Department of Medicine, Einstein Medical Center Philadelphia, PA, USA.
Department of Medicine, Einstein Medical Center Philadelphia, PA, USA; Sidney Kimmel College of Thomas Jefferson University, Philadelphia, PA, USA.
Am J Med Sci. 2021 Jun;361(6):725-730. doi: 10.1016/j.amjms.2021.03.001. Epub 2021 Mar 2.
Coronavirus disease-19 (COVID-19) infection is associated with an uncontrolled systemic inflammatory response. Statins, given their anti-inflammatory properties, may reduce the associated morbidity and mortality. This study aimed to determine the association between statin use prior to hospitalization and in-hospital mortality in COVID-19 patients.
In this retrospective study, clinical data were collected from the electronic medical records of patients admitted to the hospital with confirmed COVID-19 infection from March 1, 2020 to April 24, 2020. A multivariate regression analysis was performed to study the association of pre-admission statin use with in-hospital mortality.
Of 255 patients, 116 (45.5%) patients were on statins prior to admission and 139 (54.5%) were not. The statin group had a higher proportion of end stage renal disease (ESRD) (13.8% vs. 2.9%, p = 0.001), diabetes mellitus (63.8% vs. 35.2%, p<0.001), hypertension (87.9% vs. 61.1%, p < 0.001) and coronary artery disease (CAD) (33.6% vs. 5%, p < 0.001). On multivariate analysis, we found a statistically significant decrease in the odds of in-hospital mortality in patients on statins before admission (OR 0.14, 95% CI 0.03- 0.61, p = 0.008). In the subgroup analysis, statins were associated with a decrease in mortality in those with CAD (OR 0.02, 95% CI 0.0003-0.92 p = 0.045) and those without CAD (OR 0.05, 95% CI 0.005-0.43, p = 0.007).
Our study suggests that statins are associated with reduced in-hospital mortality among patients with COVID-19, regardless of CAD status. More comprehensive epidemiological and molecular studies are needed to establish the role of statins in COVID-19.
冠状病毒病-19(COVID-19)感染与失控的全身炎症反应有关。他汀类药物具有抗炎作用,可能降低相关发病率和死亡率。本研究旨在确定 COVID-19 患者住院前和住院期间使用他汀类药物与住院死亡率之间的关系。
在这项回顾性研究中,从 2020 年 3 月 1 日至 2020 年 4 月 24 日期间因确诊 COVID-19 感染而住院的患者的电子病历中收集临床数据。进行多变量回归分析,以研究入院前使用他汀类药物与住院死亡率之间的关系。
在 255 名患者中,116 名(45.5%)患者在入院前使用他汀类药物,139 名(54.5%)患者未使用。他汀类药物组终末期肾病(ESRD)(13.8%比 2.9%,p=0.001)、糖尿病(63.8%比 35.2%,p<0.001)、高血压(87.9%比 61.1%,p<0.001)和冠状动脉疾病(CAD)(33.6%比 5%,p<0.001)的比例较高。多变量分析发现,入院前使用他汀类药物的患者住院死亡率的几率显著降低(OR 0.14,95%CI 0.03-0.61,p=0.008)。在亚组分析中,他汀类药物与 CAD 患者(OR 0.02,95%CI 0.0003-0.92,p=0.045)和无 CAD 患者(OR 0.05,95%CI 0.005-0.43,p=0.007)死亡率降低相关。
我们的研究表明,他汀类药物与 COVID-19 患者的住院死亡率降低有关,无论 CAD 状态如何。需要进行更全面的流行病学和分子研究,以确定他汀类药物在 COVID-19 中的作用。