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

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

Aakriti Gupta #  1   2   3 , Mahesh V Madhavan #  4   5 , Timothy J Poterucha  4 , Ersilia M DeFilippis  4 , Jessica A Hennessey  4 , Bjorn Redfors  4   5   6 , Christina Eckhardt  4 , Behnood Bikdeli  4   5   7 , Jonathan Platt  4 , Ani Nalbandian  4 , Pierre Elias  4 , Matthew J Cummings  4 , Shayan N Nouri  4 , Matthew Lawlor  4 , Lauren S Ranard  4 , Jianhua Li  4 , Claudia Boyle  4 , Raymond Givens  4 , Daniel Brodie  4 , Harlan M Krumholz  7 , Gregg W Stone  5   8 , Sanjum S Sethi  4 , Daniel Burkhoff  4   5 , Nir Uriel  4 , Allan Schwartz  4 , Martin B Leon  4   5 , Ajay J Kirtane  4   5 , Elaine Y Wan  9 , Sahil A Parikh  4   5
Affiliations

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

Aakriti Gupta et al. Nat Commun. .

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 1st through May 12th, 2020 with study period ending on June 11th, 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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Conflict of interest statement

A.G. received payment from the Arnold & Porter Law Firm for work related to the Sanofi clopidogrel litigation and from the Ben C. Martin Law Firm for work related to an inferior vena cava filter litigation; received consulting fees from Edward Lifesciences; and holds equity in the healthcare telecardiology startup Heartbeat Health. M.V.M. has received support from an institutional grant by the National Institutes of Health/National Heart, Lung, and Blood Institute to Columbia University Irving Medical Center (T32 HL007854). B.B. reports that he is a consulting expert, on behalf of the plaintiff, for litigation related to a specific type of IVC filter. M.J.C. reports being a co-investigator for clinical trials evaluating the efficacy and safety of Remdesivir (Gilead Sciences) and convalescent plasma (Amazon) in hospitalized patients with COVID-19. Support for this work, which is unrelated to the current study, is paid to Columbia University. D.B. receives research support from ALung Technologies, he was previously on their medical advisory board. He has been on the medical advisory boards for Baxter, BREETHE, Xenios and Hemovent. G.W.S. reports speaker or other honoraria from Cook, Terumo, QOOL Therapeutics and Orchestra Biomed; Consultant to Valfix, TherOx, Vascular Dynamics, Robocath, HeartFlow, Gore, Ablative Solutions, Miracor, Neovasc, V-Wave, Abiomed, Ancora, MAIA Pharmaceuticals, Vectorious, Reva, Matrizyme, Cardiomech; equity/options from Ancora, Qool Therapeutics, Cagent, Applied Therapeutics, Biostar family of funds, SpectraWave, Orchestra Biomed, Aria, Cardiac Success, MedFocus family of funds, and Valfix. T.J.P. owns stock in Abbott Laboratories, AbbVie, Inc, Baxter International, and Edwards Lifesciences. H.M.K. works under contract with the Centers for Medicare & Medicaid Services to support quality measurement programs; was a recipient of a research grant, through Yale, from Medtronic and the U.S. Food and Drug Administration to develop methods for post-market surveillance of medical devices; was a recipient of a research grant with Medtronic and is the recipient of a research grant from Johnson & Johnson, through Yale University, to support clinical trial data sharing; was a recipient of a research agreement, through Yale University, from the Shenzhen Center for Health Information for work to advance intelligent disease prevention and health promotion; collaborates with the National Center for Cardiovascular Diseases in Beijing; receives payment from the Arnold & Porter Law Firm for work related to the Sanofi clopidogrel litigation, from the Ben C. Martin Law Firm for work related to the Cook Celect IVC filter litigation, and from the Siegfried and Jensen Law Firm for work related to Vioxx litigation; chairs a Cardiac Scientific Advisory Board for UnitedHealth; was a participant/participant representative of the IBM Watson Health Life Sciences Board; is a member of the Advisory Board for Element Science, the Advisory Board for Facebook, and the Physician Advisory Board for Aetna; and is the co-founder of HugoHealth, a personal health information platform, and co-founder of Refactor Health, an enterprise healthcare AI-augmented data enterprise. Other authors report no disclosures. A.J.K. reports institutional funding to Columbia University and/or Cardiovascular Research Foundation from Medtronic, Boston Scientific, Abbott Vascular, Abiomed, CSI, Philips, ReCor Medical.

Figures

Fig. 1
Fig. 1. Forest plot for in-hospital mortality within 30 days.
Forest plot demonstrating the odds ratio (OR) and 95% confidence interval (CI) for in-hospital mortality within 30 days with antecedent statin use (vs. no antecedent statin use) after multivariable logistic regression in the overall cohort. A number of other sociodemographic and baseline medication variables are also presented in this forest plot. ACE angiotensin-converting enzyme; AH Allen hospital. N = 2626 biologically independent patients.
See this image and copyright information in PMC

Update of

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