{"doi":"10.1101/2020.12.18.20248346","title":"The Association Between Alpha-1 Adrenergic Receptor Antagonists and In-Hospital Mortality from COVID-19","abstract":"Abstract Effective therapies for coronavirus disease 2019 (COVID-19) are urgently needed, and preclinical data suggest alpha-1 adrenergic receptor antagonists (α 1 -AR antagonists) may be effective in reducing mortality related to hyperinflammation independent of etiology. Using a retrospective cohort design with patients in the Department of Veterans Affairs healthcare system, we use doubly robust regression and matching to estimate the association between baseline use of α 1 -AR antagonists and likelihood of death due to COVID-19 during hospitalization. Having an active prescription for any α 1 -AR antagonist (tamsulosin, silodosin, prazosin, terazosin, doxazosin, or alfuzosin) at the time of admission had a significant negative association with in-hospital mortality (relative risk reduction 18%; odds ratio 0.73; 95% CI 0.63 to 0.85; p ≤ 0.001) and death within 28 days of admission (relative risk reduction 17%; odds ratio 0.74; 95% CI 0.65 to 0.84; p ≤ 0.001). In a subset of patients on doxazosin specifically, an inhibitor of all three alpha-1 adrenergic receptors, we observed a relative risk reduction for death of 74% (odds ratio 0.23; 95% CI 0.03 to 0.94; p = 0.028) compared to matched controls not on any α 1 -AR antagonist at the time of admission. These findings suggest that use of α 1 -AR antagonists may reduce mortality in COVID-19, supporting the need for randomized, placebo-controlled clinical trials in patients with early symptomatic infection.","journal":"medRxiv","year":2020,"id":120388,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":11,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9245,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":557638,"name":"Laura A. Graham","orcid":"0000-0002-7327-3793","position":1,"is_corresponding":false},{"id":270639,"name":"Allison Koenecke","orcid":"0000-0002-6233-8256","position":2,"is_corresponding":false},{"id":270634,"name":"Michael Powell","orcid":"0000-0003-2749-3725","position":3,"is_corresponding":false},{"id":270640,"name":"Ruoxuan Xiong","orcid":"0000-0002-3701-4428","position":4,"is_corresponding":false},{"id":557639,"name":"Zhu Shen","orcid":"0000-0003-4564-5438","position":5,"is_corresponding":false},{"id":2256,"name":"Kenneth W. Kinzler","orcid":"0000-0001-5591-1176","position":6,"is_corresponding":false},{"id":24634,"name":"Chetan Bettegowda","orcid":"0000-0001-9991-7123","position":7,"is_corresponding":false},{"id":2255,"name":"Bert Vogelstein","orcid":"0000-0003-0766-3854","position":8,"is_corresponding":false},{"id":270642,"name":"Susan Athey","orcid":"0000-0001-6934-562X","position":9,"is_corresponding":false},{"id":235162,"name":"Joshua T Vogelstein","orcid":"0000-0003-2487-6237","position":10,"is_corresponding":false},{"id":270633,"name":"Maximilian F. Konig","orcid":"0000-0001-5045-5255","position":11,"is_corresponding":false},{"id":377023,"name":"Todd H. Wagner","orcid":"0000-0001-7625-3504","position":12,"is_corresponding":false},{"id":557637,"name":"Liam Rose","orcid":"0000-0001-7195-2939","position":0,"is_corresponding":true}],"reference_count":24,"raw_metadata":null,"created_at":"2026-07-18T23:14:33.640077Z","pmid":"33398294","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}