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他汀类药物的使用与新冠病毒肺炎患者有创机械通气风险降低相关:一项初步研究。

Statin Use Is Associated with Decreased Risk of Invasive Mechanical Ventilation in COVID-19 Patients: A Preliminary Study.

作者信息

Song Sophia L, Hays Sarah B, Panton Constance E, Mylona Evangelia K, Kalligeros Markos, Shehadeh Fadi, Mylonakis Eleftherios

机构信息

Infectious Diseases Division, Warren Alpert Medical School of Brown University, Providence, RI 02903, USA.

出版信息

Pathogens. 2020 Sep 17;9(9):759. doi: 10.3390/pathogens9090759.

Abstract

COVID-19 disproportionately affects patients with medical comorbidities such as cardiovascular disease (CVD). Patients with CVD are widely prescribed 3-hydroxy-3-methyl-glutayl-CoA (HMG-CoA) reductase inhibitors (statins), a class of lipid-lowering medications known for their pleiotropic anti-inflammatory and immunomodulatory effects. However, the relationship between statin use and COVID-19 outcomes is not fully understood. In this preliminary study, we explored the association between statin use and severe COVID-19 outcomes in hospitalized patients, including intensive care unit (ICU) admission, the need for invasive mechanical ventilation (IMV), and in-hospital death. We performed a retrospective cohort study of 249 patients hospitalized with COVID-19 from 3 March 2020 to 10 April 2020 in Rhode Island, USA. Patient demographics, past medical history, current medications, and hospital course were recorded and analyzed. A multivariate logistic regression analysis was conducted to examine associations. After adjusting for age, sex, race, cardiovascular disease, chronic pulmonary disease, diabetes, and obesity, statin use was significantly associated with decreased risk for IMV (adjusted Odds Ratio (aOR) = 0.45, 95% Confidence Interval (CI): 0.20-0.99). Our results support the continued use of statins among COVID-19 patients and could have implications for future prospective studies on the management of COVID-19.

摘要

新冠病毒病(COVID-19)对患有心血管疾病(CVD)等合并症的患者影响尤为严重。心血管疾病患者广泛使用3-羟基-3-甲基戊二酰辅酶A(HMG-CoA)还原酶抑制剂(他汀类药物),这是一类降脂药物,以其多效抗炎和免疫调节作用而闻名。然而,他汀类药物的使用与COVID-19结局之间的关系尚未完全明确。在这项初步研究中,我们探讨了他汀类药物的使用与住院患者严重COVID-19结局之间的关联,包括入住重症监护病房(ICU)、有创机械通气(IMV)需求和院内死亡。我们对2020年3月3日至2020年4月10日在美国罗德岛州因COVID-19住院的249例患者进行了一项回顾性队列研究。记录并分析了患者的人口统计学特征、既往病史、当前用药情况和住院病程。进行了多因素逻辑回归分析以检验关联。在调整年龄、性别、种族、心血管疾病、慢性肺病、糖尿病和肥胖因素后,他汀类药物的使用与IMV风险降低显著相关(调整后比值比(aOR)=0.45,95%置信区间(CI):0.20-0.99)。我们的结果支持COVID-19患者继续使用他汀类药物,并且可能对未来关于COVID-19管理的前瞻性研究产生影响。

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