Effect of statin therapy on SARS-CoV-2 infection-related mortality in hospitalized patients
Effect of statin therapy on SARS-CoV-2 infection-related mortality in hospitalized patients
复制标题
DOI：
10.1093/ehjcvp/pvaa128
复制
发表时间：
2022-02-16
影响因子：
7.1
通讯作者：
Pedro-Botet, Juan
中科院分区：
文献类型：
--
作者：
Masana, Lluis;Correig, Eudald;Pedro-Botet, Juan
目的评价COVID-19患者入院时他汀类药物治疗（ST）对住院死亡率的影响。方法与结果回顾性观察研究。服用他汀类药物的患者比未服用他汀类药物的患者年龄大11岁，并且有更多的合并症。在分析死亡风险之前进行基因匹配（GM）程序。病因特异性风险（CSH）函数采用Cox比例风险模型，竞争风险Fine and Gray （FG）模型也用于研究他汀类药物对风险的直接影响。来自逆转录聚合酶链反应确诊的2157例sars - cov -2感染患者的数据[男性1234例，女性923例；年龄：67岁（IQR 54-78）]，以匿名方式从临床记录中检索。共有353人死亡。581名患者正在服用他汀类药物。GM后的单因素检验显示，ST组患者的死亡率显著低于匹配的非他汀类药物组（19.8% vs. 25.4%, chi(2)， Yates连续性校正：P = 0.027）。住院期间维持他汀类药物治疗的患者（n = 336）的死亡率甚至低于GM非他汀类药物组（17.4%;P = 0.045）。Cox模型应用于CSH函数[HR = 0.58(CI: 0.39-0.89)；P = 0.01]和竞争风险FG模型[HR = 0.60 (CI: 0.39 ~ 0.92)；P = 0.02]表明他汀类药物与降低covid -19相关死亡率有关。结论住院前接受ST治疗的患者与SARS-CoV-2感染相关的死亡率较低。他汀类药物治疗不应因全球大流行或因COVID-19住院的患者而中断。
Aim Assessing the effect of statin therapy (ST) at hospital admission for COVID-19 on in-hospital mortality. Methods and results Retrospective observational study. Patients taking statins were 11 years older and had significantly more comorbidities than patients who were not taking statins. A genetic matching (GM) procedure was performed prior to analysis of the mortality risk. A Cox proportional hazards model was used for the cause-specific hazard (CSH) function, and a competing-risks Fine and Gray (FG) model was also used to study the direct effects of statins on risk. Data from reverse transcription-polymerase chain reaction-confirmed 2157 SARS-CoV-2-infected patients [1234 men, 923 women; age: 67 y/o (IQR 54-78)] admitted to the hospital were retrieved from the clinical records in anonymized manner. Three hundred and fifty-three deaths occurred. Five hundred and eighty-one patients were taking statins. Univariate test after GM showed a significantly lower mortality rate in patients on ST than the matched non-statin group (19.8% vs. 25.4%, chi(2) with Yates continuity correction: P = 0.027). The mortality rate was even lower in patients (n = 336) who maintained their statin treatments during hospitalization compared with the GM non-statin group (17.4%; P = 0.045). The Cox model applied to the CSH function [HR = 0.58(CI: 0.39-0.89); P = 0.01] and the competing-risks FG model [HR = 0.60 (CI: 0.39-0.92); P = 0.02] suggest that statins are associated with reduced COVID-19-related mortality. Conclusions A lower SARS-CoV-2 infection-related mortality was observed in patients treated with ST prior to hospitalization. Statin therapy should not be discontinued due to the global concern of the pandemic or in patients hospitalized for COVID-19.