ABSTRACT
Background: Coronavirus disease-19 (COVID-19) infection is associated with an uncontrolled systemic inflammatory response. Statins, given their anti-inflammatory properties, may reduce the associated morbidity and mortality. This study aimed to determine the association between statin use prior to hospitalization and in-hospital mortality in COVID-19 patients. Methods: In this retrospective study, clinical data were collected from the electronic medical records of patients admitted to the hospital with confirmed COVID-19 infection from March 1, 2020 to April 24, 2020. A multivariate regression analysis was performed to study the association of pre-admission statin use with in-hospital mortality. Results: Of 255 patients, 116 (45.5%) patients were on statins prior to admission and 139 (54.5%) were not. The statin group had a higher proportion of end stage renal disease (ESRD) (13.8% vs. 2.9%, p = 0.001), diabetes mellitus (63.8% vs. 35.2%, p<0.001), hypertension (87.9% vs. 61.1%, p < 0.001) and coronary artery disease (CAD) (33.6% vs. 5%, p < 0.001). On multivariate analysis, we found a statistically significant decrease in the odds of in-hospital mortality in patients on statins before admission (OR 0.14, 95% CI 0.03-0.61, p = 0.008). In the subgroup analysis, statins were associated with a decrease in mortality in those with CAD (OR 0.02, 95% CI 0.0003-;0.92 p = 0.045) and those without CAD (OR 0.05, 95% CI 0.005-0.43, p = 0.007). Conclusions: Our study suggests that statins are associated with reduced in-hospital mortality among patients with COVID-19, regardless of CAD status. More comprehensive epidemiological and molecular studies are needed to establish the role of statins in COVID-19.
ABSTRACT
SESSION TITLE: Critical Care Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: October 18-21, 2020 PURPOSE: COVID-19 has affected millions of people all over the world with high mortality. This impact is greater in the low socioeconomic patient population. There has been debate on whether the ARDS due to COVID-19 is typical ARDS or the variant phenotypes L and H. We describe the clinical characteristics, ventilator mechanics, and outcomes in an underserved African American patient population. METHODS: This is a single-center retrospective observational study. We included all adult patients with laboratory-confirmed COVID-19 discharged from our ICU between March 15-April 25, 2020. We collected demographic data, laboratory values, respiratory mechanics and clinical outcomes RESULTS: Sixty-one critical ill adult patients with confirmed SARS-Cov-2 were included in the study. Median age was 70 (IQR 61-77) and 31 patients (51%) were female. 21% of patients had preexisting pulmonary disease and almost half were current or former smokers. Hypertension was present in 85% and Diabetes Mellitus in 62% of the patients. Fifty-one patients (83.6%) had two or more comorbidities. On intubation the median PEEP was 8 cm H2O (IQR 5-10), plateau pressure was 25 cm H2O (IQR22-30) and compliance was 26 ml/cmH2O (IQR 21-33). There was a significantly lower mean PF ratio on admission compared to PF ratios 3 days after (p=0.014). The FiO2 requirements were significantly higher on admission compared to 3 days after (89.62 vs 57.71 p=0.005). Compliance increased from the date of admission to day 3 but was not statistically significant. Mechanical ventilation was required in 82% of patients. Prone positioning was done for 30% of patients and had less mortality of 29.7% vs 36.8% (p=0.763). Overall, the mortality rate was 66%. Withdrawal of care was done in 37.7% of patients. Successful extubation rate was 23%. CONCLUSIONS: Our patients presented with the typical low compliance ARDS. The mortality in critically ill COVID-19 patients is high. Increasing age, African Americans, and patients with multiple comorbid conditions are at increased risk of morbidity and mortality. CLINICAL IMPLICATIONS: N/A DISCLOSURES: No relevant relationships by Zurab Azmaiparashvili, source=Web Response No relevant relationships by Sadia Benzaquen, source=Web Response No relevant relationships by Siddique Chaudhary, source=Web Response No relevant relationships by Kevin Bryan Lo, source=Web Response No relevant relationships by ATUL MATTA, source=Web Response No relevant relationships by Gabriel Patarroyo - Aponte, source=Web Response