他汀类药物在心血管疾病患者与新冠病毒疾病结局中的应用：一项基于意大利人群的队列研究。
Statins Use in Patients with Cardiovascular Diseases and COVID-19 Outcomes: An Italian Population-Based Cohort Study.
作者信息
Antonazzo Ippazio Cosimo, Fornari Carla, Rozza Davide, Conti Sara, Di Pasquale Raffaella, Cortesi Paolo Angelo, Kaleci Shaniko, Ferrara Pietro, Zucchi Alberto, Maifredi Giovanni, Silenzi Andrea, Cesana Giancarlo, Mantovani Lorenzo Giovanni, Mazzaglia Giampiero
机构信息
Research Centre on Public Health, University of Milano-Bicocca, 20900 Monza, Italy.
IRCCS, Istituto Auxologico Italiano, 20145 Milan, Italy.
出版信息
J Clin Med. 2022 Dec 17;11(24):7492. doi: 10.3390/jcm11247492.
BACKGROUND
The role of statins among patients with established cardiovascular diseases (CVDs) who are hospitalized with COVID-19 is still debated. This study aimed at assessing whether the prior use of statins was associated with a less severe COVID-19 prognosis.
METHODS
Subjects with CVDs infected with SARS-CoV-2 and hospitalized between 20 February 2020 and 31 December 2020 were selected. These were classified into two mutually exclusive groups: statins-users and non-users of lipid-lowering therapies (non-LLT users). The relationship between statins exposure and the risk of Mechanical Ventilation (MV), Intensive Care Unit (ICU) access and death were evaluated by using logistic and Cox regressions models.
RESULTS
Of 1127 selected patients, 571 were statins-users whereas 556 were non-LLT users. The previous use of statins was not associated with a variation in the risk of need of MV (Odds Ratio [OR]: 1.00; 95% Confidence Intervals [CI]: 0.38-2.67), ICU access (OR: 0.54; 95% CI: 0.22-1.32) and mortality at 14 days (Hazard Ratio [HR]: 0.42; 95% CI: 0.16-1.10). However, a decreased risk of mortality at 30 days (HR: 0.39; 95% CI: 0.18-0.85) was observed in statins-users compared with non-LLT users.
CONCLUSIONS
These findings support the clinical advice for patients CVDs to continue their treatment with statins during SARS-CoV-2 infection.
背景
他汀类药物在确诊患有心血管疾病（CVD）且因COVID-19住院的患者中的作用仍存在争议。本研究旨在评估先前使用他汀类药物是否与COVID-19的较轻预后相关。
方法
选取2020年2月20日至2020年12月31日期间感染SARS-CoV-2并住院的CVD患者。这些患者被分为两个相互排斥的组：他汀类药物使用者和非降脂治疗使用者（非LLT使用者）。使用逻辑回归和Cox回归模型评估他汀类药物暴露与机械通气（MV）风险、重症监护病房（ICU）入住率和死亡率之间的关系。
结果
在1127名选定患者中，571名是他汀类药物使用者，而556名是非LLT使用者。先前使用他汀类药物与MV需求风险的变化（优势比[OR]：1.00；95%置信区间[CI]：0.38 - 2.67）、ICU入住率（OR：0.54；95%CI：0.22 - 1.32）和14天死亡率（风险比[HR]：0.42；95%CI：0.16 - 1.10）无关。然而，与非LLT使用者相比，他汀类药物使用者在30天时的死亡风险降低（HR：0.39；95%CI：0.18 - 0.85）。
结论
这些发现支持了针对CVD患者在感染SARS-CoV-2期间继续使用他汀类药物治疗的临床建议。
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