Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain.
Institute of Health Research of Santiago de Compostela (IDIS), Santiago de Compostela, Spain.
J Med Virol. 2023 Jul;95(7):e28971. doi: 10.1002/jmv.28971.
Evidence of the effect of statins on patients with coronavirus disease (2019) COVID-19 is inconsistent. The aim of this study was to evaluate the association between chronic use of statins-both overall and by active ingredient-and severe outcomes of COVID-19 (risk of hospitalization and mortality), progression to severe outcomes, and susceptibility to the virus. We conducted a population-based case-control study with data from electronic records to assess the risk of (1) hospitalization: cases were patients admitted due to COVID-19 and controls were subjects without COVID-19; (2) mortality: cases were hospitalized patients who died due to COVID-19 and controls were subjects without COVID-19; (3) progression: cases were hospitalized COVID-19 subjects and controls were nonhospitalized COVID-19 patients; and (4) susceptibility: cases were patients with COVID-19 (both hospitalized and nonhospitalized) and controls were subjects without COVID-19. We collected data on 2821 hospitalized cases, 26 996 nonhospitalized cases, and 52 318 controls. Chronic use of atorvastatin was associated with a decreased risk of hospitalization (adjusted odds ratios [aOR] = 0.83; 95% confidence interval [CI]: 0.74-0.92) and mortality (aOR = 0.70; 95% CI: 0.53-0.93), attributable in part to a lower risk of susceptibility to the virus (aOR = 0.91; 95% CI: 0.86-0.96). Simvastatin was associated with a reduced risk of mortality (aOR = 0.59; 95% CI: 0.40-0.87). The wide degree of heterogeneity observed in the estimated odds ratios (ORs) of the different statins suggests that there is no class effect. The results of this real-world study suggest that chronic use of atorvastatin (and to a lesser degree, of simvastatin) is associated with a decrease in risk of severe COVID-19 outcomes.
他汀类药物对 2019 年冠状病毒病 (COVID-19) 患者的影响证据不一致。本研究旨在评估慢性使用他汀类药物（包括整体使用和按活性成分使用）与 COVID-19 的严重结局（住院风险和死亡率）、向严重结局进展以及对病毒的易感性之间的关系。我们进行了一项基于人群的病例对照研究，使用电子病历中的数据评估以下风险：（1）住院：病例为因 COVID-19 住院的患者，对照组为未感染 COVID-19 的患者；（2）死亡率：病例为因 COVID-19 住院死亡的患者，对照组为未感染 COVID-19 的患者；（3）进展：病例为住院 COVID-19 患者，对照组为非住院 COVID-19 患者；（4）易感性：病例为 COVID-19 患者（包括住院和非住院患者），对照组为未感染 COVID-19 的患者。我们收集了 2821 例住院病例、26996 例非住院病例和 52318 例对照组的数据。阿托伐他汀的慢性使用与住院风险降低相关（调整后的优势比[aOR] = 0.83；95%置信区间[CI]：0.74-0.92）和死亡率降低相关（aOR = 0.70；95%CI：0.53-0.93），部分原因是降低了对病毒的易感性（aOR = 0.91；95%CI：0.86-0.96）。辛伐他汀与死亡率降低相关（aOR = 0.59；95%CI：0.40-0.87）。不同他汀类药物估计比值比（OR）的异质性程度很大，这表明没有类别效应。这项真实世界研究的结果表明，阿托伐他汀（在较小程度上还有辛伐他汀）的慢性使用与 COVID-19 严重结局风险降低相关。
