Barge-Caballero Eduardo, Marcos-Rodríguez Pedro J, Domenech-García Nieves, Bou-Arévalo Germán, Cid-Fernández Javier, Iglesias-Reinoso Raquel, López-Vázquez Paula, Muñiz Javier, Vázquez-Rodríguez José M, Crespo-Leiro María G
Servicio de Cardiología, Complejo Hospitalario Universitario de A Coruña (CHUAC), A Coruña, Spain.
Instituto de Investigación Biomédica de A Coruña (INIBIC), A Coruña, Spain.
Med Clin (Engl Ed). 2023 Jan 5;160(1):1-9. doi: 10.1016/j.medcle.2022.03.021. Epub 2022 Dec 7.
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 71 years 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特性,其治疗可能对新型冠状病毒肺炎(COVID-19)患者的预后产生有益影响。我们的目的是通过西班牙一家大学医院的COVID-19登记系统来验证这一假设。
我们进行了一项单中心、观察性和回顾性研究,纳入了2020年3月至2020年10月期间经聚合酶链反应(PCR)确诊为COVID-19的住院患者。通过逻辑回归,我们设计了一个倾向评分来估计患者入院前接受他汀类药物治疗的可能性。我们采用Cox回归和治疗权重逆概率(IPTW)比较了接受和未接受他汀类药物治疗的COVID-19患者的生存率。中位随访时间为406天。
我们研究了1122例COVID-19住院患者,他们的中位年龄为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,先前的他汀类药物治疗与死亡率显著降低相关(风险比:0.76;95%置信区间:0.59 - 0.97)。先前他汀类药物治疗的最大益处出现在冠状动脉疾病亚组(风险比:0.32;95%置信区间:0.18 - 0.56)和心外动脉疾病亚组(风险比:0.45;95%置信区间:0.28 - 0.73)。
我们的研究表明,先前使用他汀类药物治疗与COVID-19住院患者较低的死亡率之间存在显著关联。在先前患有冠状动脉或心外动脉粥样硬化疾病的患者中,观察到的预后益处更大。