Author: Gupta, Aakriti; Madhavan, Mahesh V.; Poterucha, Timothy J.; DeFilippis, Ersilia M.; Hennessey, Jessica A.; Redfors, Bjorn; Eckhardt, Christina; Bikdeli, Behnood; Platt, Jonathan; Nalbandian, Ani; Elias, Pierre; Cummings, Matthew J.; Nouri, Shayan N.; Lawlor, Matthew; Ranard, Lauren S.; Li, Jianhua; Boyle, Claudia; Givens, Raymond; Brodie, Daniel; Krumholz, Harlan M.; Stone, Gregg W.; Sethi, Sanjum S.; Burkhoff, Daniel; Uriel, Nir; Schwartz, Allan; Leon, Martin B.; Kirtane, Ajay J.; Wan, Elaine Y.; Parikh, Sahil A.
Title: Association Between Antecedent Statin Use and Decreased Mortality in Hospitalized Patients with COVID-19 Cord-id: sw37uxn1 Document date: 2020_8_11
ID: sw37uxn1
Snippet: The coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), can result in a hyperinflammatory state, leading to acute respiratory distress syndrome (ARDS), myocardial injury, and thrombotic complications, among other sequelae. Statins, which are known to have anti-inflammatory and antithrombotic properties, have been studied in the setting of other viral infections and ARDS, but their benefit has not been assessed in COVID-19. Thus, we sou
Document: The coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), can result in a hyperinflammatory state, leading to acute respiratory distress syndrome (ARDS), myocardial injury, and thrombotic complications, among other sequelae. Statins, which are known to have anti-inflammatory and antithrombotic properties, have been studied in the setting of other viral infections and ARDS, but their benefit has not been assessed in COVID-19. Thus, we sought to determine whether antecedent statin use is associated with lower in-hospital mortality in patients hospitalized for COVID-19. This is a retrospective analysis of patients admitted with COVID-19 from February 1 (st) through May 12 (th) , 2020 with study period ending on June 11 (th) , 2020. Antecedent statin use was assessed using medication information available in the electronic medical record. We constructed a multivariable logistic regression model to predict the propensity of receiving statins, adjusting for baseline socio-demographic and clinical characteristics, and outpatient medications. The primary endpoint included in-hospital mortality within 30 days. A total of 2626 patients were admitted during the study period, of whom 951 (36.2%) were antecedent statin users. Among 1296 patients (648 statin users, 648 non-statin users) identified with 1:1 propensity-score matching, demographic, baseline, and outpatient medication information were well balanced. Statin use was significantly associated with lower odds of the primary endpoint in the propensity-matched cohort (OR 0.48, 95% CI 0.36 – 0.64, p<0.001). We conclude that antecedent statin use in patients hospitalized with COVID-19 was associated with lower inpatient mortality. Randomized clinical trials evaluating the utility of statin therapy in patients with COVID-19 are needed.
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