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他汀类药物预先治疗与 COVID-19 患者的改善结局相关:来自 SEMI-COVID-19 登记处的数据。

Prior Treatment with Statins is Associated with Improved Outcomes of Patients with COVID-19: Data from the SEMI-COVID-19 Registry.

机构信息

Lipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain.

CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.

出版信息

Drugs. 2021 Apr;81(6):685-695. doi: 10.1007/s40265-021-01498-x. Epub 2021 Mar 29.

Abstract

BACKGROUND

The impact of statins on COVID-19 outcomes is important given the high prevalence of their use among individuals at risk for severe COVID-19. Our aim is to assess whether patients receiving chronic statin treatment who are hospitalized with COVID-19 have reduced in-hospital mortality if statin therapy is maintained during hospitalization.

METHODS

This work is a cross-sectional, observational, retrospective multicenter study that analyzed 2921 patients who required hospital admission at 150 Spanish centers included in the nationwide SEMI-COVID-19 Network. We compared the clinical characteristics and COVID-19 disease outcomes between patients receiving chronic statin therapy who maintained this therapy during hospitalization versus those who did not. Propensity score matching was used to match each statin user whose therapy was maintained during hospitalization to a statin user whose therapy was withdrawn during hospitalization.

RESULTS

After propensity score matching, continuation of statin therapy was associated with lower all-cause mortality (OR 0.67, 0.54-0.83, p < 0.001); lower incidence of acute kidney injury (AKI) (OR 0.76,0.6-0.97, p = 0.025), acute respiratory distress syndrome (ARDS) (OR 0.78, 0.69- 0.89, p < 0.001), and sepsis (4.82% vs 9.85%, p = 0.008); and less need for invasive mechanical ventilation (IMV) (5.35% vs 8.57, p < 0.001) compared to patients whose statin therapy was withdrawn during hospitalization.

CONCLUSIONS

Patients previously treated with statins who are hospitalized for COVID-19 and maintain statin therapy during hospitalization have a lower mortality rate than those in whom therapy is withdrawn. In addition, statin therapy was associated with a decreased probability that patients with COVID-19 will develop AKI, ARDS, or sepsis and decreases the need for IMV.

摘要

背景

鉴于他汀类药物在有重症 COVID-19 风险的人群中的广泛应用,他汀类药物对 COVID-19 结局的影响非常重要。我们的目的是评估在 COVID-19 住院期间维持他汀类药物治疗的情况下,接受慢性他汀类药物治疗的患者的住院死亡率是否降低。

方法

这是一项横断面、观察性、回顾性多中心研究,分析了在西班牙全国 SEMI-COVID-19 网络中 150 个中心住院的 2921 名患者。我们比较了在住院期间维持他汀类药物治疗的患者与未维持治疗的患者的临床特征和 COVID-19 疾病结局。使用倾向评分匹配将每个在住院期间维持他汀类药物治疗的他汀类药物使用者与在住院期间停止他汀类药物治疗的他汀类药物使用者进行匹配。

结果

在倾向评分匹配后,继续使用他汀类药物治疗与全因死亡率降低相关(OR 0.67,0.54-0.83,p < 0.001);急性肾损伤(AKI)(OR 0.76,0.6-0.97,p = 0.025)、急性呼吸窘迫综合征(ARDS)(OR 0.78,0.69-0.89,p < 0.001)和脓毒症(4.82% vs 9.85%,p = 0.008)的发生率降低;与在住院期间停止他汀类药物治疗的患者相比,需要有创机械通气(IMV)的患者比例也较低(5.35% vs 8.57%,p < 0.001)。

结论

因 COVID-19 住院且在住院期间维持他汀类药物治疗的既往接受他汀类药物治疗的患者死亡率低于停止治疗的患者。此外,他汀类药物治疗与 COVID-19 患者发生 AKI、ARDS 或脓毒症的可能性降低以及减少对 IMV 的需求相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0fc3/8006631/148325b4d3ce/40265_2021_1498_Fig1_HTML.jpg

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