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新冠病毒肺炎住院患者长期使用他汀类药物与30天死亡率之间的关联

Association Between Chronic Statin Use and 30-Day Mortality in Hospitalized Patients With COVID-19.

作者信息

Yetmar Zachary A, Challener Douglas W, Tleyjeh Imad M, Sohail M Rizwan, Cerhan James R, Badley Andrew D, O'Horo John C

机构信息

Division of Infectious Diseases, Mayo Clinic, Rochester, MN.

Division of Epidemiology, Mayo Clinic, Rochester, MN.

出版信息

Mayo Clin Proc Innov Qual Outcomes. 2021 Apr;5(2):442-446. doi: 10.1016/j.mayocpiqo.2021.02.002. Epub 2021 Mar 14.

Abstract

OBJECTIVE

To determine the association between chronic statin use and mortality in patients hospitalized with coronavirus disease 2019 (COVID-19).

PATIENTS AND METHODS

We identified a retrospective cohort of patients requiring admission at the Mayo Clinic using our enterprise-wide COVID-19 registry from March 1, 2020, through September 30, 2020. Available information included age, sex, use of statins, medical comorbidities, and 30-day mortality. We estimated the association of statins with 30-day mortality using odds ratios and 95% CIs from logistic regression modeling.

RESULTS

Patients (N=1295) between the ages of 30 and 80 years tested positive for COVID-19 and required admission during the study period, of whom 500 (38.6%) were taking statins at admission. Patients taking statins were older and more likely to have diabetes mellitus or congestive heart failure. Within 30 days of diagnosis, 59 (4.6%) died. In multivariable analysis, statin users did not have statistically different odds of death within 30 days with an odds ratio of 1.14 (95% CI, 0.64 to 2.03; =.67) compared to nonusers.

CONCLUSION

Patients with COVID-19 taking statins had similar 30-day mortality to those not taking statins after adjusting for relevant covariates. Although this is partly influenced by a higher prevalence of risk factors for more severe COVID-19 presentation not entirely adjusted for by the Charlson comorbidity index, these data would not support statins as a likely therapeutic intervention for COVID-19 in the hospital setting.

摘要

目的

确定2019冠状病毒病(COVID-19)住院患者长期使用他汀类药物与死亡率之间的关联。

患者与方法

我们使用2020年3月1日至2020年9月30日全企业范围的COVID-19登记系统,确定了梅奥诊所需要入院治疗的患者的回顾性队列。可用信息包括年龄、性别、他汀类药物使用情况、合并症以及30天死亡率。我们使用逻辑回归模型的比值比和95%置信区间估计他汀类药物与30天死亡率之间的关联。

结果

年龄在30至80岁之间的患者(N = 1295)在研究期间COVID-19检测呈阳性且需要入院治疗,其中500人(38.6%)在入院时正在服用他汀类药物。服用他汀类药物的患者年龄较大,更有可能患有糖尿病或充血性心力衰竭。在诊断后的30天内,59人(4.6%)死亡。在多变量分析中,与未使用者相比,他汀类药物使用者在30天内死亡的几率在统计学上没有差异,比值比为1.14(95%置信区间,0.64至2.03;P = 0.67)。

结论

在调整相关协变量后,COVID-19患者服用他汀类药物与未服用他汀类药物的患者30天死亡率相似。尽管这部分受到Charlson合并症指数未完全调整的更严重COVID-19表现的风险因素较高患病率的影响,但这些数据不支持他汀类药物作为医院环境中COVID-19的可能治疗干预措施。

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