Association of Pre-Admission Statin Use With Reduced In-Hospital Mortality in COVID-19.
Association of Pre-Admission Statin Use With Reduced In-Hospital Mortality in COVID-19.
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DOI：
10.1016/j.amjms.2021.03.001
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发表时间：
2021-06
期刊：
影响因子：
--
通讯作者：
Gupta E
中科院分区：
文献类型：
--
作者：
Chacko SR;DeJoy R 3rd;Lo KB;Albano J;Peterson E;Bhargav R;Gu F;Salacup G;Pelayo J;Azmaiparashvili Z;Rangaswami J;Patarroyo-Aponte G;Benzaquen S;Gupta E
冠状病毒病-19（COVID-19）感染与不受控制的全身炎症反应相关。他汀类药物，鉴于其抗炎特性，可能会降低相关的发病率和死亡率。本研究旨在确定COVID-19患者住院前使用他汀类药物与住院死亡率之间的关联。在这项回顾性研究中，临床数据收集自2020年3月1日至2020年4月24日确诊COVID-19感染的入院患者的电子病历。采用多元回归分析研究入院前他汀类药物使用与住院死亡率的关系。在255例患者中，116例（45.5%）患者在入院前接受了他汀类药物治疗，139例（54.5%）患者未接受。他汀类药物组终末期肾病（ESRD）（13.8% vs. 2.9%，p = 0.001）、糖尿病（63.8% vs. 35.2%，p<0.001）、高血压（87.9% vs. 61.1%，p < 0.001）和冠状动脉疾病（CAD）（33.6% vs. 5%，p < 0.001）的比例较高。在多变量分析中，我们发现在入院前使用他汀类药物的患者的院内死亡率在统计学上显著降低（OR 0.14，95%CI 0.03- 0.61，p = 0.008）。在亚组分析中，他汀类药物与CAD患者（OR 0.02，95% CI 0.0003-0.92，p = 0.045）和非CAD患者（OR 0.05，95% CI 0.005-0.43，p = 0.007）的死亡率降低相关。我们的研究表明，他汀类药物与降低COVID-19患者的住院死亡率相关，无论CAD状态如何。需要更全面的流行病学和分子研究来确定他汀类药物在COVID-19中的作用。
Coronavirus disease-19 (COVID-19) infection is associated with an uncontrolled systemic inflammatory response. Statins, given their anti-inflammatory properties, may reduce the associated morbidity and mortality. This study aimed to determine the association between statin use prior to hospitalization and in-hospital mortality in COVID-19 patients. In this retrospective study, clinical data were collected from the electronic medical records of patients admitted to the hospital with confirmed COVID-19 infection from March 1, 2020 to April 24, 2020. A multivariate regression analysis was performed to study the association of pre-admission statin use with in-hospital mortality. Of 255 patients, 116 (45.5%) patients were on statins prior to admission and 139 (54.5%) were not. The statin group had a higher proportion of end stage renal disease (ESRD) (13.8% vs. 2.9%, p = 0.001), diabetes mellitus (63.8% vs. 35.2%, p<0.001), hypertension (87.9% vs. 61.1%, p < 0.001) and coronary artery disease (CAD) (33.6% vs. 5%, p < 0.001). On multivariate analysis, we found a statistically significant decrease in the odds of in-hospital mortality in patients on statins before admission (OR 0.14, 95% CI 0.03- 0.61, p = 0.008). In the subgroup analysis, statins were associated with a decrease in mortality in those with CAD (OR 0.02, 95% CI 0.0003–0.92 p = 0.045) and those without CAD (OR 0.05, 95% CI 0.005–0.43, p = 0.007). Our study suggests that statins are associated with reduced in-hospital mortality among patients with COVID-19, regardless of CAD status. More comprehensive epidemiological and molecular studies are needed to establish the role of statins in COVID-19.
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