Statins Use in Patients with Cardiovascular Diseases and COVID-19 Outcomes: An Italian Population-Based Cohort Study.

COVID-19 ICU access mechanical ventilation mortality pharmacoepidemiology public health statins

Journal

Journal of clinical medicine
ISSN: 2077-0383
Titre abrégé: J Clin Med
Pays: Switzerland
ID NLM: 101606588

Informations de publication

Date de publication:
17 Dec 2022
Historique:
received: 30 11 2022
revised: 12 12 2022
accepted: 13 12 2022
entrez: 23 12 2022
pubmed: 24 12 2022
medline: 24 12 2022
Statut: epublish

Résumé

The role of statins among patients with established cardiovascular diseases (CVDs) who are hospitalized with COVID-19 is still debated. This study aimed at assessing whether the prior use of statins was associated with a less severe COVID-19 prognosis. Subjects with CVDs infected with SARS-CoV-2 and hospitalized between 20 February 2020 and 31 December 2020 were selected. These were classified into two mutually exclusive groups: statins-users and non-users of lipid-lowering therapies (non-LLT users). The relationship between statins exposure and the risk of Mechanical Ventilation (MV), Intensive Care Unit (ICU) access and death were evaluated by using logistic and Cox regressions models. Of 1127 selected patients, 571 were statins-users whereas 556 were non-LLT users. The previous use of statins was not associated with a variation in the risk of need of MV (Odds Ratio [OR]: 1.00; 95% Confidence Intervals [CI]: 0.38-2.67), ICU access (OR: 0.54; 95% CI: 0.22-1.32) and mortality at 14 days (Hazard Ratio [HR]: 0.42; 95% CI: 0.16-1.10). However, a decreased risk of mortality at 30 days (HR: 0.39; 95% CI: 0.18-0.85) was observed in statins-users compared with non-LLT users. These findings support the clinical advice for patients CVDs to continue their treatment with statins during SARS-CoV-2 infection.

Sections du résumé

BACKGROUND BACKGROUND
The role of statins among patients with established cardiovascular diseases (CVDs) who are hospitalized with COVID-19 is still debated. This study aimed at assessing whether the prior use of statins was associated with a less severe COVID-19 prognosis.
METHODS METHODS
Subjects with CVDs infected with SARS-CoV-2 and hospitalized between 20 February 2020 and 31 December 2020 were selected. These were classified into two mutually exclusive groups: statins-users and non-users of lipid-lowering therapies (non-LLT users). The relationship between statins exposure and the risk of Mechanical Ventilation (MV), Intensive Care Unit (ICU) access and death were evaluated by using logistic and Cox regressions models.
RESULTS RESULTS
Of 1127 selected patients, 571 were statins-users whereas 556 were non-LLT users. The previous use of statins was not associated with a variation in the risk of need of MV (Odds Ratio [OR]: 1.00; 95% Confidence Intervals [CI]: 0.38-2.67), ICU access (OR: 0.54; 95% CI: 0.22-1.32) and mortality at 14 days (Hazard Ratio [HR]: 0.42; 95% CI: 0.16-1.10). However, a decreased risk of mortality at 30 days (HR: 0.39; 95% CI: 0.18-0.85) was observed in statins-users compared with non-LLT users.
CONCLUSIONS CONCLUSIONS
These findings support the clinical advice for patients CVDs to continue their treatment with statins during SARS-CoV-2 infection.

Identifiants

pubmed: 36556112
pii: jcm11247492
doi: 10.3390/jcm11247492
pmc: PMC9781425
pii:
doi:

Types de publication

Journal Article

Langues

eng

Subventions

Organisme : The VICES-SMIRE project was funded by Regione Lombardia (DGR nr. XI/3017/2020 and D.G. Welfare nr. 7082/2020).
ID : 7082/2020

