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他汀类药物与 2019 冠状病毒病(COVID-19)结局的关系:系统评价、荟萃分析和荟萃回归。

Statin and outcomes of coronavirus disease 2019 (COVID-19): A systematic review, meta-analysis, and meta-regression.

机构信息

Faculty of Medicine, Pelita Harapan University, Boulevard Jendral Sudirman street, Karawaci, Tangerang, 15811, Indonesia.

Department of Internal Medicine, Faculty of Medicine, Pelita Harapan University, Boulevard Jendral Sudirman street, Karawaci, Tangerang, 15811, Indonesia.

出版信息

Nutr Metab Cardiovasc Dis. 2021 Jun 7;31(6):1662-1670. doi: 10.1016/j.numecd.2021.02.020. Epub 2021 Feb 27.

Abstract

AIMS

One of the comorbidities associated with severe outcome and mortality of COVID-19 is dyslipidemia. Statin is one of the drugs which is most commonly used for the treatment of dyslipidemic patients. This study aims to analyze the association between statin use and composite poor outcomes of COVID-19.

DATA SYNTHESIS

We systematically searched the PubMed and Europe PMC database using specific keywords related to our aims until November 25th, 2020. All articles published on COVID-19 and statin were retrieved. Statistical analysis was done using Review Manager 5.4 and Comprehensive Meta-Analysis 3 software.

RESULTS

A total of 35 studies with a total of 11, 930, 583 patients were included in our analysis. Our meta-analysis showed that statin use did not improve the composite poor outcomes of COVID-19 [OR 1.08 (95% CI 0.86-1.35), p = 0.50, I = 98%, random-effect modelling]. Meta-regression showed that the association with composite poor outcomes of COVID-19 was influenced by age (p = 0.010), gender (p = 0.045), and cardiovascular disease (p = 0.012). Subgroup analysis showed that the association was weaker in studies with median age ≥60 years-old (OR 0.94) compared to <60 years-old (OR 1.43), and in the prevalence of cardiovascular disease ≥25% (RR 0.94) compared to <25% (RR 1.24).

CONCLUSION

Statin use did not improve the composite poor outcomes of COVID-19. Patients with dyslipidemia should continue taking statin drugs despite COVID-19 infection status, given its beneficial effects on cardiovascular outcomes.

摘要

目的

与 COVID-19 严重结局和死亡率相关的合并症之一是血脂异常。他汀类药物是最常用于治疗血脂异常患者的药物之一。本研究旨在分析他汀类药物使用与 COVID-19 复合不良结局之间的关系。

数据综合

我们使用与我们的目标相关的特定关键字系统地搜索了 PubMed 和 Europe PMC 数据库,直到 2020 年 11 月 25 日。检索了所有关于 COVID-19 和他汀类药物的已发表文章。使用 Review Manager 5.4 和 Comprehensive Meta-Analysis 3 软件进行统计分析。

结果

共有 35 项研究,共纳入 11930583 例患者。我们的荟萃分析表明,他汀类药物的使用并不能改善 COVID-19 的复合不良结局[OR 1.08(95% CI 0.86-1.35),p=0.50,I=98%,随机效应模型]。Meta 回归表明,与 COVID-19 复合不良结局的关联受到年龄(p=0.010)、性别(p=0.045)和心血管疾病(p=0.012)的影响。亚组分析表明,在中位年龄≥60 岁的研究中,与年龄<60 岁的研究相比,这种关联较弱(OR 0.94),在心血管疾病患病率≥25%的研究中,与患病率<25%的研究相比,这种关联较弱(RR 0.94)。

结论

他汀类药物的使用并不能改善 COVID-19 的复合不良结局。鉴于他汀类药物对心血管结局的有益影响,血脂异常患者应继续服用他汀类药物,即使感染了 COVID-19。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a779/7910652/9078aa8a6136/gr1_lrg.jpg

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