Abstract
COVID-19 disproportionately affects patients with medical comorbidities such as cardiovascular disease (CVD). Patients with CVD are widely prescribed 3-hydroxy-3-methyl-glutayl-CoA (HMG-CoA) reductase inhibitors (statins), a class of lipid-lowering medications known for their pleiotropic anti-inflammatory and immunomodulatory effects. However, the relationship between statin use and COVID-19 outcomes is not fully understood. In this preliminary study, we explored the association between statin use and severe COVID-19 outcomes in hospitalized patients, including intensive care unit (ICU) admission, the need for invasive mechanical ventilation (IMV), and in-hospital death. We performed a retrospective cohort study of 249 patients hospitalized with COVID-19 from 3 March 2020 to 10 April 2020 in Rhode Island, USA. Patient demographics, past medical history, current medications, and hospital course were recorded and analyzed. A multivariate logistic regression analysis was conducted to examine associations. After adjusting for age, sex, race, cardiovascular disease, chronic pulmonary disease, diabetes, and obesity, statin use was significantly associated with decreased risk for IMV (adjusted Odds Ratio (aOR) = 0.45, 95% Confidence Interval (CI): 0.20–0.99). Our results support the continued use of statins among COVID-19 patients and could have implications for future prospective studies on the management of COVID-19.
Highlights
Five months after coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV2), was declared a pandemic by the World Health Organization, cases continue to rise across the world
We examined the relationship between commonly used chronic medications, including statins and angiotensin-converting enzyme inhibitors (ACEis)/angiotensin II receptor blockers (ARBs), and severe COVID-19 outcomes, including intensive care unit (ICU) admissions, invasive mechanical ventilation (IMV), and death, among patients hospitalized with COVID-19
We report the results of a preliminary retrospective cohort study investigating associations between commonly used chronic medications, including statins and ACEis/ARBs, and severe COVID-19 outcomes among patients hospitalized with COVID-19, including ICU admission, invasive mechanical ventilation, and in-hospital mortality
Summary
Five months after coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV2), was declared a pandemic by the World Health Organization, cases continue to rise across the world. COVID-19 manifests as a mild upper respiratory infection in most individuals, older adults with medical comorbidities are at the greatest risk of serious illness, leading to hospitalization and, eventually, death [2,3,4,5,6]. CVD is the third most frequent comorbidity in COVID-19 patients, behind hypertension and diabetes [9,10]. These three comorbidities are closely related in terms of risk factors and underlying pathophysiology, including upregulation of the renin-angiotensin-aldosterone system, vascular injury, and inflammation [11]
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