Dataset Information

Influence of statin treatment in a cohort of patients admitted for COVID-19.

ABSTRACT:

Aims and objectives

Statins have been proposed as potentially useful agents for modulating the host response in COVID-19. However, solid evidence-based recommendations are still lacking. Our aim was to study the association between statin use and clinical outcomes in a large cohort of hospitalized patients with SARS-CoV-2 infection, as well as the specific consequences of chronic treatment withdrawal during hospital admission.

Material and methods

Retrospective observational study including 2191 hospitalized patients with confirmed SARS-CoV-2 infection.

Results

Mean age was 68.0±17.8 years and 597 (27.3%) patients died during follow-up. A total of 827 patients (37.7% of the whole sample), received chronic treatment with statins. Even though they underwent more frequent admissions in critical care units, chronic treatment with statins was not independently associated with all-cause mortality [HR 0.95 (0.72-1.25)]. During the whole hospital admission, 371 patients (16.9%) received at least one dose of statin. Although these patients had a significantly worse clinical profile, both treatment with statins during admission [HR 1.03 (0.78-1.35)] and withdrawal of chronic statin treatment [HR 1.01 (0.78-1.30)] showed a neutral effect in mortality. However, patients treated with statins presented more frequently hepatic cytolysis, rhabdomyolysis and thrombotic/hemorrhagic events.

Conclusions

In this large cohort of hospitalized COVID-19 patients, statins were not independently associated with all-cause mortality during follow-up. Clinically relevant statin-associated adverse effects should be carefully monitored during hospital admission.

SUBMITTER: Rey JR

PROVIDER: S-EPMC8302844 | biostudies-literature | 2022 Jun

REPOSITORIES: biostudies-literature

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Publications

Influence of statin treatment in a cohort of patients admitted for COVID-19.

Rey Juan R JR Merino Llorens José Luis JL Iniesta Manjavacas Ángel Manuel ÁM Rodríguez Sandra Ofelia Rosillo SOR Castrejón-Castrejón Sergio S Arbas-Redondo Emilio E Poveda-Pinedo Isabel Dolores ID Tebar-Márquez Daniel D Severo-Sánchez Andrea A Rivero-Santana Borja B Juárez-Olmos Víctor V Martínez-Cossiani Marcel M Buño-Soto Antonio A Gonzalez-Valle Luis L Herrero-Ambrosio Alicia A López-de-Sá Esteban E Caro-Codón Juan J

Medicina clinica 20210724 12

<h4>Aims and objectives</h4>Statins have been proposed as potentially useful agents for modulating the host response in COVID-19. However, solid evidence-based recommendations are still lacking. Our aim was to study the association between statin use and clinical outcomes in a large cohort of hospitalized patients with SARS-CoV-2 infection, as well as the specific consequences of chronic treatment withdrawal during hospital admission.<h4>Material and methods</h4>Retrospective observational study ...[more]

PMID: 34511251

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Project description:ImportanceStatin use prior to hospitalization for Coronavirus Disease 2019 (COVID-19) is hypothesized to improve inpatient outcomes including mortality, but prior findings from large observational studies have been inconsistent, due in part to confounding. Recent advances in statistics, including incorporation of machine learning techniques into augmented inverse probability weighting with targeted maximum likelihood estimation, address baseline covariate imbalance while maximizing statistical efficiency.ObjectiveTo estimate the association of antecedent statin use with progression to severe inpatient outcomes among patients admitted for COVD-19.Design, setting and participantsWe retrospectively analyzed electronic health records (EHR) from individuals ≥ 40-years-old who were admitted between March 2020 and September 2022 for ≥ 24 h and tested positive for SARS-CoV-2 infection in the 30 days before to 7 days after admission.ExposureAntecedent statin use-statin prescription ≥ 30 days prior to COVID-19 admission.Main outcomeComposite end point of in-hospital death, intubation, and intensive care unit (ICU) admission.ResultsOf 15,524 eligible COVID-19 patients, 4412 (20%) were antecedent statin users. Compared with non-users, statin users were older (72.9 (SD: 12.6) versus 65.6 (SD: 14.5) years) and more likely to be male (54% vs. 51%), White (76% vs. 71%), and have ≥ 1 medical comorbidity (99% vs. 86%). Unadjusted analysis demonstrated that a lower proportion of antecedent users experienced the composite outcome (14.8% vs 19.3%), ICU admission (13.9% vs 18.3%), intubation (5.1% vs 8.3%) and inpatient deaths (4.4% vs 5.2%) compared with non-users. Risk differences adjusted for labs and demographics were estimated using augmented inverse probability weighting with targeted maximum likelihood estimation using Super Learner. Statin users still had lower rates of the composite outcome (adjusted risk difference: - 3.4%; 95% CI: - 4.6% to - 2.1%), ICU admissions (- 3.3%; - 4.5% to - 2.1%), and intubation (- 1.9%; - 2.8% to - 1.0%) but comparable inpatient deaths (0.6%; - 1.3% to 0.1%).Conclusions and relevanceAfter controlling for confounding using doubly robust methods, antecedent statin use was associated with minimally lower risk of severe COVID-19-related outcomes, ICU admission and intubation, however, we were not able to corroborate a statin-associated mortality benefit.

Dataset Information

Influence of statin treatment in a cohort of patients admitted for COVID-19.

Aims and objectives

Material and methods

Results

Conclusions

Publications

Influence of statin treatment in a cohort of patients admitted for COVID-19.

Similar Datasets

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