Abstract 9513: Association of Statins for Primary Prevention of Cardiovascular Disease With Hospitalization for Covid-19: A Nationwide Matched Population-Based Cohort Study

Abstract

Background: Numerous studies have reported a lower risk of serious in-hospital outcomes of COVID-19 associated with statin use. However, there is little evidence on the relationship between statin use and the risk of hospitalization due to COVID-19. Methods: The French National Health Insurance database was used to conduct a matched-cohort study. For each adult aged 40 years or more receiving statin for primary prevention of cardiovascular disease, one non-user was randomly selected matched for year of birth, sex, residence area, and comorbidities (hypertension, diabetes mellitus, and chronic respiratory condition). The association between statin use and hospitalization for COVID-19 was examined using the conditional Cox proportional hazards models, adjusted for baseline characteristics, comorbidities, and long-term medications. Its association with in-hospital death from COVID-19 was also investigated. Multivariable analysis weighted with inverse probability of treatment weights was also performed. All participants were followed-up from February 15 to June 15, 2020. Results: The 1:1 matching procedure generated 2,058,249 adults in the statin group and 2,058,249 in the control group composed of 46.6% of men with a mean age of 68.7 years. Statin users had a 16% lower risk of hospitalization for COVID-19 than non-users (adjusted hazard ratio (HR), 0.84; 95%CI, 0.81-0.88). All types of statin were significantly associated with a lower risk of hospitalization; adjusted HR ranging from 0.75 (95%CI, 0.57-0.99) for fluvastatin to 0.89 (95%CI, 0.84-0.95) for atorvastatin. Low- and moderate-intensity statins also showed a lower risk compared with non-users (HR, 0.78; 95%CI, 0.71-0.86 and HR, 0.84; 95%CI, 0.80-0.89, respectively) whereas high-intensity statins did not (HR, 1.01; 95%CI, 0.86-1.18). We found similar results with in-hospital death from COVID-19. Conclusions: Our findings support the hypothesis that the use of statin for primary prevention is associated with lower risks of hospitalization for COVID-19 and of in-hospital death from COVID-19.