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住院 COVID-19 患者使用他汀类药物:纽约市公立医院系统的综合分析。

Statin Use in Hospitalized Patients with COVID-19: A Comprehensive Analysis of the New York City Public Hospital System.

机构信息

Department of Medicine, New York City Health + Hospitals/Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY.

Department of Medicine, New York City Health + Hospitals/Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY.

出版信息

Am J Med. 2022 Jul;135(7):897-905. doi: 10.1016/j.amjmed.2022.02.018. Epub 2022 Mar 14.

Abstract

INTRODUCTION

Statins have been commonly used for primary and secondary cardiovascular prevention. We hypothesized that statins may improve in-hospital outcomes for hospitalized patients with Coronavirus disease 2019 (COVID-19) due to its known anti-inflammatory effects.

METHODS

We conducted a retrospective study at the largest municipal health care system in the United States, including adult patients who were hospitalized for COVID-19 between March 1 and December 1, 2020. The primary endpoint was in-hospital death. Propensity score matching was conducted to balance possible confounding variables between patients receiving statins during hospitalization (statin group) and those not receiving statins (non-statin group). Multivariate logistic regression was used to evaluate the association of statin use and other variables with in-hospital outcomes.

RESULTS

There were 8897 patients eligible for study enrollment, with 3359 patients in the statin group and 5538 patients in the non-statin group. After propensity score matching, both the statin and non-statin groups included 2817 patients. Multivariate logistic regression analysis showed that the statin group had a significantly lower risk of in-hospital mortality (odds ratio 0.71; 95% confidence interval, 0.63-0.80; P < .001) and mechanical ventilation (OR 0.80; 95% confidence interval, 0.71-0.90; P < .001) compared with the non-statin group.

CONCLUSION

Statin use was associated with lower likelihood of in-hospital mortality and invasive mechanical ventilation in hospitalized patients with COVID-19.

摘要

简介

他汀类药物已被广泛用于一级和二级心血管预防。我们假设,由于其已知的抗炎作用,他汀类药物可能会改善因 2019 年冠状病毒病(COVID-19)住院的患者的住院期间结局。

方法

我们在美国最大的市级医疗保健系统中进行了一项回顾性研究,纳入 2020 年 3 月 1 日至 12 月 1 日期间因 COVID-19 住院的成年患者。主要终点是住院期间死亡。采用倾向评分匹配来平衡住院期间接受他汀类药物治疗的患者(他汀类药物组)和未接受他汀类药物治疗的患者(非他汀类药物组)之间的可能混杂变量。采用多变量逻辑回归评估他汀类药物使用与其他变量与住院期间结局的相关性。

结果

共有 8897 名患者符合研究纳入标准,其中他汀类药物组 3359 例,非他汀类药物组 5538 例。经过倾向评分匹配后,他汀类药物组和非他汀类药物组各包括 2817 例患者。多变量逻辑回归分析表明,他汀类药物组住院期间死亡率(比值比 0.71;95%置信区间,0.63-0.80;P <.001)和机械通气(OR 0.80;95%置信区间,0.71-0.90;P <.001)的风险明显低于非他汀类药物组。

结论

与未使用他汀类药物的患者相比,COVID-19 住院患者使用他汀类药物与住院期间死亡率和有创机械通气的可能性降低相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e85/8920066/367e77e8dc28/gr1_lrg.jpg

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