Department of Pharmacy Administration, University of Mississippi School of Pharmacy, University, Mississippi, USA.
MedTech Epidemiology and Real-World Data Sciences, Johnson and Johnson, New Brunswick, New Jersey, USA.
BMJ Open. 2023 Nov 19;13(11):e076195. doi: 10.1136/bmjopen-2023-076195.
To assess if the antecedent statin use was associated with all-cause death among COVID-19 patients enrolled in Medicaid.
Cohort study.
Mississippi Medicaid population.
This study included 10 792 Mississippi Medicaid-enrolled patients between 18 and 64 years of age with a confirmed COVID-19 diagnosis from March 2020 to June 2021.
Antecedent statin use, which was determined by a record of statin prescription in the 90-day period prior to the COVID diagnosis.
The outcomes of interest included mortality from all cause within 30 days, 60 days and 90 days after index.
A total of 10 792 patients with COVID-19 met the inclusion and exclusion criteria, with 13.1% of them being antecedent statin users. Statin users were matched 1:1 with non-users based on age, sex, race, comorbidities and medication use by propensity score matching. In total, the matched cohort consisted of 1107 beneficiaries in each group. Multivariable logistic regression showed that statin users were less likely to die within 30 days (adjusted OR: 0.51, 95% CI: 0.32 to 0.83), 60 days (OR: 0.56, 95% CI: 0.37 to 0.85) and 90 days (OR: 0.55, 95% CI: 0.37 to 0.82) after diagnosis of COVID-19. Those with low-intensity/moderate-intensity statin use had significantly lower mortality risk in the 60-day and the 90-day follow-up period, while the high intensity of statin use was only found to be significantly associated with a lower odd of mortality within 30 days post index.
After COVID infection, Medicaid beneficiaries who had taken statins antecedently could be at lower risk for death. For patients with chronic conditions, continuity of care is crucial when interruptions occur in their medical care. Further research is required to further investigate the potential mechanisms and optimal use of statins in COVID-19 treatment.
评估在参加医疗补助计划的 COVID-19 患者中，先前使用他汀类药物是否与全因死亡相关。
队列研究。
密西西比州医疗补助计划人群。
这项研究纳入了 2020 年 3 月至 2021 年 6 月期间年龄在 18 至 64 岁之间、确诊 COVID-19 的 10792 名密西西比州医疗补助计划参保患者。
先前使用他汀类药物，通过在 COVID 诊断前 90 天内的他汀类药物处方记录来确定。
感兴趣的结果包括指数后 30、60 和 90 天内的全因死亡率。
共有 10792 名 COVID-19 患者符合纳入和排除标准，其中 13.1%为先前使用他汀类药物者。通过倾向评分匹配，根据年龄、性别、种族、合并症和药物使用情况，将他汀类药物使用者与非使用者按 1:1 进行匹配。总共，匹配队列中每组有 1107 名受益人。多变量逻辑回归显示，他汀类药物使用者在 COVID-19 诊断后 30 天（校正比值比：0.51，95%置信区间：0.32 至 0.83）、60 天（比值比：0.56，95%置信区间：0.37 至 0.85）和 90 天（比值比：0.55，95%置信区间：0.37 至 0.82）内死亡的可能性较小。低强度/中强度他汀类药物使用者在 60 天和 90 天的随访期间死亡率风险显著降低，而高强度他汀类药物使用者仅在指数后 30 天内死亡的几率显著降低。
COVID 感染后，先前使用过他汀类药物的医疗补助计划受益人的死亡风险可能较低。对于患有慢性病的患者，当他们的医疗保健中断时，连续性护理至关重要。需要进一步研究以进一步探讨他汀类药物在 COVID-19 治疗中的潜在机制和最佳使用。
