Student Research Committee, Hamadan University of Medical Sciences, Hamadan, Iran.
Department of Anatomical Sciences, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran.
Biomed Res Int. 2021 Sep 23;2021:1901772. doi: 10.1155/2021/1901772. eCollection 2021.
Although vaccine rollout for COVID-19 has been effective in some countries, there is still an urgent need to reduce disease transmission and severity. We recently carried out a meta-analysis and found that pre- and in-hospital use of statins may improve COVID-19 mortality outcomes. Here, we provide an updated meta-analysis in an attempt to validate these results and increase the statistical power of these potentially important findings.
The meta-analysis investigated the effect of observational and randomized clinical studies on intensive care unit (ICU) admission, tracheal intubation, and death outcomes in COVID-19 cases involving statin treatment, by searching the scientific literature up to April 23, 2021. Statistical analysis and random effect modeling were performed to assess the combined effects of the updated and previous findings on the outcome measures. . The updated literature search led to the identification of 23 additional studies on statin use in COVID-19 patients. Analysis of the combined studies ( = 47; 3,238,508 subjects) showed no significant effect of statin treatment on ICU admission and all-cause mortality but a significant reduction in tracheal intubation (OR = 0.73, 95% CI: 0.54-0.99, = 0.04, = 10 studies). The further analysis showed that death outcomes were significantly reduced in the patients who received statins during hospitalization (OR = 0.54, 95% CI: 0.50-0.58, < 0.001, = 7 studies), with no such effect of statin therapy before hospital admission (OR = 1.06, 95% CI = 0.82-1.37, = 0.670, = 29 studies).
Taken together, this updated meta-analysis extends and confirms the findings of our previous study, suggesting that in-hospital statin use leads to significant reduction of all-cause mortality in COVID-19 cases. Considering these results, statin therapy during hospitalization, while indicated, should be recommended.
尽管一些国家的 COVID-19 疫苗接种工作已初见成效,但仍迫切需要降低疾病传播和严重程度。我们最近进行了一项荟萃分析,发现他汀类药物的预先和住院治疗可能会改善 COVID-19 的死亡率结果。在此,我们进行了一项更新的荟萃分析,试图验证这些结果并增加这些潜在重要发现的统计效力。
通过搜索科学文献,我们对截至 2021 年 4 月 23 日的他汀类药物治疗 COVID-19 病例的重症监护病房(ICU)入院、气管插管和死亡结局的观察性和随机临床试验进行了荟萃分析。进行统计分析和随机效应建模,以评估更新和先前研究结果对结局指标的综合影响。更新的文献检索导致确定了 23 项关于 COVID-19 患者使用他汀类药物的额外研究。对合并研究(n=47;3238508 例患者)的分析表明,他汀类药物治疗对 ICU 入院和全因死亡率没有显著影响,但显著降低了气管插管率(OR=0.73,95%CI:0.54-0.99,P=0.04,n=10 项研究)。进一步分析表明,住院期间使用他汀类药物的患者死亡结局显著降低(OR=0.54,95%CI:0.50-0.58,P<0.001,n=7 项研究),而入院前使用他汀类药物治疗则无此效果(OR=1.06,95%CI=0.82-1.37,P=0.67,n=29 项研究)。
总的来说,这项更新的荟萃分析扩展并证实了我们之前研究的结果,表明 COVID-19 患者住院期间使用他汀类药物可显著降低全因死亡率。考虑到这些结果,在有指征的情况下,应建议在住院期间进行他汀类药物治疗。