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Statin Use and In‐Hospital Mortality in Patients With Diabetes Mellitus and COVID‐19

BACKGROUND: Severe coronavirus disease 2019 (COVID‐19) is characterized by a proinflammatory state with high mortality. Statins have anti‐inflammatory effects and may attenuate the severity of COVID‐19. METHODS AND RESULTS: An observational study of all consecutive adult patients with COVID‐19 admit...

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Autores principales: Saeed, Omar, Castagna, Francesco, Agalliu, Ilir, Xue, Xiaonan, Patel, Snehal R., Rochlani, Yogita, Kataria, Rachna, Vukelic, Sasa, Sims, Daniel B., Alvarez, Chikezie, Rivas‐Lasarte, Mercedes, Garcia, Mario J., Jorde, Ulrich P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7955378/
https://www.ncbi.nlm.nih.gov/pubmed/33092446
http://dx.doi.org/10.1161/JAHA.120.018475
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author Saeed, Omar
Castagna, Francesco
Agalliu, Ilir
Xue, Xiaonan
Patel, Snehal R.
Rochlani, Yogita
Kataria, Rachna
Vukelic, Sasa
Sims, Daniel B.
Alvarez, Chikezie
Rivas‐Lasarte, Mercedes
Garcia, Mario J.
Jorde, Ulrich P.
author_facet Saeed, Omar
Castagna, Francesco
Agalliu, Ilir
Xue, Xiaonan
Patel, Snehal R.
Rochlani, Yogita
Kataria, Rachna
Vukelic, Sasa
Sims, Daniel B.
Alvarez, Chikezie
Rivas‐Lasarte, Mercedes
Garcia, Mario J.
Jorde, Ulrich P.
author_sort Saeed, Omar
collection PubMed
description BACKGROUND: Severe coronavirus disease 2019 (COVID‐19) is characterized by a proinflammatory state with high mortality. Statins have anti‐inflammatory effects and may attenuate the severity of COVID‐19. METHODS AND RESULTS: An observational study of all consecutive adult patients with COVID‐19 admitted to a single center located in Bronx, New York, was conducted from March 1, 2020, to May 2, 2020. Patients were grouped as those who did and those who did not receive a statin, and in‐hospital mortality was compared by competing events regression. In addition, propensity score matching and inverse probability treatment weighting were used in survival models to examine the association between statin use and death during hospitalization. A total of 4252 patients were admitted with COVID‐19. Diabetes mellitus modified the association between statin use and in‐hospital mortality. Patients with diabetes mellitus on a statin (n=983) were older (69±11 versus 67±14 years; P<0.01), had lower inflammatory markers (C‐reactive protein, 10.2; interquartile range, 4.5–18.4 versus 12.9; interquartile range, 5.9–21.4 mg/dL; P<0.01) and reduced cumulative in‐hospital mortality (24% versus 39%; P<0.01) than those not on a statin (n=1283). No difference in hospital mortality was noted in patients without diabetes mellitus on or off statin (20% versus 21%; P=0.82). Propensity score matching (hazard ratio, 0.88; 95% CI, 0.83–0.94; P<0.01) and inverse probability treatment weighting (HR, 0.88; 95% CI, 0.84–0.92; P<0.01) showed a 12% lower risk of death during hospitalization for statin users than for nonusers. CONCLUSIONS: Statin use was associated with reduced in‐hospital mortality from COVID‐19 in patients with diabetes mellitus. These findings, if validated, may further reemphasize administration of statins to patients with diabetes mellitus during the COVID‐19 era.
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spelling pubmed-79553782021-03-17 Statin Use and In‐Hospital Mortality in Patients With Diabetes Mellitus and COVID‐19 Saeed, Omar Castagna, Francesco Agalliu, Ilir Xue, Xiaonan Patel, Snehal R. Rochlani, Yogita Kataria, Rachna Vukelic, Sasa Sims, Daniel B. Alvarez, Chikezie Rivas‐Lasarte, Mercedes Garcia, Mario J. Jorde, Ulrich P. J Am Heart Assoc Original Research BACKGROUND: Severe coronavirus disease 2019 (COVID‐19) is characterized by a proinflammatory state with high mortality. Statins have anti‐inflammatory effects and may attenuate the severity of COVID‐19. METHODS AND RESULTS: An observational study of all consecutive adult patients with COVID‐19 admitted to a single center located in Bronx, New York, was conducted from March 1, 2020, to May 2, 2020. Patients were grouped as those who did and those who did not receive a statin, and in‐hospital mortality was compared by competing events regression. In addition, propensity score matching and inverse probability treatment weighting were used in survival models to examine the association between statin use and death during hospitalization. A total of 4252 patients were admitted with COVID‐19. Diabetes mellitus modified the association between statin use and in‐hospital mortality. Patients with diabetes mellitus on a statin (n=983) were older (69±11 versus 67±14 years; P<0.01), had lower inflammatory markers (C‐reactive protein, 10.2; interquartile range, 4.5–18.4 versus 12.9; interquartile range, 5.9–21.4 mg/dL; P<0.01) and reduced cumulative in‐hospital mortality (24% versus 39%; P<0.01) than those not on a statin (n=1283). No difference in hospital mortality was noted in patients without diabetes mellitus on or off statin (20% versus 21%; P=0.82). Propensity score matching (hazard ratio, 0.88; 95% CI, 0.83–0.94; P<0.01) and inverse probability treatment weighting (HR, 0.88; 95% CI, 0.84–0.92; P<0.01) showed a 12% lower risk of death during hospitalization for statin users than for nonusers. CONCLUSIONS: Statin use was associated with reduced in‐hospital mortality from COVID‐19 in patients with diabetes mellitus. These findings, if validated, may further reemphasize administration of statins to patients with diabetes mellitus during the COVID‐19 era. John Wiley and Sons Inc. 2020-12-11 /pmc/articles/PMC7955378/ /pubmed/33092446 http://dx.doi.org/10.1161/JAHA.120.018475 Text en © 2020 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Research
Saeed, Omar
Castagna, Francesco
Agalliu, Ilir
Xue, Xiaonan
Patel, Snehal R.
Rochlani, Yogita
Kataria, Rachna
Vukelic, Sasa
Sims, Daniel B.
Alvarez, Chikezie
Rivas‐Lasarte, Mercedes
Garcia, Mario J.
Jorde, Ulrich P.
Statin Use and In‐Hospital Mortality in Patients With Diabetes Mellitus and COVID‐19
title Statin Use and In‐Hospital Mortality in Patients With Diabetes Mellitus and COVID‐19
title_full Statin Use and In‐Hospital Mortality in Patients With Diabetes Mellitus and COVID‐19
title_fullStr Statin Use and In‐Hospital Mortality in Patients With Diabetes Mellitus and COVID‐19
title_full_unstemmed Statin Use and In‐Hospital Mortality in Patients With Diabetes Mellitus and COVID‐19
title_short Statin Use and In‐Hospital Mortality in Patients With Diabetes Mellitus and COVID‐19
title_sort statin use and in‐hospital mortality in patients with diabetes mellitus and covid‐19
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7955378/
https://www.ncbi.nlm.nih.gov/pubmed/33092446
http://dx.doi.org/10.1161/JAHA.120.018475
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