Statin use and in-hospital mortality in patients with diabetes mellitus and covid-19

Omar Saeed, Francesco Castagna, Ilir Agalliu, Xiaonan Xue, Snehal R. Patel, Yogita Rochlani, Rachna Kataria, Sasa Vukelic, Daniel B. Sims, Chikezie Alvarez, Mercedes Rivas-Lasarte, Mario J. Garcia, Ulrich P. Jorde

Research output: Contribution to journalArticlepeer-review

76 Scopus citations

Abstract

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.

Original languageEnglish (US)
Article numbere018475
JournalJournal of the American Heart Association
Volume9
Issue number24
DOIs
StatePublished - Dec 15 2020

Keywords

  • COVID-19
  • Diabetes mellitus
  • Hospitalization
  • Statin

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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