Background The pleiotropic effects of statins may reduce the severity of COVID-19 disease. This study aims to determine the association between inpatient statin use and severe disease outcomes among hospitalized COVID-19 patients, especially those with Diabetes Mellitus (DM). Research design and methods A retrospective cohort study on hospitalized patients with confirmed COVID-19 diagnosis. The primary outcome was mortality during hospitalization. Patients were classified into statin and non-statin groups based on the administration of statins during hospitalization. Analysis included multivariable regression analysis adjusting for confounders and propensity score matching to achieve a 1:1 balanced cohort. Subgroup analyses based on presence of DM were conducted. Results In the cohort of 922 patients, 413 had a history of DM. About 27.1% patients (n = 250) in the total cohort (TC) and 32.9% patients (n = 136) in DM cohort received inpatient statins. Atorvastatin (n = 205, 82%) was the most commonly prescribed statin medication in TC. On multivariable analysis in TC, inpatient statin group had reduced mortality compared to the non-statin group (OR, 0.61; 95% CI, 0.42–0.90; p = 0.01). DM modified this association between inpatient statins and mortality. Patients with DM who received inpatient statins had reduced mortality (OR, 0.35; 95% CI, 0.21–0.61; p < 0.001). However, no such association was noted among patients without DM (OR, 1.21; 95% CI, 0.67–2.17; p = 0.52). These results were further validated using propensity score matching. Conclusions Inpatient statin use was associated with significant reduction in mortality among COVID-19 patients especially those with DM. These findings support the pursuit of randomized clinical trials and inpatient statin use appears safe among COVID-19 patients. Supplementary Information The online version contains supplementary material available at 10.1186/s12933-021-01336-0.
【저자키워드】 COVID-19, Mortality, intensive care, mechanical ventilation, Diabetes Mellitus, race, statins, Inpatient, 【초록키워드】 randomized clinical trial, Hospitalization, outcome, Cohort, severity of COVID-19, Patient, COVID-19 diagnosis, atorvastatin, group, medication, disease, patients, COVID-19 patients, association, administration, Research design, propensity score matching, severe disease, COVID-19 patient, Safe, Support, regression analysis, retrospective cohort study, Primary outcome, hospitalized COVID-19 patients, supplementary material, 95% CI, multivariable analysis, pursuit, reduction in mortality, confounder, multivariable, Result, conducted, reduced, appear, determine, hospitalized patient, reduce, 1:1, pleiotropic effect, Subgroup analysis, 【제목키워드】 Clinical outcome, statin, hospitalized COVID-19 patient, propensity score matching, retrospective cohort study,