Background Statins have anti-inflammatory and immunomodulatory effects that may reduce the severity of coronavirus disease 2019 (COVID-19), in which organ dysfunction is mediated by severe inflammation. Large studies with diverse populations evaluating statin use and outcomes in COVID-19 are lacking. Methods and results We used data from 10,541 patients hospitalized with COVID-19 through September 2020 at 104 US hospitals enrolled in the American Heart Association’s COVID-19 Cardiovascular Disease (CVD) Registry to evaluate the associations between statin use and outcomes. Prior to admission, 42% of subjects (n = 4,449) used statins (7% on statins alone, 35% on statins plus anti-hypertensives). Death (or discharge to hospice) occurred in 2,212 subjects (21%). Outpatient use of statins, either alone or with anti-hypertensives, was associated with a reduced risk of death (adjusted odds ratio [aOR] 0.59, 95% CI 0.50–0.69), adjusting for demographic characteristics, insurance status, hospital site, and concurrent medications by logistic regression. In propensity-matched analyses, use of statins and/or anti-hypertensives was associated with a reduced risk of death among those with a history of CVD and/or hypertension (aOR 0.68, 95% CI 0.58–0.81). An observed 16% reduction in odds of death among those without CVD and/or hypertension was not statistically significant. Conclusions Patients taking statins prior to hospitalization for COVID-19 had substantially lower odds of death, primarily among individuals with a history of CVD and/or hypertension. These observations support the continuation and aggressive initiation of statin and anti-hypertensive therapies among patients at risk for COVID-19, if these treatments are indicated based upon underlying medical conditions.
【초록키워드】 COVID-19, Treatment, coronavirus disease, therapy, Anti-inflammatory, Hospitalization, severity, hospital, risk, outcome, hypertension, discharge, Population, cardiovascular, outcomes, heart, Patient, statin, death, organ dysfunction, Logistic regression, registry, medication, Admission, association, Outpatient, Medical conditions, demographic characteristics, Support, observation, CVD, adjusted odds ratio, 95% CI, reduced risk, subject, individual, severe inflammation, immunomodulatory effect, enrolled, evaluate, occurred, indicated, reduce, reduction in, statistically significant, analyses, patients hospitalized, used data, with COVID-19, 【제목키워드】 COVID-19, cardiovascular, heart, Severity of disease, registry, finding, relation, patients hospitalized,