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他汀类药物在新型冠状病毒肺炎患者中的应用与临床结局:一项更新的系统评价和荟萃分析。

Statin use and clinical outcomes in patients with COVID-19: An updated systematic review and meta-analysis.

作者信息

Pal Rimesh, Banerjee Mainak, Yadav Urmila, Bhattacharjee Sukrita

机构信息

Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh, Chandigarh, India

Internal Medicine, Institute of Postgraduate Medical Education and Research, Kolkata, West Bengal, India.

出版信息

Postgrad Med J. 2022 May;98(1159):354-359. doi: 10.1136/postgradmedj-2020-139172. Epub 2021 Feb 4.

Abstract

PURPOSE

Observations studies have shown that prior use of statins is associated with a reduced risk of adverse clinical outcomes in patients with COVID-19. However, the available data are limited, inconsistent and conflicting. Besides, no randomised controlled trial exists in this regard. Hence, the present meta-analysis was conducted to provide an updated summary and collate the effect of statin use on clinical outcomes in COVID-19 using unadjusted and adjusted risk estimates.

METHODS

PubMed, Scopus and Web of Science databases were systematically searched using appropriate keywords till December 18 2020, to identify observational studies reporting clinical outcomes in COVID-19 patients using statins versus those not using statins. Prior and in-hospital use of statins were considered. Study quality was assessed using the Newcastle-Ottawa Scale. Unadjusted and adjusted pooled odds ratio (OR) with 95% CIs were calculated.

RESULTS

We included 14 observational studies pooling data retrieved from 19 988 patients with COVID-19. All the studies were of high/moderate quality. Pooled analysis of unadjusted data showed that statin use was not associated with improved clinical outcomes (OR 1.02; 95% CI 0.69 to 1.50, p=0.94, I=94%, random-effects model). However, on pooling adjusted risk estimates, the use of statin was found to significantly reduce the risk of adverse outcomes (OR 0.51; 95% CI 0.41 to 0.63, p<0.0005, I=0%, fixed-effects model).

CONCLUSIONS

Statin use is associated with improved clinical outcomes in patients with COVID-19. Individuals with multiple comorbidities on statin therapy should be encouraged to continue the drug amid the ongoing pandemic.

摘要

目的

观察性研究表明,既往使用他汀类药物与降低2019冠状病毒病(COVID-19)患者不良临床结局的风险相关。然而,现有数据有限、不一致且相互矛盾。此外,在这方面尚无随机对照试验。因此,本荟萃分析旨在提供最新总结,并使用未调整和调整后的风险估计值,整理他汀类药物使用对COVID-19临床结局的影响。

方法

截至2020年12月18日,使用适当关键词对PubMed、Scopus和Web of Science数据库进行系统检索,以识别报告使用他汀类药物与未使用他汀类药物的COVID-19患者临床结局的观察性研究。考虑了他汀类药物的既往使用情况和住院期间使用情况。使用纽卡斯尔-渥太华量表评估研究质量。计算未调整和调整后的合并优势比(OR)及95%置信区间(CI)。

结果

我们纳入了14项观察性研究,汇总了从19988例COVID-19患者中检索到的数据。所有研究质量均为高/中等。未调整数据的汇总分析表明,使用他汀类药物与改善临床结局无关(OR 1.02;95%CI 0.69至1.50,p=0.94,I=94%,随机效应模型)。然而,汇总调整后的风险估计值后,发现使用他汀类药物可显著降低不良结局的风险(OR 0.51;95%CI 0.41至0.63,p<0.0005,I=0%,固定效应模型)。

结论

使用他汀类药物与改善COVID-19患者的临床结局相关。在当前大流行期间,应鼓励接受他汀类治疗的患有多种合并症的个体继续使用该药物。

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