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Association of Statin Use With the In-Hospital Outcomes of 2019-Coronavirus Disease Patients: A Retrospective Study.
Fan, Yongzhen; Guo, Tao; Yan, Feifei; Gong, Ming; Zhang, Xin A; Li, Chenze; He, Tao; Luo, Huimin; Zhang, Lin; Chen, Ming; Wu, Xiaoyan; Wang, Hairong; Deng, Ke-Qiong; Bai, Jiao; Cai, Lin; Lu, Zhibing.
  • Fan Y; Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, China.
  • Guo T; Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, China.
  • Yan F; Department of Orthopedics, Zhongnan Hospital of Wuhan University, Wuhan, China.
  • Gong M; Department of Medical Quality Control, Leishenshan Hospital, Wuhan, China.
  • Zhang XA; Department of Orthopedics, Zhongnan Hospital of Wuhan University, Wuhan, China.
  • Li C; Department of Medical Quality Control, Leishenshan Hospital, Wuhan, China.
  • He T; University of Oklahoma Health Science Center, Oklahoma City, OK, United States.
  • Luo H; Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, China.
  • Zhang L; Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, China.
  • Chen M; Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, China.
  • Wu X; Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, China.
  • Wang H; Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, China.
  • Deng KQ; Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, China.
  • Bai J; Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, China.
  • Cai L; Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, China.
  • Lu Z; Department of Ultrasonography, Zhongnan Hospital of Wuhan University, Wuhan, China.
Front Med (Lausanne) ; 7: 584870, 2020.
Article in English | MEDLINE | ID: covidwho-963101
Semantic information from SemMedBD (by NLM)
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Subject
Hydroxymethylglutaryl-CoA Reductase Inhibitors
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PREVENTS
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Inflammation
2. Coagulation procedure TREATS Pneumonia
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Coagulation procedure
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TREATS
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Pneumonia
3. COVID-19 PROCESS_OF Patients
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COVID-19
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PROCESS_OF
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Patients
4. Therapeutic procedure compared_with Hydroxymethylglutaryl-CoA Reductase Inhibitors
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Hydroxymethylglutaryl-CoA Reductase Inhibitors
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8. Hydroxymethylglutaryl-CoA Reductase Inhibitors TREATS COVID-19
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Hydroxymethylglutaryl-CoA Reductase Inhibitors
Predicate
TREATS
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COVID-19
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Hydroxymethylglutaryl-CoA Reductase Inhibitors
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TREATS
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Patients
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Hydroxymethylglutaryl-CoA Reductase Inhibitors
Predicate
PREVENTS
Object
Inflammation
11. Coagulation procedure TREATS Pneumonia
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Coagulation procedure
Predicate
TREATS
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Pneumonia
12. COVID-19 PROCESS_OF Patients
Subject
COVID-19
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PROCESS_OF
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Patients
13. Therapeutic procedure compared_with Hydroxymethylglutaryl-CoA Reductase Inhibitors
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Therapeutic procedure
Predicate
compared_with
Object
Hydroxymethylglutaryl-CoA Reductase Inhibitors
14. Therapeutic procedure NEG_ADMINISTERED_TO Patients
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Therapeutic procedure
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NEG_ADMINISTERED_TO
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Patients
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Hydroxymethylglutaryl-CoA Reductase Inhibitors
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16. Hydroxymethylglutaryl-CoA Reductase Inhibitors ADMINISTERED_TO Patients
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Hydroxymethylglutaryl-CoA Reductase Inhibitors
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17. Hydroxymethylglutaryl-CoA Reductase Inhibitors TREATS COVID-19
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Hydroxymethylglutaryl-CoA Reductase Inhibitors
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TREATS
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COVID-19
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ABSTRACT

Background:

Statins have multiple protective effects on inflammation, immunity and coagulation, and may help alleviate pneumonia. However, there was no report focusing on the association of statin use with in-hospital outcomes of patients with coronavirus disease 2019 (COVID-19). We investigated the association between the use of statins and in-hospital outcomes of patients with COVID-19.

Methods:

In this retrospective case series, consecutive COVID-19 patients admitted at 2 hospitals in Wuhan, China, from March 12, 2020 to April 14, 2020 were analyzed. A 11 matched cohort was created by propensity score-matched analysis. Demographic data, laboratory findings, comorbidities, treatments and in-hospital outcomes were collected and compared between COVID-19 patients taking and not taking statins.

Result:

A total of 2,147 patients with COVID-19 were enrolled in this study. Of which, 250 patients were on statin therapy. The mortality was 2.4% (6/250) for patients taking statins while 3.7% (70/1,897) for those not taking statins. In the multivariate Cox model, after adjusting for age, gender, admitted hospital, comorbidities, in-hospital medications and blood lipids, the risk was lower for mortality (adjusted HR, 0.428; 95% CI, 0.169-0.907; P = 0.029), acute respiratory distress syndrome (ARDS) (adjusted HR, 0.371; 95% CI, 0.180-0.772; P = 0.008) or intensive care unit (ICU) care (adjusted HR, 0.319; 95% CI, 0.270-0.945; P = 0.032) in the statin group vs. the non-statin group. After propensity score-matched analysis based on 18 potential confounders, a 11 matched cohort (206206) was created. In the matched cohort, the Kaplan-Meier survival curves showed that the use of statins was associated with better survival (P = 0.025). In a Cox regression model, the use of statins was associated with lower risk of mortality (unadjusted HR, 0.254; 95% CI, 0.070-0.926; P = 0.038), development of ARDS (unadjusted HR, 0.240; 95% CI, 0.087-0.657; P = 0.006), and admission of ICU (unadjusted HR, 0.349; 95% CI, 0.150-0.813; P = 0.015). The results remained consistent when being adjusted for age, gender, total cholesterol, triglyceride, low density lipoprotein cholesterol, procalcitonin, and brain natriuretic peptide. The favorable outcomes in statin users remained statistically significant in the first sensitivity analysis with comorbid diabetes being excluded in matching and in the second sensitivity analysis with chronic obstructive pulmonary disease being added in matching.

Conclusion:

In this retrospective analysis, the use of statins in COVID-19 patients was associated with better clinical outcomes and is recommended to be continued in patients with COVID-19.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Observational study / Prognostic study / Risk factors Language: English Journal: Front Med (Lausanne) Year: 2020 Document Type: Article Affiliation country: Fmed.2020.584870

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Observational study / Prognostic study / Risk factors Language: English Journal: Front Med (Lausanne) Year: 2020 Document Type: Article Affiliation country: Fmed.2020.584870