Association between antecedent statin use and decreased mortality in hospitalized patients with COVID-19

Aakriti Gupta(Yale New Haven Hospital), Mahesh V. Madhavan(NewYork–Presbyterian Hospital), Timothy J. Poterucha(NewYork–Presbyterian Hospital), Ersilia M. DeFilippis(NewYork–Presbyterian Hospital), Jessica A. Hennessey(NewYork–Presbyterian Hospital), Björn Redfors(NewYork–Presbyterian Hospital), C. Eckhardt(NewYork–Presbyterian Hospital), Behnood Bikdeli(NewYork–Presbyterian Hospital), Jonathan Platt(NewYork–Presbyterian Hospital), Ani Nalbandian(NewYork–Presbyterian Hospital), Pierre Elias(NewYork–Presbyterian Hospital), Matthew J. Cummings(NewYork–Presbyterian Hospital), Shayan Nabavi Nouri(NewYork–Presbyterian Hospital), Matthew Lawlor(NewYork–Presbyterian Hospital), Lauren S. Ranard(NewYork–Presbyterian Hospital), Jianhua Li(NewYork–Presbyterian Hospital), Claudia Boyle(NewYork–Presbyterian Hospital), Raymond C. Givens(NewYork–Presbyterian Hospital), Daniel Brodie(NewYork–Presbyterian Hospital), Harlan M. Krumholz, Gregg W. Stone(Cardiovascular Institute of the South), Sanjum S. Sethi(NewYork–Presbyterian Hospital), Daniel Burkhoff(NewYork–Presbyterian Hospital), Nir Uriel(NewYork–Presbyterian Hospital), Allan Schwartz(NewYork–Presbyterian Hospital), Martin B. Leon(NewYork–Presbyterian Hospital), Ajay J. Kirtane(NewYork–Presbyterian Hospital), Elaine Y. Wan(NewYork–Presbyterian Hospital), Sahil A. Parikh(NewYork–Presbyterian Hospital)
Nature Communications
February 26, 2021
Cited by 194Open Access
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Abstract

Abstract The coronavirus disease 2019 (COVID-19) can result in a hyperinflammatory state, leading to acute respiratory distress syndrome (ARDS), myocardial injury, and thrombotic complications, among other sequelae. Statins, which are known to have anti-inflammatory and antithrombotic properties, have been studied in the setting of other viral infections, but their benefit has not been assessed in COVID-19. This is a retrospective analysis of patients admitted with COVID-19 from February 1 st through May 12 th , 2020 with study period ending on June 11 th , 2020. Antecedent statin use was assessed using medication information available in the electronic medical record. We constructed a multivariable logistic regression model to predict the propensity of receiving statins, adjusting for baseline sociodemographic and clinical characteristics, and outpatient medications. The primary endpoint includes in-hospital mortality within 30 days. A total of 2626 patients were admitted during the study period, of whom 951 (36.2%) were antecedent statin users. Among 1296 patients (648 statin users, 648 non-statin users) identified with 1:1 propensity-score matching, statin use is significantly associated with lower odds of the primary endpoint in the propensity-matched cohort (OR 0.47, 95% CI 0.36–0.62, p < 0.001). We conclude that antecedent statin use in patients hospitalized with COVID-19 is associated with lower inpatient mortality.


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