The Effect of Montelukast Treatment on Elderly Patients Diagnosed with COVID-19

Abstract

Background/Aims: The clinical course in COVID-19 patients can vary from asymptomatic cases to acute respiratory distress syndrome (ARDS), respiratory failure and multiorgan dysfunction. Clinical progression is thought to be mainly due to the release of proinflammatory cytokines. The most common symptoms are fever, cough, malaise, and shortness of breath. Montelukast, which is used in the treatment of seasonal allergic rhinitis and asthma, has brought its use in COVID-19 infection due to its anti-inflammatory and cytokine secretion-reducing effect. There are many studies in the literature that montelukast treatment has a positive effect on the prognosis and mortality of COVID-19. However, there are not enough studies evaluating the efficacy of montelukast treatment in elderly patients. The aim of our study is to evaluate the clinical and laboratory efficacy of montelukast treatment in patients aged 60 and over in COVID-19 disease, and to indicate the differences from the studies in the literature. Methods: Our research was planned as a retrospective, single-center, observational study. The medical records of 75 COVID-19 patients aged 60 and over who were hospitalized in the internal medicine clinic of Ankara Bilkent City Hospital between September 2021 and December 2022 were included. Diagnosis of COVID-19 was confirmed with a reverse transcription polymerase chain reaction (RT-PCR) test from nasopharyngeal swab. Results: Clinical findings and results were compared between the patients who received montelukast and the control group. There was no statistically significant difference between the two groups in terms of cough, dyspnea, gastroenteritis and oxygen theraphy requirement. There is no significant difference between the two groups in terms of the need for intensive care unit admission and mortality. The length of hospital stay was compared in both groups, it was 10.88±7.24 days in the control group and 10.51±5.44 days in the montelukast group, and there was no statistically significant difference between the groups. The laboratory parameters of the patients in both groups were compared. The neutrophil count and leukocyte count measured before hospitalization were found to be significantly lower in the patient group receiving montelukast (p=0.022, p=0.016). No significant difference was found in other laboratory parameters. Conclusions: Although montelukast treatment has positive effects on prognosis in COVID-19 disease in the literature, a similar effect was not observed in the population aged 60 and over in our study. We did not find the positive effect of short-term montelukast treatment on the prognosis of patients aged 60 years and older who were hospitalized due to COVID-19. We thought that this was due to the low efficacy of montelukast in the elderly population. Our study is one of the first to examine montelukast therapy in the geriatric population with COVID-19.