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Statin and mortality in COVID-19: a systematic review and meta-analysis of pooled adjusted effect estimates from propensity-matched cohorts.
Zein, Ahmad Fariz Malvi Zamzam; Sulistiyana, Catur Setiya; Khasanah, Uswatun; Wibowo, Arief; Lim, Michael Anthonius; Pranata, Raymond.
  • Zein AFMZ; Department of Internal Medicine, Faculty of Medicine, Universitas Swadaya Gunung Jati, Cirebon, Jawa Barat, Indonesia fariz_zein_dr@yahoo.com.
  • Sulistiyana CS; Department of Internal Medicine, Waled General Hospital, Cirebon, Jawa Barat, Indonesia.
  • Khasanah U; Department of Medical Education, Faculty of Medicine, Universitas Swadaya Gunung Jati, Cirebon, Jawa Barat, Indonesia.
  • Wibowo A; Department of Biostatistics and Epidemiology, Faculty of Medicine, Universitas Swadaya Gunung Jati, Cirebon, Jawa Barat, Indonesia.
  • Lim MA; Department of Cardiology and Vascular Medicine, Universitas Padjadjaran, Bandung, Jawa Barat, Indonesia.
  • Pranata R; Universitas Pelita Harapan Fakultas Kedokteran, Tangerang, Banten, Indonesia.
Postgrad Med J ; 98(1161): 503-508, 2022 Jul.
Article in English | MEDLINE | ID: covidwho-1292178
ABSTRACT

PURPOSE:

Statin potentially improved outcome in patients with COVID-19. Patients who receive statin generally have a higher proportion of comorbidities than those who did not, which may introduce bias. In this meta-analysis, we aimed to investigate the association between statin use and mortality in patients with COVID-19 by pooling the adjusted effect estimates from propensity-score matching (PSM) matched studies or randomised controlled trials to reduce bias.

METHODS:

A systematic literature search using the PubMed, Scopus and Embase databases were performed up until 1 March 2021. Studies that were designed the study to assess statin and mortality using PSM with the addition of Inverse Probability Treatment Weighting or multivariable regression analysis on top of PSM-matched cohorts were included. The effect estimate was reported in term of relative risk (RR).

RESULTS:

14 446 patients were included in the eight PSM-matched studies. Statin was associated with decreased mortality in patients with COVID-19 (RR 0.72 (0.55, 0.95), p=0.018; I2 84.3%, p<0.001). Subgroup analysis in patients receiving statin in-hospital showed that it was associated with lower mortality (RR 0.71 (0.54, 0.94), p=0.030; I2 64.1%, p<0.025). The association of statin and mortality was not significantly affected by age (coefficient -0.04, p=0.382), male gender (RR 0.96 (0.95, 1.02), p=0.456), diabetes (RR 1.02 (0.99, 1.04), p=0.271) and hypertension (RR 1.01 (0.97, 1.04), p=0.732) in this pooled analysis.

CONCLUSION:

In this meta-analysis of PSM-matched cohorts with adjusted analysis, statin was shown to decrease the risk of mortality in patients with COVID-19. PROSPERO REGISTRATION NUMBER CRD42021240137.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Hydroxymethylglutaryl-CoA Reductase Inhibitors / Diabetes Mellitus / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Limits: Humans / Male Language: English Journal: Postgrad Med J Year: 2022 Document Type: Article Affiliation country: Postgradmedj-2021-140409

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Hydroxymethylglutaryl-CoA Reductase Inhibitors / Diabetes Mellitus / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Limits: Humans / Male Language: English Journal: Postgrad Med J Year: 2022 Document Type: Article Affiliation country: Postgradmedj-2021-140409