The association of statins use with survival of patients with COVID-19. Issue 4 (April 2022)

• Record Type: Journal Article
• Authors: Kuno, Toshiki; So, Matsuo; Iwagami, Masao; Takahashi, Mai; Egorova, Natalia N.
• Is Part Of: Journal of cardiology. Volume 79:Issue 4(2022)
• Page Start: 494
• Page End: 500
• Publication Date: 2022-04
• Subjects: COVID-19 -- Statin; Cardiology -- Periodicals; 616.12
• DOI: 10.1016/j.jjcc.2021.12.012
• Languages: English
• ISSNs: 0914-5087

Abstract

Highlights: Our observational study with 6095 coronavirus disease 2019 patients demonstrated no differences in mortality between use of statins and no use of statins. In-hospital mortality was lower with continuous use of statins compared to no statins. Discontinuation of statins were associated with higher in-hospital mortality compared to no statins. Abstract: Background: Statins are frequently prescribed for patients with dyslipidemia and diabetes mellitus. These comorbidities are highly prevalent in coronavirus disease 2019 (COVID-19) patients. Statin's beneficial effect on mortality in COVID-19 infection has been reported in several studies. However, these findings are still inconclusive. Methods: We conducted a retrospective observational study among 6, 095 patients with laboratory confirmed COVID-19 hospitalized in Mount Sinai Health System between March 1st 2020 and May 7th 2020. Patients were stratified into two groups: statin use prior to or during hospitalization ( N = 2, 423) versus no statins ( N = 3, 672). We evaluated in-hospital mortality as a primary outcome using propensity score matching and inverse probability treatment weighted (IPTW) analysis. In additional analysis, we compared continuous use of statins ( N = 1, 108) with no statins, continuous use of statins with discontinuation of statins ( N = 644), and discontinuation of statins with no statins. Results: Among 6, 095 COVID-19 patients, statin use prior to or during hospitalization group were older (70.8 ± 12.7 years versus 59.2 ± 18.2 years, p <0.001) and had more comorbidities compared to no statins group. After matching by propensity score (1, 790 pairs), there were no significant differences in-hospital mortality between patients with statins and those without [28.9% versus 31.0%, p = 0.19, odds ratio (OR) 95% confidence interval (CI): 0.91 (0.79–1.05)]. This result was confirmed by IPTW analysis [OR (95% CI): 0.96 (0.81–1.12), p = 0.53]. In the additional analysis comparing continuous use of statins with no statins group, in-hospital mortality was significantly lower in continuous use of statins compared to no statins group [26.3% versus 34.5%, p <0.001, OR (95% CI): 0.68 (0.55–0.82)] after matching by propensity score (944 pairs), as well as IPTW analysis [OR (95% CI): 0.77 (0.64–0.94), p = 0.009]. Finally, comparison of continuous use of statins with discontinuation of statins showed lower in-hospital mortality in continuous use of statins group [27.9% versus 42.1%, p <0.001, OR (95% CI): 0.53 (0.41–0.68)]. Conclusions: Use of statins prior to or during hospitalization was not associated with a decreased risk of in-hospital mortality, however, continuous use of statins was associated with lower in-hospital mortality compared to no statin use and discontinuation of statins. Graphical abstract: In hospital mortality for patients who used statins prior to or during hospitalization group versus no statins group, antecedent use of statins group versus no statins group, continuous use of statins group versus no statins group, discontinuation of statins group versus no statins group, and discontinuation of statins group versus continuation of statins group Image, graphical abstract