ABSTRACT
Statins constitute a cornerstone in the primary and secondary prevention of atherosclerotic cardiovascular disease (ASCVD). The routine use of these lipid-lowering agents may lead to unintentional neglect of their well-known myotoxic properties. We report the case of a 77-year-old female with a two-year history of rosuvastatin use who presented with progressive bilateral upper and lower extremity muscular weakness for one week, which improved upon discontinuation of her long-term statin therapy. The authors aim to draw attention to this potentially underdiagnosed cause of disability. It is imperative that clinicians are able to appreciate the myopathic spectrum of statin therapy, irrespective of the duration of use. Myonecrosis, in particular, can progress to rhabdomyolysis, leading to irreversible renal dysfunction, electrolyte abnormalities, and subsequent cardiac dysrhythmias. Ultimately, statin-induced myopathy may significantly hinder activities of daily living and impair quality of life. It is, however, a reversible condition if diagnosed and appropriately managed early on. Clinicians are encouraged to acquaint themselves with the symptomatology and relevant laboratory values that commonly accompany this acute condition.
ABSTRACT
The Hispanic population is regarded among those who are at greater risk of adverse prognoses due to higher rates of diabetes and obesity in the USA during the COVID-19 pandemic. Statin medications are speculated to help treat the infection by decreasing inflammation caused by COVID-19. In this retrospective, observational study, outcomes of statin use were assessed among Hispanic patients with COVID-19 by screening all patients hospitalized between March, 2020 and March, 2021 at a tertiary care hospital in El Paso, Texas, resulting in a total of 1039 patients. The patients were categorized into a group of either being on statins or not. The considered outcomes were mechanical ventilation, intensive care unit (ICU) hospitalization, oxygen supplementation at discharge, hospital length of stay, and mortality. Patients receiving statins were observed to be older with more comorbidities. In the propensity-scores adjusted analysis, no association was found between statin use and: mortality (adjusted risk ratio (aRR)=0.96, p=0.754), mechanical ventilation (aRR=0.91, p=0.503), ICU transfer (aRR=0.96, p=0.395), and O2 supplementation at discharge (aRR=1.03, p=0.729). These outcomes were also evaluated in patients who had myocardial infarction and stroke with COVID-19. Among these patients, association was found between statin use and: a reduced risk of mortality (aRR=0.61, p=0.005), mechanical ventilation (aRR=0.53, p=0.012) and ICU transfers (aRR=0.81, p=0.005). These results may not give us a reason to start patients on statins for the specific treatment of COVID-19, but it may be sufficient evidence to suggest statins should not be discontinued during hospitalization due to COVID-19.
