Objective: Although statins are widely prescribed lipid-lowering drugs, there are concerns about the safety of their use in the context of coronavirus disease 2019 (COVID-19), since statins increase the expression of ACE2 (angiotensin-converting enzyme 2). This study aimed to disclose the association between statins and 60-day COVID-19 mortality. Approach and Results: All patients hospitalized with laboratory-confirmed COVID-19 were enrolled in this study from January 19 to April 16, 2020, in Korea. We evaluated the association between the use of statins and COVID-19-related mortality in the overall and the nested 1:2 propensity score-matched study. Furthermore, a comparison of the hazard ratio for death was performed between COVID-19 patients and a retrospective cohort of patients hospitalized with pneumonia between January and June 2019 in Korea. The median age of the 10 448 COVID-19 patients was 45 years. Statins were prescribed in 533 (5.1%) patients. After adjusting for age, sex, and comorbidities, Cox regression showed a significant decrease in hazard ratio associated with the use of statins (hazard ratio, 0.637 [95% CI, 0.425-0.953]; P=0.0283). Moreover, on comparing the hazard ratio between COVID-19 patients and the retrospective cohort of hospitalized pneumonia patients, the use of statins showed similar benefits. Conclusions: The use of statins correlates significantly with lower mortality in patients with COVID-19, consistent with the findings in patients with pneumonia.
|Journal||Arteriosclerosis, Thrombosis, and Vascular Biology|
|State||Published - 1 Mar 2021|
Bibliographical noteFunding Information:
This study was supported by a research grant from the Korea Disease Control and Prevention Agency (No. 4838-330-320-01) and by the Seoul National University Hospital (No. 04-2020-0030). The Korea Disease Control and Prevention Agency supported the organization of the National Committee for Clinical Management of Emerging Infectious Diseases, which conducted this study.
This research was supported by research grant from the Korea Centers for Disease Control and Prevention (No. 4838-330-320-01) and Seoul National University Hospital (No. 04-2020-0030).
We report a population-based cohort study supported by the Korea Disease Control and Prevention Agency, the National Health Insurance Service, and the Korean Society of Hypertension. The study was approved by the Institutional Review Board of Seoul National University Hospital (No. 2003-102-1109). Informed consent was waived by the institutional review board. All authors reviewed the manuscript for the accuracy and completeness of the data.
This study was supported by the Korean Society of Hypertension and the National Committee for Clinical Management of Emerging Infectious Diseases. M.-d. Oh and H.-Y. Lee conceived and designed the study, had full access to all of the data in the study, and take responsibility for the integrity of the data and the accuracy of the data analysis. H.-Y. Lee, J. Ahn, D. Wook Kim, and C. Kyung Kang drafted the paper. S.-H. Won, J. Ahn, D. Wook Kim, J. Park, and J.-H. Park did the analysis, and C. Hee Kang, K.-H. Chung, J.-S. Joh, J. Bang, W. Bum Pyun, and M.-d. Oh contributed to data collection and interpretation. All authors critically revised the manuscript for relevant intellectual content and gave final approval for the version to be published. All authors agree to be accountable for all aspects of the work and will answer any questions related to the accuracy or integrity of the work. We declare no competing interests. We acknowledge all health care workers involved in the diagnosis and treatment of patients in Korea. We thank all the hospital staff members for their effort in collecting the information used in this study: Hongsang Oh, Junghan Kim (Armed Forces Caital Hospital), Yeonjae Kim, Ji Hwan Bang, Bumsik Jin (National Medical Center), Sangjun Park, Wangjun Lee, Kangwon Choe, Kiduk Lee, Yumin Kang (Myongji Hospital), Jinwon Jung, Jeeyoung Park (Chung-Ang University Hospital), Eu Suk Kim, Hong Bin Kim, Kyoung-Ho Song (Bundang Seoul National University Hospital), Jeeyoung Seo (Samsung Medical Center), Nam Joong Kim, Chang Kyung Kang, Myoung-don Oh, Wan Beom Park, Pyeong Gyun Choe (Seoul National University Hospital), Jaephil Choi, Donghyun Oh (Seoul Medical Center), Jinyong Kim (Incheon Medical Center), Jaehoon Lee (Wonkwang University Hospital), Sookin Jung, Kyung-wha Park, Sungen Kim, Taehoon Oh (Chonnam National University Hospital), Hyunah Jang (Kyungpook National University Hospital), Younghee Jung (Hallym University Medical Center), Hyejine Jung (Daegu Medical Center), Dongmin Kim, Nara Yoon, Joonwon Suh (Chosun University Hospital), Boram Koh (Gyeonggi Provincial Medical Center Ansung Hospital), Woonjung Nam (Daenam Hospital), Joonsup Yeom (Korean Society of Infectious Diseases), Donggun Lee, and Yeon-sook Kim (Korean Society for Antimicrobial Therapy). We thank all of the organizing committee members of the Korean Society of Hypertension for the critical review and the endorsement of this study: Sungha Park, Kwang-il Kim, Jinho Shin, Ki Chul Sung, Hyeon Chang Kim, Sang-Hyun Ihm, Eun Joo Cho, Juhan Kim, Dae-Hee Kim, Il-Suk Sohn, Wook Jin Chung, Sung Kee Ryu, Myeong-Chan Cho, and Wook Bum Pyun (President).
© 2021 Lippincott Williams and Wilkins. All rights reserved.
- cohort studies
- hydroxymethylglutaryl-CoA reductase inhibitors
- propensity score