Department of R&D, Medaman BV, Geel, Belgium.
Department of Real-World Evidence, Open Health, Marlow, UK.
Hum Vaccin Immunother. 2021 Sep 2;17(9):2841-2850. doi: 10.1080/21645515.2021.1920271. Epub 2021 May 28.
The COVID-19 pandemic has disrupted life throughout the world. Newly developed vaccines promise relief to people who live in high-income countries, although vaccines and expensive new treatments are unlikely to arrive in time to help people who live in low-and middle-income countries. The pathogenesis of COVID-19 is characterized by endothelial dysfunction. Several widely available drugs like statins, ACE inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) have immunometabolic activities that (among other things) maintain or restore endothelial cell function. For this reason, we undertook an observational study in four Belgian hospitals to determine whether in-hospital treatment with these drugs could improve survival in 959 COVID-19 patients. We found that treatment with statins and ACEIs/ARBs reduced 28-day mortality in hospitalized COVID-19 patients. Moreover, combination treatment with these drugs resulted in a 3-fold reduction in the odds of hospital mortality (OR = 0.33; 95% CI 0.17-0.69). These findings were in general agreement with other published studies. Additional observational studies and clinical trials are needed to convincingly show that in-hospital treatment with statins, ACEIs/ARBs, and especially their combination saves lives.
新冠疫情已在全球范围内扰乱了人们的生活。新研发的疫苗有望为高收入国家的民众带来缓解，但疫苗和昂贵的新疗法不太可能及时到达中低收入国家，帮助当地民众。新冠疫情的发病机制以血管内皮功能障碍为特征。他汀类药物、血管紧张素转换酶抑制剂（ACEI）和血管紧张素受体阻滞剂（ARB）等几种广泛应用的药物具有免疫代谢活性，可维持或恢复内皮细胞功能。基于此，我们在比利时的 4 家医院开展了一项观察性研究，以确定这些药物的住院治疗是否可以改善 959 名 COVID-19 患者的生存。结果显示，他汀类药物和 ACEI/ARB 治疗可降低住院 COVID-19 患者 28 天死亡率。此外，联合使用这些药物可使住院死亡率降低三分之二（OR=0.33；95%CI 0.17-0.69）。这些发现与其他已发表的研究基本一致。还需要进行更多的观察性研究和临床试验，以确凿证明他汀类药物、ACEI/ARB 及其联合使用的住院治疗可以挽救生命。
