Korean Society of Hypertension (H.-Y.L., W.B.P.).
Department of Internal Medicine, Seoul National University College of Medicine, Korea (H.-Y.L., M.-d.O.).
Arterioscler Thromb Vasc Biol. 2021 Mar;41(3):e175-e182. doi: 10.1161/ATVBAHA.120.315551. Epub 2021 Feb 4.
Although statins are widely prescribed lipid-lowering drugs, there are concerns about the safety of their use in the context of coronavirus disease 2019 (COVID-19), since statins increase the expression of ACE2 (angiotensin-converting enzyme 2). This study aimed to disclose the association between statins and 60-day COVID-19 mortality. Approach and Results: All patients hospitalized with laboratory-confirmed COVID-19 were enrolled in this study from January 19 to April 16, 2020, in Korea. We evaluated the association between the use of statins and COVID-19-related mortality in the overall and the nested 1:2 propensity score-matched study. Furthermore, a comparison of the hazard ratio for death was performed between COVID-19 patients and a retrospective cohort of patients hospitalized with pneumonia between January and June 2019 in Korea. The median age of the 10 448 COVID-19 patients was 45 years. Statins were prescribed in 533 (5.1%) patients. After adjusting for age, sex, and comorbidities, Cox regression showed a significant decrease in hazard ratio associated with the use of statins (hazard ratio, 0.637 [95% CI, 0.425-0.953]; =0.0283). Moreover, on comparing the hazard ratio between COVID-19 patients and the retrospective cohort of hospitalized pneumonia patients, the use of statins showed similar benefits.
The use of statins correlates significantly with lower mortality in patients with COVID-19, consistent with the findings in patients with pneumonia. Graphic Abstract: A graphic abstract is available for this article.
尽管他汀类药物被广泛用于降脂治疗,但由于他汀类药物会增加 ACE2(血管紧张素转换酶 2)的表达,因此人们对其在 2019 年冠状病毒病(COVID-19)背景下使用的安全性存在担忧。本研究旨在揭示他汀类药物与 COVID-19 患者 60 天死亡率之间的关联。
本研究于 2020 年 1 月 19 日至 4 月 16 日期间在韩国,纳入所有经实验室确诊的 COVID-19 住院患者。我们评估了他汀类药物的使用与 COVID-19 相关死亡率之间的关系,包括总体研究和嵌套的 1:2 倾向评分匹配研究。此外,还比较了 COVID-19 患者与 2019 年 1 月至 6 月期间韩国因肺炎住院的回顾性队列患者的死亡风险比。10448 例 COVID-19 患者的中位年龄为 45 岁,533 例(5.1%)患者接受了他汀类药物治疗。在调整年龄、性别和合并症后,Cox 回归显示,使用他汀类药物与降低死亡风险比显著相关(风险比,0.637[95%CI,0.425-0.953];=0.0283)。此外,在比较 COVID-19 患者与回顾性肺炎住院患者队列的风险比时,他汀类药物的使用显示出类似的获益。
在 COVID-19 患者中,他汀类药物的使用与死亡率降低显著相关,与肺炎患者的研究结果一致。