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COVID-19 住院患者中使用他汀类药物前史与死亡率降低的关联。

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

机构信息

NewYork-Presbyterian Hospital and the Columbia University Irving Medical Center, New York, NY, USA.

Cardiovascular Research Foundation, New York, NY, USA.

出版信息

Nat Commun. 2021 Feb 26;12(1):1325. doi: 10.1038/s41467-021-21553-1.

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 through May 12, 2020 with study period ending on June 11, 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.

摘要

2019 年冠状病毒病(COVID-19)可导致过度炎症状态,从而导致急性呼吸窘迫综合征(ARDS)、心肌损伤和血栓并发症等后遗症。他汀类药物具有抗炎和抗血栓作用,已在其他病毒感染的情况下进行了研究,但尚未在 COVID-19 中评估其益处。这是一项回顾性分析,纳入了 2020 年 2 月 1 日至 5 月 12 日因 COVID-19 住院的患者,研究截止日期为 2020 年 6 月 11 日。使用电子病历中可用的药物信息评估了先前使用他汀类药物的情况。我们构建了一个多变量逻辑回归模型,以预测接受他汀类药物的倾向,调整了基线社会人口统计学和临床特征以及门诊药物。主要终点包括 30 天内院内死亡率。在研究期间共收治了 2626 名患者,其中 951 名(36.2%)为先前使用他汀类药物的患者。在确定的 1296 名患者(648 名他汀类药物使用者,648 名非他汀类药物使用者)中,采用 1:1 倾向评分匹配,他汀类药物的使用与倾向性匹配队列中主要终点的几率显著降低相关(OR 0.47,95%CI 0.36-0.62,p<0.001)。我们得出结论,COVID-19 住院患者使用他汀类药物与住院死亡率降低相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d3f/7910606/7de2c525c1ea/41467_2021_21553_Fig1_HTML.jpg

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