Infectious Disease

Statins can enhance mortality in hospitalized sufferers with COVID-19

March 09, 2021

2 min read

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Disclosure:
Gupta reports that she received payment from the Arnold and Porter law firm for work related to the Sanofi clopidogrel litigation and from the Ben C. Martin law firm for work related to inferior vena cava filter litigation. received consulting fees from Edwards Lifesciences; and holds a stake in Heartbeat Health. In the study you will find all relevant financial information from all other authors.

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Previous statin therapy resulted in improved 30-day hospital mortality in patients approved for COVID-19, although patients were older and had higher levels of CVD than those who did not receive statins.

However, the need for invasive mechanical ventilation was not different between the two groups, according to the study published in Nature Communications.

Previous statin therapy resulted in improved 30-day hospital mortality in patients approved for COVID-19, although patients were older and had higher levels of CVD than those who did not receive statins. The data were provided by Gupta A et al. Nat Commun. 2021; doi: 10.1038 / s41467-021-21553-1.

“COVID-19 can lead to a hyperinflammatory condition that leads to acute respiratory distress syndrome (ARDS), myocardial injury and thrombotic complications, among other things.” Aakriti Gupta, MD, Cardiologist at Irving Medical Center, New York Presbyterian / Columbia University, and colleagues wrote. “Statins known to have anti-inflammatory and antithrombotic properties have been studied in other viral infections, but their benefits have not been evaluated in COVID-19.”

For the retrospective study, from February 1 to May 12, 2020, researchers analyzed 2,626 patients admitted with COVID-19 at Columbia University’s Irving Medical Center and New York-Presbyterian Hospital’s Allen Hospital to assess the effect of staining therapy on the Determine outcomes in COVID-19. The primary endpoint was in-hospital mortality within 30 days and the secondary endpoint was invasive mechanical ventilation after 30 days.

Basic characteristics

Overall, patients with statins were older (mean age 70 vs. 62 years) than patients without statins. There were no significant differences in terms of gender (P = 0.06) or race / ethnicity (P = 0.12).

Patients in the statin group were more likely than non-users to have:

  • Hypertension (74% versus 43.3%);
  • Diabetes (55.8% versus 26.1%);
  • CAD (22.5% versus 6.9%);
  • HF (17% versus 6.7%);
  • chronic kidney disease (22% versus 9.6%);
  • History of stroke or transient ischemic attack (13.9% versus 5.6%); and
  • atrial arrhythmias (11% versus 5.6%).

In addition, 77% of patients with antecedent statins and 8.6% of patients without antecedent statins received statins during their COVID-19 hospitalization.

In a tilt-adjusted analysis, the researchers found that patients taking statins had lower white blood cell counts and lower C-reactive protein levels at presentation (P for both <0.01).

There are no differences in the concentrations of the highly sensitive troponin T, D-dimer, ferritin or erythrocyte sedimentation rates between the groups.

Statins and 30-day mortality

The researchers found that statin use was associated with a decrease in the primary endpoint in the full cohort in univariate (adjusted OR = 0.69; 95% CI, 0.56-0.85) and multivariable adjusted analysis (aOR = 0.49; 95% CI, 0.38-). 0.63) compared to non-use.

“There are many possible explanations for how statins might have helped lower 30-day hospital mortality in our cohort,” the researchers wrote. “Statins that target the reduction of HMG-CoA (3-hydroxy-3-methylglutaryl-coenzyme A) give patients with atherosclerotic cardiovascular disease, who are overrepresented in hospitalized patients with COVID-19, a significant mortality advantage . In addition to hyperlipidemia and other cardiovascular risk factors, inflammation has been identified as a key modulator of atherogenesis and can contribute to adverse cardiovascular events. “

According to the study, previous statin use at any point in time was associated with a lower in-hospital death rate than non-use (20.8% versus 33.7%; P <0.001).

There was a trend that statins were associated with lower chances of the secondary endpoint (aOR = 0.8; 95% CI, 0.64-1.02).

“Identifying treatment strategies to prevent the serious consequences of this viral infection can improve the prognosis,” the researchers write. “The current analysis suggests that statins deserve further evaluation in COVID-19 because of their pleiotropic properties and potentially disease-modifying effects in the development of this viral disease.”

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