Abstract
The coronavirus disease 2019 (COVID-19) can result in a hyperinflammatory state, leading to acute respiratory distress syndrome (ARDS), myocardial injury, and thrombotic complications, among other sequelae. Statins, which are known to have anti-inflammatory and antithrombotic properties, have been studied in the setting of other viral infections, but their benefit has not been assessed in COVID-19. This is a retrospective analysis of patients admitted with COVID-19 from February 1st through May 12th, 2020 with study period ending on June 11th, 2020. Antecedent statin use was assessed using medication information available in the electronic medical record. We constructed a multivariable logistic regression model to predict the propensity of receiving statins, adjusting for baseline sociodemographic and clinical characteristics, and outpatient medications. The primary endpoint includes in-hospital mortality within 30 days. A total of 2626 patients were admitted during the study period, of whom 951 (36.2%) were antecedent statin users. Among 1296 patients (648 statin users, 648 non-statin users) identified with 1:1 propensity-score matching, statin use is significantly associated with lower odds of the primary endpoint in the propensity-matched cohort (OR 0.47, 95% CI 0.36–0.62, p < 0.001). We conclude that antecedent statin use in patients hospitalized with COVID-19 is associated with lower inpatient mortality.
Highlights
The coronavirus disease 2019 (COVID-19) can result in a hyperinflammatory state, leading to acute respiratory distress syndrome (ARDS), myocardial injury, and thrombotic complications, among other sequelae
Statins appear to have the potential to mitigate the impact of myocardial injury and thrombotic events that are associated with severe COVID-19 presentations[13]
Of 2626 patients included in the analysis, 951 (36.2%) were considered antecedent statin users (Table 1)
Summary
The coronavirus disease 2019 (COVID-19) can result in a hyperinflammatory state, leading to acute respiratory distress syndrome (ARDS), myocardial injury, and thrombotic complications, among other sequelae. Statins, which are known to have anti-inflammatory and antithrombotic properties, have been studied in the setting of other viral infections, but their benefit has not been assessed in COVID-19. Through effects on lipid rafts in cellular membranes[9,10,11,12], statins may influence viral transmission and infectivity By these putative mechanisms, statins appear to have the potential to mitigate the impact of myocardial injury and thrombotic events that are associated with severe COVID-19 presentations[13]. We compared patient baseline and presentation characteristics as well as clinical outcomes, including inhospital mortality, stratified by antecedent statin use, in a cohort of patients admitted with COVID-19 to a quaternary academic medical center in New York City. We show that patients with antecedent statin use were generally older with more comorbidities, presented with lower levels of C-reactive protein at time of admission, and experienced lower inpatient mortality at 30 days in a propensity-matched cohort
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