Diaz-Arocutipa Carlos, Melgar-Talavera Beatriz, Alvarado-Yarasca Ángel, Saravia-Bartra María M, Cazorla Pedro, Belzusarri Iván, Hernandez Adrian V
Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru; Programa de Atencion Domiciliaria - EsSalud, Lima, Peru; Asociación para el Desarrollo de la Investigación Estudiantil en Ciencias de la Salud (ADIECS), Lima, Peru.
Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru.
Int J Infect Dis. 2021 Sep;110:374-381. doi: 10.1016/j.ijid.2021.08.004. Epub 2021 Aug 8.
There is conflicting evidence about the efficacy of statin use in regard to clinical outcomes in patients with coronavirus disease 2019 (COVID-19). A systematic review and meta-analysis was performed to examine the effect of statin use on mortality in COVID-19 patients.
The electronic databases were searched, from inception to March 3, 2021. Unadjusted and adjusted effect estimates with their 95% confidence intervals (95% CI) were pooled using random-effects models.
Twenty-five cohort studies involving 147 824 patients were included. The mean age of the patients ranged from 44.9 to 70.9 years; 57% of patients were male and 43% were female. The use of statins was not associated with mortality when applying the unadjusted risk ratio (uRR 1.16, 95% CI 0.86-1.57; 19 studies). In contrast, meta-analyses of the adjusted odds ratio (aOR 0.67, 95% CI 0.52-0.86; 11 studies) and adjusted hazard ratio (aHR 0.73, 95% CI 0.58-0.91; 10 studies) showed that statins were independently associated with a significant reduction in mortality. Subgroup analyses showed that only chronic use of statins significantly reduced mortality according to the adjusted models.
The use of statins was found to be associated with a lower risk of mortality in COVID-19 patients based on adjusted effects of cohort studies. However, randomized controlled trials are still needed to confirm these findings.
关于他汀类药物在2019冠状病毒病（COVID-19）患者临床结局方面的疗效，证据存在冲突。进行了一项系统评价和荟萃分析，以研究使用他汀类药物对COVID-19患者死亡率的影响。
检索了从数据库建立至2021年3月3日的电子数据库。使用随机效应模型汇总未调整和调整后的效应估计值及其95%置信区间（95%CI）。
纳入了25项队列研究，涉及147824例患者。患者的平均年龄在44.9岁至70.9岁之间；57%为男性，43%为女性。应用未调整风险比时，他汀类药物的使用与死亡率无关（未调整风险比1.16，95%CI 0.86-1.57；19项研究）。相比之下，调整后的优势比（调整后优势比0.67，95%CI 0.52-0.86；11项研究）和调整后的风险比（调整后风险比0.73，95%CI 0.58-0.91；10项研究）的荟萃分析表明，他汀类药物与死亡率显著降低独立相关。亚组分析表明，根据调整模型，仅长期使用他汀类药物可显著降低死亡率。
根据队列研究的调整效应，发现使用他汀类药物与COVID-19患者较低的死亡风险相关。然而，仍需要随机对照试验来证实这些发现。
