Department of Data Science, Sejong University College of Software Convergence, Seoul, Republic of Korea.
Department of Otorhinolaryngology-Head & Neck Surgery, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea.
JMIR Public Health Surveill. 2021 Oct 8;7(10):e29379. doi: 10.2196/29379.
Basic studies suggest that statins as add-on therapy may benefit patients with COVID-19; however, real-world evidence of such a beneficial association is lacking.
We investigated differences in SARS-CoV-2 test positivity and clinical outcomes of COVID-19 (composite endpoint: admission to intensive care unit, invasive ventilation, or death) between statin users and nonusers.
Two independent population-based cohorts were analyzed, and we investigated the differences in SARS-CoV-2 test positivity and severe clinical outcomes of COVID-19, such as admission to the intensive care unit, invasive ventilation, or death, between statin users and nonusers. One group comprised an unmatched cohort of 214,207 patients who underwent SARS-CoV-2 testing from the Global Research Collaboration Project (GRCP)-COVID cohort, and the other group comprised an unmatched cohort of 74,866 patients who underwent SARS-CoV-2 testing from the National Health Insurance Service (NHIS)-COVID cohort.
The GRCP-COVID cohort with propensity score matching had 29,701 statin users and 29,701 matched nonusers. The SARS-CoV-2 test positivity rate was not associated with statin use (statin users, 2.82% [837/29,701]; nonusers, 2.65% [787/29,701]; adjusted relative risk [aRR] 0.97; 95% CI 0.88-1.07). Among patients with confirmed COVID-19 in the GRCP-COVID cohort, 804 were statin users and 1573 were matched nonusers. Statin users were associated with a decreased likelihood of severe clinical outcomes (statin users, 3.98% [32/804]; nonusers, 5.40% [85/1573]; aRR 0.62; 95% CI 0.41-0.91) and length of hospital stay (statin users, 23.8 days; nonusers, 26.3 days; adjusted mean difference -2.87; 95% CI -5.68 to -0.93) than nonusers. The results of the NHIS-COVID cohort were similar to the primary results of the GRCP-COVID cohort.
Our findings indicate that prior statin use is related to a decreased risk of worsening clinical outcomes of COVID-19 and length of hospital stay but not to that of SARS-CoV-2 infection.
基础研究表明，他汀类药物作为附加疗法可能对 COVID-19 患者有益；然而，缺乏这种有益关联的真实世界证据。
我们研究了他汀类药物使用者和非使用者之间 SARS-CoV-2 检测阳性率和 COVID-19（复合终点：入住重症监护病房、有创通气或死亡）临床结局的差异。
分析了两个独立的基于人群的队列，并研究了他汀类药物使用者和非使用者之间 SARS-CoV-2 检测阳性率和 COVID-19 严重临床结局（如入住重症监护病房、有创通气或死亡）的差异。一组是来自全球研究协作项目（GRCP）-COVID 队列的未经匹配的 214207 名接受 SARS-CoV-2 检测的患者，另一组是来自国家健康保险服务（NHIS）-COVID 队列的未经匹配的 74866 名接受 SARS-CoV-2 检测的患者。
GRCP-COVID 队列经倾向评分匹配后有 29701 名他汀类药物使用者和 29701 名匹配的非使用者。他汀类药物使用与 SARS-CoV-2 检测阳性率无关（他汀类药物使用者，2.82%[837/29701]；非使用者，2.65%[787/29701]；调整后的相对风险[aRR]0.97；95%CI0.88-1.07）。在 GRCP-COVID 队列中，确诊 COVID-19 的患者中，804 名是他汀类药物使用者，1573 名是匹配的非使用者。他汀类药物使用者的严重临床结局不良发生率较低（他汀类药物使用者，3.98%[32/804]；非使用者，5.40%[85/1573]；aRR0.62；95%CI0.41-0.91）和住院时间较短（他汀类药物使用者，23.8 天；非使用者，26.3 天；调整后的平均差异-2.87；95%CI-5.68 至-0.93）。NHIS-COVID 队列的结果与 GRCP-COVID 队列的主要结果相似。
我们的研究结果表明，既往他汀类药物使用与 COVID-19 临床结局恶化和住院时间缩短的风险降低相关，但与 SARS-CoV-2 感染无关。
