In-Hospital Use of Statins Is Associated with a Reduced Risk of Mortality among Individuals with COVID-19
In-Hospital Use of Statins Is Associated with a Reduced Risk of Mortality among Individuals with COVID-19
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院内使用他汀类药物可降低 COVID-19 患者的死亡风险
DOI：
10.1016/j.cmet.2020.06.015
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发表时间：
2020-08-04
期刊：
影响因子：
29
通讯作者：
Li, Hongliang
中科院分区：
文献类型：
--
作者：
Zhang, Xiao-Jin;Qin, Juan-Juan;Li, Hongliang
他汀类药物是一种具有良好抗炎特征的降脂药物，已被建议作为新冠肺炎的辅助治疗。然而，他汀类药物可能通过诱导ACE2的表达而增加SARS-CoV-2病毒进入的风险。我们对湖北省13,981例新冠肺炎患者中国进行了回顾性研究，其中1,219例接受了他汀类药物治疗。基于概率得分匹配后的混合效应Cox模型，我们发现匹配的他汀类药物组和非他汀类药物组28天全因死亡率的风险分别为5.2%和9.4%，调整后的风险比为0.58。在Cox时变模型和边际结构模型分析中也观察到他汀类药物使用相关的较低的死亡风险。这些结果支持正在进行的涉及他汀类药物治疗新冠肺炎的前瞻性研究和随机对照试验的完成，这些研究和随机对照试验是进一步验证这类药物在对抗这一大流行的死亡率方面的效用所必需的。
Statins are lipid-lowering therapeutics with favorable anti-inflammatory profiles and have been proposed as an adjunct therapy for COVID-19. However, statins may increase the risk of SARS-CoV-2 viral entry by inducing ACE2 expression. Here, we performed a retrospective study on 13,981 patients with COVID-19 in Hubei Province, China, among which 1,219 received statins. Based on a mixed-effect Cox model after pro-pensity score-matching, we found that the risk for 28-day all-cause mortality was 5.2% and 9.4% in the matched statin and non-statin groups, respectively, with an adjusted hazard ratio of 0.58. The statin use -associated lower risk of mortality was also observed in the Cox time-varying model and marginal structural model analysis. These results give support for the completion of ongoing prospective studies and random-ized controlled trials involving statin treatment for COVID-19, which are needed to further validate the utility of this class of drugs to combat the mortality of this pandemic.