Effect of statin therapy on SARS-CoV-2 infection-related mortality in hospitalized patients
Lluís Masana, Eudald Correig, Cèlia Rodríguez-Borjabad, Eva Anoro, Juan Antonio Arroyo, Carlos Jericó, Angels Pedragosa, Marcel la Miret, Silvia Näf, Anna Pardo, Verónica Perea, Rosa Pérez-Bernalte, Núria Plana, Rafael Ramírez-Montesinos, Meritxell Royuela, Cristina Soler, Maria Urquizu-Padilla, Alberto Zamora, Juan Pedro-Botet, Lluís Masana, Eudald Correig, Cèlia Rodríguez-Borjabad, Eva Anoro, Juan Antonio Arroyo, Carlos Jericó, Angels Pedragosa, Marcel la Miret, Silvia Näf, Anna Pardo, Verónica Perea, Rosa Pérez-Bernalte, Núria Plana, Rafael Ramírez-Montesinos, Meritxell Royuela, Cristina Soler, Maria Urquizu-Padilla, Alberto Zamora, Juan Pedro-Botet
Abstract
Aim: Assessing the effect of statin therapy (ST) at hospital admission for COVID-19 on in-hospital mortality.
Methods and results: Retrospective observational study. Patients taking statins were 11 years older and had significantly more comorbidities than patients who were not taking statins. A genetic matching (GM) procedure was performed prior to analysis of the mortality risk. A Cox proportional hazards model was used for the cause-specific hazard (CSH) function, and a competing-risks Fine and Gray (FG) model was also used to study the direct effects of statins on risk. Data from reverse transcription-polymerase chain reaction-confirmed 2157 SARS-CoV-2-infected patients [1234 men, 923 women; age: 67 y/o (IQR 54-78)] admitted to the hospital were retrieved from the clinical records in anonymized manner. Three hundred and fifty-three deaths occurred. Five hundred and eighty-one patients were taking statins. Univariate test after GM showed a significantly lower mortality rate in patients on ST than the matched non-statin group (19.8% vs. 25.4%, χ2 with Yates continuity correction: P = 0.027). The mortality rate was even lower in patients (n = 336) who maintained their statin treatments during hospitalization compared with the GM non-statin group (17.4%; P = 0.045). The Cox model applied to the CSH function [HR = 0.58(CI: 0.39-0.89); P = 0.01] and the competing-risks FG model [HR = 0.60 (CI: 0.39-0.92); P = 0.02] suggest that statins are associated with reduced COVID-19-related mortality.
Conclusions: A lower SARS-CoV-2 infection-related mortality was observed in patients treated with ST prior to hospitalization. Statin therapy should not be discontinued due to the global concern of the pandemic or in patients hospitalized for COVID-19.
Keywords: COVID-19; Cardiovascular risk; Mortality; SARS-CoV-2; Statins.
Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2020. For permissions, please email: journals.permissions@oup.com.
Source: PubMed