Servicio de Cardiología, Complejo Hospitalario Universitario de A Coruña (CHUAC), A Coruña, España; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, España; Instituto de Investigación Biomédica de A Coruña (INIBIC), A Coruña, España.
Instituto de Investigación Biomédica de A Coruña (INIBIC), A Coruña, España; Servicio de Neumología, CHUAC, A Coruña, España.
Med Clin (Barc). 2023 Jan 5;160(1):1-9. doi: 10.1016/j.medcli.2022.03.015. Epub 2022 May 8.
Statin therapy might have a beneficial prognostic effect in patients with COVID-19, given its immunomodulative, anti-inflammatory and anti-atherosclerotic properties. Our purpose was to test this hypothesis by using the COVID-19 registry of a Spanish university hospital.
We conducted a single-center, observational and retrospective study in which hospitalized patients with COVID-19 diagnosed by PCR between March 2020 and October 2020 were included. By means of logistic regression, we designed a propensity score to estimate the likelihood that a patient would receive statin treatment prior to admission. We compared the survival of COVID-19 patients with and without statin treatment by means of Cox regression with inverse probability of treatment weighting (IPTW). The median follow-up was 406 days.
We studied 1122 hospitalized patients with COVID-19, whose median age was 71years and of which 488 (43.5%) were women. 451 (40.2%) patients received statins before admission. In the IPTW survival analysis, prior statin treatment was associated with a significant reduction in mortality (HR: 0.76; 95%CI: 0.59-0.97). The greatest benefit of previous statin therapy was seen in subgroups of patients with coronary artery disease (HR: 0.32; 95%CI: 0.18-0.56) and extracardiac arterial disease (HR: 0.45; 95%CI: 0.28-0.73).
Our study showed a significant association between previous treatment with statins and lower mortality in hospitalized patients with COVID-19. The observed prognostic benefit was greater in patients with previous coronary or extracardiac atherosclerotic disease.
鉴于他汀类药物具有免疫调节、抗炎和抗动脉粥样硬化作用，其可能对 COVID-19 患者具有有益的预后作用。我们的目的是使用一家西班牙大学医院的 COVID-19 登记处来检验这一假设。
我们进行了一项单中心、观察性和回顾性研究，其中纳入了 2020 年 3 月至 2020 年 10 月期间通过 PCR 诊断为 COVID-19 的住院患者。通过逻辑回归，我们设计了倾向评分来估计患者在入院前接受他汀类药物治疗的可能性。我们通过逆概率治疗加权（Inverse Probability of Treatment Weighting，IPTW）的 Cox 回归比较了有和没有他汀类药物治疗的 COVID-19 患者的生存情况。中位随访时间为 406 天。
我们研究了 1122 例住院 COVID-19 患者，其年龄中位数为 71 岁，其中 488 例（43.5%）为女性。451 例（40.2%）患者在入院前接受了他汀类药物治疗。在 IPTW 生存分析中，入院前他汀类药物治疗与死亡率显著降低相关（HR：0.76；95%CI：0.59-0.97）。在冠状动脉疾病（HR：0.32；95%CI：0.18-0.56）和心脏外动脉疾病（HR：0.45；95%CI：0.28-0.73）患者亚组中，先前他汀类药物治疗的获益最大。
我们的研究表明，COVID-19 住院患者入院前接受他汀类药物治疗与死亡率降低显著相关。在有先前冠状动脉或心脏外动脉粥样硬化疾病的患者中，观察到的预后获益更大。
