Abstract
Statins have been advocated as a potential treatment for coronavirus disease-2019 (COVID-19) due to its pleotropic properties. The aim of the study was to elucidate the association between antecedent statin exposure and 30-day all-cause mortality, intensive care unit (ICU) admission and hypoxic respiratory failure requiring mechanical ventilation in patients diagnosed with COVID-19. Observational cohort study derived from the VA Corporate Data Warehouse of all veterans tested positive for COVID-19 between January 1st and May 31st, 2020. Antecedent use of statins was defined as a redeemed drug prescription in the 6 months prior to COVID-19 diagnosis. Propensity-matched mixed-effects logistic regression was performed, stratified by statin use. The study population comprised 14,268 patients with COVID-19 (median age 66 years (25th-75th percentile, 53-74), 90.7% men), of whom 7,168 were receiving a prescription for statins. Patients with statin exposure had a greater prevalence of comorbidities and a higher risk of mortality (Odd ratio [OR] 1.52; 95% confidence interval [CI] 1.37-1.68). After adjusting for covariates, statin exposure was not associated with a decreased mortality in the overall cohort by either Cox proportional hazards stratified model (HR 0.99; 95% CI 0.88-1.12) or propensity matching (HR .86; 95% CI 0.74-1.01). Similarly, there was no demonstrated advantage of statins in reducing the risk of ICU admission (HR 0.92; 95% CI 0.74-1.31) or hypoxic respiratory failure requiring mechanical ventilation (HR 1.02; 95% CI 0.81-1.29). Antecedent statin exposure in patients with COVID-19 was not associated with a decreased risk of 30-day all-cause mortality or need for mechanical ventilation.
Keywords: COVID-19; ICU admission; Mechanical ventilation; Mortality; Respiratory failure; Statins.
【저자키워드】 COVID-19, Respiratory failure, Mortality, mechanical ventilation, statins., ICU admission, 【초록키워드】 coronavirus, intensive care, hypoxic respiratory failure, Comorbidity, risk, ICU, cohort study, Prevalence, Cohort, Patient, COVID-19 diagnosis, statin, Logistic regression, covariates, respiratory, Admission, statins, association, Potential treatment, higher risk, 95% CI, 95% confidence interval, decreased mortality, study population, median age, all-cause mortality, positive, warehouse, men, antecedent, greater, defined, tested, receiving, was performed, reducing, demonstrated, stratified, Cox proportional hazard, diagnosed with COVID-19, Mechanical, patients with COVID-19, 【제목키워드】 database, cohort study, Analysis, COVID-19 patient, receiving,