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. 2022 Jun 24;158(12):586-595.
doi: 10.1016/j.medcle.2022.05.004. Epub 2022 Jun 3.

Influence of statin treatment in a cohort of patients admitted for COVID-19

Juan R Rey  1 , José Luis Merino Llorens  1 , Ángel Manuel Iniesta Manjavacas  1 , Sandra Ofelia Rosillo Rodríguez  1 , Sergio Castrejón-Castrejón  1 , Emilio Arbas-Redondo  1 , Isabel Dolores Poveda-Pinedo  1 , Daniel Tebar-Márquez  1 , Andrea Severo-Sánchez  1 , Borja Rivero-Santana  1 , Víctor Juárez-Olmos  1 , Marcel Martínez-Cossiani  1 , Antonio Buño-Soto  2 , Luis Gonzalez-Valle  3 , Alicia Herrero-Ambrosio  3 , Esteban López-de-Sá  1 , Juan Caro-Codón  1
Affiliations

Influence of statin treatment in a cohort of patients admitted for COVID-19

Juan R Rey et al. Med Clin (Engl Ed). .

Abstract
in English, Spanish

Aims and objectives: Statins have been proposed as potentially useful agents for modulating the host response in COVID-19. However, solid evidence-based recommendations are still lacking. Our aim was to study the association between statin use and clinical outcomes in a large cohort of hospitalized patients with SARS-CoV-2 infection, as well as the specific consequences of chronic treatment withdrawal during hospital admission.

Material and methods: Retrospective observational study including 2191 hospitalized patients with confirmed SARS-CoV-2 infection.

Results: Mean age was 68.0±17.8 years and 597 (27.3%) patients died during follow-up. A total of 827 patients (37.7% of the whole sample), received chronic treatment with statins. Even though they underwent more frequent admissions in critical care units, chronic treatment with statins was not independently associated with all-cause mortality [HR 0.95 (0.72-1.25)]. During the whole hospital admission, 371 patients (16.9%) received at least one dose of statin. Although these patients had a significantly worse clinical profile, both treatment with statins during admission [HR 1.03 (0.78-1.35)] and withdrawal of chronic statin treatment [HR 1.01 (0.78-1.30)] showed a neutral effect in mortality. However, patients treated with statins presented more frequently hepatic cytolysis, rhabdomyolysis and thrombotic/hemorrhagic events.

Conclusions: In this large cohort of hospitalized COVID-19 patients, statins were not independently associated with all-cause mortality during follow-up. Clinically relevant statin-associated adverse effects should be carefully monitored during hospital admission.

Antecedentes y objetivos: Se ha especulado que las estatinas pueden ser de utilidad en el tratamiento de pacientes con COVID-19, pero no existen evidencias clínicas sólidas. El objetivo de este trabajo es conocer su utilidad en una cohorte de gran tamaño de pacientes hospitalizados por COVID-19, así como si su retirada se asocia con un peor pronóstico.

Material y métodos: Estudio retrospectivo observacional. Se incluyeron 2.191 pacientes hospitalizados con infección confirmada con SARS-CoV-2.

Resultados: La edad media fue de 68,0 ± 17,8 años y fallecieron un total de 597 (27,3%) pacientes. Un total de 827 pacientes (37,7% de la muestra) estaban tratados previamente con estatinas. Aunque precisaron con mayor frecuencia de ingreso en camas de críticos, dicho grupo terapéutico no resultó un factor predictor independiente de muerte en el seguimiento [HR 0,95 (0,72-1,25)]. Un total de 371 pacientes (16,9%) recibió al menos una dosis de estatina durante el ingreso. A pesar de ser una población con un perfil clínico más desfavorable, tanto su uso [HR 1,03 (0,78-1,35)] como la suspensión durante el ingreso en pacientes que las recibían crónicamente [HR 1,01 (0,78-1,30)] presentaron un efecto neutro en la mortalidad. No obstante, el grupo con estatinas desarrolló con mayor frecuencia datos de citolisis hepática, rabdomiolisis y más eventos trombóticos y hemorrágicos.

Conclusiones: En nuestra muestra, las estatinas no se asociaron de forma independiente a una menor mortalidad en pacientes con COVID-19. En aquellos pacientes que tengan indicación de recibirlas por su patología previa es necesario monitorizar estrechamente sus potenciales efectos adversos durante el ingreso hospitalario.

Keywords: Adverse effects; COVID-19; Morbidity; Mortality; Statins; Treatment with drawal.

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Figures

Fig. 1
Fig. 1
Flow of patients during the study period.
Fig. 2
Fig. 2
Survival analysis according to the discontinuation or not of statins during hospital admission for COVID-19 according to the Kaplan-Meier method in patients who had chronic treatment with these drugs. Their discontinuation was not associated with a higher incidence of mortality [HR 1.01 (0.78-1.30)].
See this image and copyright information in PMC

References

    1. COVID-19 Map. Johns Hopkins Coronavirus Resource Center. (consultado 19 Abr 2020). Disponible en https://coronavirus.jhu.edu/map.htlm.
    1. Guan W.J., Ni Z.Y., Hu Y., Liang W.H., Ou C.Q., He J.X., et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020;382:1708–1720. doi: 10.1056/NEJMoa2002032. - DOI - PMC - PubMed
    1. Zhou F., Yu T., Du R., Fan G., Liu Y., Liu Z., et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395(10229):1054–1062. doi: 10.1016/S0140-6736(20)30566-3. - DOI - PMC - PubMed
    1. Mach F., Baigent C., Catapano A.L., Koskinas K.C., Casula M., Badimon L., et al. 2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk. Eur Heart J. 2020;41:111–188. doi: 10.1093/eurheartj/ehz455. - DOI - PubMed
    1. Oesterle A., Laufs U., Liao J.K. Pleiotropic Effects of Statins on the Cardiovascular System. Circ Res. 2017;120:229–243. doi: 10.1161/CIRCRESAHA.116.308537. - DOI - PMC - PubMed

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