Bianconi Vanessa, Mannarino Massimo R, Cosentini Elena, Figorilli Filippo, Colangelo Cecilia, Cellini Giulia, Braca Marco, Lombardini Rita, Paltriccia Rita, Sahebkar Amirhossein, Pirro Matteo
Department of Medicine and Surgery, Unit of Internal Medicine, University of Perugia, Perugia, Italy.
Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran.
J Med Virol. 2023 Mar;95(3):e28678. doi: 10.1002/jmv.28678.
Statins may protect against adverse outcomes from Coronavirus disease 2019 (COVID-19) through their pleiotropic effects. Endothelial dysfunction seems to be implicated in the pathophysiology of COVID-19, and can be attenuated by statins. This study assessed the role of preadmission statin therapy and its interaction with endothelial function, measured using flow-mediated dilation (FMD) at hospital admission, in predicting in-hospital outcomes among patients with COVID-19 having high-to-very high cardiovascular (CV) risk. We conducted a retrospective cohort study of hospitalized patients with COVID-19 having high-to-very high CV risk, including a subgroup of patients who underwent FMD assessment. Among 342 patients, 119 (35%) were treated with statins at study baseline. Preadmission statin therapy was independently associated with a 75% risk reduction of intensive care unit admission/in-hospital death (adjusted hazard ratio 0.252, 95% confidence interval 0.122-0.521, p < 0.001). In the subgroup of patients with an FMD assessment (245 patients, 40% statin-treated), preadmission statin therapy was independently associated with higher FMD values (β = 0.159, p = 0.013). However, preadmission statin therapy × FMD interaction was not associated with in-hospital outcomes (F = 0.002, p = 0.960). Preadmission statin therapy is associated with better in-hospital outcomes among patients with COVID-19 having high-to-very high CV risk, independent of the endothelium-protective effects of these drugs.
他汀类药物可能通过其多效性作用预防2019冠状病毒病（COVID-19）的不良结局。内皮功能障碍似乎与COVID-19的病理生理学有关，而他汀类药物可使其减轻。本研究评估了入院前他汀类药物治疗的作用及其与内皮功能入院时使用血流介导的血管舒张（FMD）测量的与内皮功能的相互作用，对心血管（CV）风险高至极高的COVID-19患者的住院结局进行预测。我们对CV风险高至极高的COVID-19住院患者进行了一项回顾性队列研究，包括接受FMD评估的患者亚组。在342例患者中，119例（35%）在研究基线时接受了他汀类药物治疗。入院前他汀类药物治疗与重症监护病房入院/院内死亡风险降低75%独立相关（校正风险比0.252，95%置信区间0.122-0.521，p<0.001）。在进行FMD评估的患者亚组（245例患者，40%接受他汀类药物治疗）中，入院前他汀类药物治疗与更高的FMD值独立相关（β=0.159，p=0.013）。然而，入院前他汀类药物治疗×FMD相互作用与住院结局无关（F=0.002，p=0.960）。入院前他汀类药物治疗与CV风险高至极高的COVID-19患者更好的住院结局相关，与这些药物的内皮保护作用无关。
