4.7 Article

Association of Statins and 28-Day Mortality Rates in Patients Hospitalized With Severe Acute Respiratory Syndrome Coronavirus 2 Infection

期刊

JOURNAL OF INFECTIOUS DISEASES
卷 225, 期 1, 页码 19-29

出版社

OXFORD UNIV PRESS INC
DOI: 10.1093/infdis/jiab539

关键词

COVID-19; Statins; Mortality; Inpatient Hospitalization; marginal structural model

资金

  1. Massachusetts General Hospital Division of Clinical Research

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The study found that in-hospital statin use was associated with reduced 28-day mortality rates among patients with SARS-CoV-2 infection. This association held true regardless of whether patients used statins before hospitalization, but it had a greater effect in patients aged over 65.
Background. Statins may be protective in severe acute respiratory syndrome coronavirus 2 SARS-CoV-2 infection. The aim of the current study was to evaluate the effect of in-hospital statin use on 28-day mortality rates and intensive care unit (ICU) admission among patients with SARS-CoV-2, stratified into 4 groups: those who used statins before hospitalization (treatment continued or discontinued in the hospital) and those who did not (treatment newly initiated in the hospital or never initiated). Methods. In a cohort study of 1179 patients with SARS-CoV-2, record review was used to assess demographics, laboratory measurements, comorbid conditions, and time from admission to death, ICU admission, or discharge. Using marginal structural Cox models, we estimated hazard ratios (HRs) for death and ICU admission. Results. Among 1179 patients, 676 (57%) were male, 443 (37%) were >65 years old, and 493 (46%) had a body mass index >= 30 (calculated as weight in kilograms divided by height in meters squared). Inpatient statin use reduced the hazard of death (HR, 0.566; P = .008). 'This association held among patients who did and those who did not use statins before hospitalization (HR, 0.270 [P = .003] and 0.493 [P = .04], respectively). Statin use was associated with improved time to death for patients aged >65 years but not for those <= 65 years old. Conclusion. Statin use during hospitalization for SARS-CoV-2 infection was associated with reduced 28-day mortality rates. Well-designed randomized control trials are needed to better define this relationship.

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