Références

Pharmacotherapy. 2020 May;40(5):484-486
pubmed: 32267560
Immunology. 2018 May;154(1):69-75
pubmed: 29392731
Front Physiol. 2021 May 11;12:667024
pubmed: 34045976
Pharmacol Rep. 2021 Jun;73(3):769-780
pubmed: 33608850
Clin Biochem. 2007 Feb;40(3-4):162-6
pubmed: 17217941
Diabetes Metab. 2021 Nov;47(6):101220
pubmed: 33359486
Eur Heart J Qual Care Clin Outcomes. 2021 Jul 21;7(4):330-339
pubmed: 34107535
Biochim Biophys Acta Mol Cell Biol Lipids. 2021 Feb;1866(2):158849
pubmed: 33157278
Intern Emerg Med. 2022 Apr;17(3):685-694
pubmed: 34637080
Clin Biochem. 2006 Mar;39(3):287-92
pubmed: 16487950
JAMA. 2020 Apr 7;323(13):1239-1242
pubmed: 32091533
Am J Cardiol. 2022 Aug 15;177:28-33
pubmed: 35715239
PLoS One. 2021 Jul 15;16(7):e0254635
pubmed: 34264974
Int J Infect Dis. 2022 Nov;124:27-34
pubmed: 36089152
Cell Metab. 2020 Aug 4;32(2):145-147
pubmed: 32755604
PLoS One. 2021 Sep 10;16(9):e0256899
pubmed: 34506533
Eur Heart J Cardiovasc Pharmacother. 2020 Jul 1;6(4):258-259
pubmed: 32347925
Metabolism. 2020 Dec;113:154375
pubmed: 32976855
J Clin Med. 2020 Jun 02;9(6):
pubmed: 32498230
N Engl J Med. 2020 Jul 9;383(2):120-128
pubmed: 32437596
mBio. 2015 May 26;6(3):e00638-15
pubmed: 26015500
Nat Rev Microbiol. 2022 May;20(5):270-284
pubmed: 35354968
J Clin Lipidol. 2021 Jan-Feb;15(1):68-78
pubmed: 33390341
Arch Med Sci. 2020 Apr 25;16(3):490-496
pubmed: 32399094
Am J Cardiovasc Drugs. 2022 Mar;22(2):167-181
pubmed: 34341972
Diabetes Metab Syndr. 2020 Sep - Oct;14(5):1225-1229
pubmed: 32683320
Ann Palliat Med. 2020 Nov;9(6):3716-3720
pubmed: 32921099
Biomed Res Int. 2021 Sep 23;2021:1901772
pubmed: 34568488
Circ J. 2021 May 25;85(6):939-943
pubmed: 33952833
Pharmacoepidemiol Drug Saf. 2006 Aug;15(8):565-74; discussion 575-7
pubmed: 16514590
Postgrad Med J. 2022 May;98(1159):354-359
pubmed: 33541927
Circulation. 2004 Jun 1;109(21 Suppl 1):II18-26
pubmed: 15173059
Kardiol Pol. 2021;79(7-8):773-780
pubmed: 33926173
Antioxid Redox Signal. 2014 Mar 10;20(8):1198-215
pubmed: 24111702
Sci Rep. 2021 Dec 13;11(1):23874
pubmed: 34903765
Gerontology. 2000 Jan-Feb;46(1):22-7
pubmed: 11111225
Diabetes Metab Syndr. 2020 May - Jun;14(3):247-250
pubmed: 32247212
J Gen Intern Med. 2011 May;26(5):546-50
pubmed: 21203857
Ann Med. 2021 Dec;53(1):874-884
pubmed: 34096808
Diabetes Metab Syndr. 2020 Nov-Dec;14(6):1613-1615
pubmed: 32882643
Circulation. 2019 Sep 10;140(11):e596-e646
pubmed: 30879355
Thromb Res. 2020 Dec;196:382-394
pubmed: 32992075
Nutr Metab Cardiovasc Dis. 2021 Jun 7;31(6):1662-1670
pubmed: 33838992
Diabetes Metab Syndr. 2020 Nov-Dec;14(6):2063-2067
pubmed: 33120281
Int J Infect Dis. 2021 Sep;110:374-381
pubmed: 34375760
Nat Rev Cardiol. 2020 Sep;17(9):543-558
pubmed: 32690910
J Clin Med. 2022 Sep 25;11(19):
pubmed: 36233511

Auteurs

Ippazio Cosimo Antonazzo (IC)

Research Centre on Public Health, University of Milano-Bicocca, 20900 Monza, Italy.

Carla Fornari (C)

Research Centre on Public Health, University of Milano-Bicocca, 20900 Monza, Italy.

Davide Rozza (D)

Research Centre on Public Health, University of Milano-Bicocca, 20900 Monza, Italy.

Sara Conti (S)

Research Centre on Public Health, University of Milano-Bicocca, 20900 Monza, Italy.

Raffaella Di Pasquale (R)

Research Centre on Public Health, University of Milano-Bicocca, 20900 Monza, Italy.

Paolo Angelo Cortesi (PA)

Research Centre on Public Health, University of Milano-Bicocca, 20900 Monza, Italy.

Shaniko Kaleci (S)

Research Centre on Public Health, University of Milano-Bicocca, 20900 Monza, Italy.

Pietro Ferrara (P)

Research Centre on Public Health, University of Milano-Bicocca, 20900 Monza, Italy.
IRCCS, Istituto Auxologico Italiano, 20145 Milan, Italy.

Alberto Zucchi (A)

Health Protection Agency of Bergamo (ATS Bergamo), 24121 Bergamo, Italy.

Giovanni Maifredi (G)

Health Protection Agency of Brescia (ATS Brescia), 25124 Brescia, Italy.

Andrea Silenzi (A)

General Directorate of Health Prevention, Ministry of Health, 00144 Rome, Italy.

Giancarlo Cesana (G)

Research Centre on Public Health, University of Milano-Bicocca, 20900 Monza, Italy.

Lorenzo Giovanni Mantovani (LG)

Research Centre on Public Health, University of Milano-Bicocca, 20900 Monza, Italy.
IRCCS, Istituto Auxologico Italiano, 20145 Milan, Italy.

Giampiero Mazzaglia (G)

Research Centre on Public Health, University of Milano-Bicocca, 20900 Monza, Italy.

Classifications MeSH