Our aim was to investigate the incidence and severity of SARS-CoV-2 infection in VPA users as compared with the general population.

Material and methods: A case-control study nested within a cohort, carried out between March 1 and December 17, 2020. Retrospectively, we identified confirmed SARS-CoV-2 infection patients exposed to VPA in our health department (defined as case). We ascertained VPA regimen (all the time (AT) (292 days) or at least 20% of the study period (notAT) (≥58 days) and if VPA levels were in therapeutic range (ATR) (50–100 mcg/mL) in the last 24 months. We calculated the cumulative incidence of SARS-CoV-2 infection and hospital admission in the cases, comparing it with the general unexposed VPA population (controls).

Results: During the study period, 6183 PCR+ were detected among 281,035 inhabitants, of these, 746 were hospitalized. 691 patients were on VPA notAT and 628 (90.1%) AT. The indication for VPA use was epilepsy in 54.9%. The incidence of PCR+ was 1.736% (OR 0.785 (95%CI 0.443–1.390) and 1.910% (OR 0.865 (95%CI 0.488–1.533), on VPA notAT and VPA AT patients, respectively vs. 2.201% in people without VPA regimen. Those patients with VPA ATR had a lower risk of PCR + (OR 0.233 (95%CI 0.057–0.951) notAT; OR 0.218 (95%CI 0.053–0.890) AT). Hospital admission incidence was lower in patient on VPA (OR was 0.543 (95% CI 0.076–3.871).

Conclusion: Patients with VPA within the therapeutic range had a reduction of SARS-Cov-2 infection incidence greater than 75%. There is a downward trend in the risk of COVID-19 admission by SARS-CoV-2 in patients on VPA therapy. These findings warrant further investigation.

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Figures

**Figure 1**
Flowchart of patients included in the study and clinical outcomes by Valproic acid use.

See this image and copyright information in PMC

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[Valproic Acid Could Help in the Fight Against COVID-19: a case-control study]

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[Valproic Acid Could Help in the Fight Against COVID-19: a case-control study]

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