tetano
Editor, Senior Moderator
PLoS One
. 2021 Jul 15;16(7):e0254635.
doi: 10.1371/journal.pone.0254635. eCollection 2021.
Relation of prior statin and anti-hypertensive use to severity of disease among patients hospitalized with COVID-19: Findings from the American Heart Association's COVID-19 Cardiovascular Disease Registry
Lori B Daniels[SUP] 1 2 [/SUP], Junting Ren[SUP] 3 [/SUP], Kris Kumar[SUP] 4 [/SUP], Quan M Bui[SUP] 1 [/SUP], Jing Zhang[SUP] 5 [/SUP], Xinlian Zhang[SUP] 3 [/SUP], Mariem A Sawan[SUP] 6 [/SUP], Howard Eisen[SUP] 7 [/SUP], Christopher A Longhurst[SUP] 8 [/SUP], Karen Messer[SUP] 3 5 [/SUP]
Affiliations
Abstract
Background: Statins have anti-inflammatory and immunomodulatory effects that may reduce the severity of coronavirus disease 2019 (COVID-19), in which organ dysfunction is mediated by severe inflammation. Large studies with diverse populations evaluating statin use and outcomes in COVID-19 are lacking.
Methods and results: We used data from 10,541 patients hospitalized with COVID-19 through September 2020 at 104 US hospitals enrolled in the American Heart Association's COVID-19 Cardiovascular Disease (CVD) Registry to evaluate the associations between statin use and outcomes. Prior to admission, 42% of subjects (n = 4,449) used statins (7% on statins alone, 35% on statins plus anti-hypertensives). Death (or discharge to hospice) occurred in 2,212 subjects (21%). Outpatient use of statins, either alone or with anti-hypertensives, was associated with a reduced risk of death (adjusted odds ratio [aOR] 0.59, 95% CI 0.50-0.69), adjusting for demographic characteristics, insurance status, hospital site, and concurrent medications by logistic regression. In propensity-matched analyses, use of statins and/or anti-hypertensives was associated with a reduced risk of death among those with a history of CVD and/or hypertension (aOR 0.68, 95% CI 0.58-0.81). An observed 16% reduction in odds of death among those without CVD and/or hypertension was not statistically significant.
Conclusions: Patients taking statins prior to hospitalization for COVID-19 had substantially lower odds of death, primarily among individuals with a history of CVD and/or hypertension. These observations support the continuation and aggressive initiation of statin and anti-hypertensive therapies among patients at risk for COVID-19, if these treatments are indicated based upon underlying medical conditions.
. 2021 Jul 15;16(7):e0254635.
doi: 10.1371/journal.pone.0254635. eCollection 2021.
Relation of prior statin and anti-hypertensive use to severity of disease among patients hospitalized with COVID-19: Findings from the American Heart Association's COVID-19 Cardiovascular Disease Registry
Lori B Daniels[SUP] 1 2 [/SUP], Junting Ren[SUP] 3 [/SUP], Kris Kumar[SUP] 4 [/SUP], Quan M Bui[SUP] 1 [/SUP], Jing Zhang[SUP] 5 [/SUP], Xinlian Zhang[SUP] 3 [/SUP], Mariem A Sawan[SUP] 6 [/SUP], Howard Eisen[SUP] 7 [/SUP], Christopher A Longhurst[SUP] 8 [/SUP], Karen Messer[SUP] 3 5 [/SUP]
Affiliations
- PMID: 34264974
- DOI: 10.1371/journal.pone.0254635
Abstract
Background: Statins have anti-inflammatory and immunomodulatory effects that may reduce the severity of coronavirus disease 2019 (COVID-19), in which organ dysfunction is mediated by severe inflammation. Large studies with diverse populations evaluating statin use and outcomes in COVID-19 are lacking.
Methods and results: We used data from 10,541 patients hospitalized with COVID-19 through September 2020 at 104 US hospitals enrolled in the American Heart Association's COVID-19 Cardiovascular Disease (CVD) Registry to evaluate the associations between statin use and outcomes. Prior to admission, 42% of subjects (n = 4,449) used statins (7% on statins alone, 35% on statins plus anti-hypertensives). Death (or discharge to hospice) occurred in 2,212 subjects (21%). Outpatient use of statins, either alone or with anti-hypertensives, was associated with a reduced risk of death (adjusted odds ratio [aOR] 0.59, 95% CI 0.50-0.69), adjusting for demographic characteristics, insurance status, hospital site, and concurrent medications by logistic regression. In propensity-matched analyses, use of statins and/or anti-hypertensives was associated with a reduced risk of death among those with a history of CVD and/or hypertension (aOR 0.68, 95% CI 0.58-0.81). An observed 16% reduction in odds of death among those without CVD and/or hypertension was not statistically significant.
Conclusions: Patients taking statins prior to hospitalization for COVID-19 had substantially lower odds of death, primarily among individuals with a history of CVD and/or hypertension. These observations support the continuation and aggressive initiation of statin and anti-hypertensive therapies among patients at risk for COVID-19, if these treatments are indicated based upon underlying medical conditions.