Survival impact of previous statin therapy in patients hospitalized with COVID-19
Eduardo Barge-Caballero1, Pedro J Marcos-Rodríguez2,3, Nieves Domenech-García4,2
1Servicio de Cardiología, Complejo Hospitalario Universitario de A Coruña (CHUAC), A Coruña, Spain.
Insights
Statin therapy significantly reduced mortality in hospitalized COVID-19 patients. This benefit was most pronounced in patients with pre-existing coronary or extracardiac arterial disease, suggesting statins improve COVID-19 prognosis.
Area of Science:
- Cardiology
- Infectious Diseases
- Pharmacology
Background:
- Statin therapy possesses immunomodulatory, anti-inflammatory, and anti-atherosclerotic properties.
- These properties suggest a potential beneficial prognostic effect in patients with COVID-19.
Purpose of the Study:
- To investigate the hypothesis that statin therapy improves outcomes in hospitalized COVID-19 patients.
- To analyze the association between pre-admission statin use and mortality in COVID-19 patients.
Main Methods:
- A single-center, observational, retrospective study of 1122 hospitalized COVID-19 patients.
- Propensity score matching and Cox regression with inverse probability of treatment weighting (IPTW) were used for survival analysis.
- Follow-up median was 406 days.
Main Results:
- 451 (40.2%) patients received statins prior to admission.
- IPTW survival analysis revealed a significant reduction in mortality associated with prior statin treatment (HR: 0.76).
- The greatest mortality reduction was observed in patients with coronary artery disease (HR: 0.32) and extracardiac arterial disease (HR: 0.45).
Conclusions:
- Previous statin treatment was significantly associated with lower mortality in hospitalized COVID-19 patients.
- The prognostic benefit of statins was more pronounced in patients with pre-existing coronary or extracardiac atherosclerotic disease.
Introduction:
Statin therapy might have a beneficial prognostic effect in patients with COVID-19, given its immunomodulative, anti-inflammatory and anti-atherosclerotic properties. Our purpose was to test this hypothesis by using the COVID-19 registry of a Spanish university hospital.
Methods:
We conducted a single-center, observational and retrospective study in which hospitalized patients with COVID-19 diagnosed by PCR between March 2020 and October 2020 were included. By means of logistic regression, we designed a propensity score to estimate the likelihood that a patient would receive statin treatment prior to admission. We compared the survival of COVID-19 patients with and without statin treatment by means of Cox regression with inverse probability of treatment weighting (IPTW). The median follow-up was 406 days.
Results:
We studied 1122 hospitalized patients with COVID-19, whose median age was 71 years and of which 488 (43.5%) were women. 451 (40.2%) patients received statins before admission. In the IPTW survival analysis, prior statin treatment was associated with a significant reduction in mortality (HR: 0.76; 95% CI: 0.59-0.97). The greatest benefit of previous statin therapy was seen in subgroups of patients with coronary artery disease (HR: 0.32; 95% CI: 0.18-0.56) and extracardiac arterial disease (HR: 0.45; 95% CI: 0.28-0.73).
Conclusions:
Our study showed a significant association between previous treatment with statins and lower mortality in hospitalized patients with COVID-19. The observed prognostic benefit was greater in patients with previous coronary or extracardiac atherosclerotic disease.
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