Statins and SARS‐CoV‐2 Infection: Results of a Population‐Based Prospective Cohort Study of 469 749 Adults From 2 Canadian Provinces
Background Small observational studies have suggested that statin users have a lower risk of dying with COVID‐19. We tested this hypothesis in a large, population‐based cohort of adults in 2 of Canada’s most populous provinces: Ontario and Alberta. Methods and Results We examined reverse transcripta...
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2021-11-01
|
| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.121.022330 |
| _version_ | 1797884394494492672 |
|---|---|
| author | Finlay A. McAlister Ting Wang Xuesong Wang Anna Chu Shaun G. Goodman Sean van Diepen Cynthia A. Jackevicius Padma Kaul Jacob Udell Dennis T. Ko Jeffrey C. Kwong Peter C. Austin Douglas S. Lee |
| author_facet | Finlay A. McAlister Ting Wang Xuesong Wang Anna Chu Shaun G. Goodman Sean van Diepen Cynthia A. Jackevicius Padma Kaul Jacob Udell Dennis T. Ko Jeffrey C. Kwong Peter C. Austin Douglas S. Lee |
| author_sort | Finlay A. McAlister |
| collection | DOAJ |
| description | Background Small observational studies have suggested that statin users have a lower risk of dying with COVID‐19. We tested this hypothesis in a large, population‐based cohort of adults in 2 of Canada’s most populous provinces: Ontario and Alberta. Methods and Results We examined reverse transcriptase–polymerase chain reaction swab positivity rates for SARS‐CoV‐2 in adults using statins compared with nonusers. In patients with SARS‐CoV‐2 infection, we compared 30‐day risk of all‐cause emergency department visit, hospitalization, intensive care unit admission, or death in statin users versus nonusers, adjusting for baseline differences in demographics, clinical comorbidities, and prior health care use, as well as propensity for statin use. Between January and June 2020, 2.4% of 226 142 tested individuals aged 18 to 65 years, 2.7% of 88 387 people aged 66 to 75 years, and 4.1% of 154 950 people older than 75 years had a positive reverse transcriptase–polymerase chain reaction swab for SARS‐CoV‐2. Compared with 353 878 nonusers, the 115 871 statin users were more likely to test positive for SARS‐CoV‐2 (3.6% versus 2.8%, P<0.001), but this difference was not significant after adjustment for baseline differences and propensity for statin use in each age stratum (adjusted odds ratio 1.00 [95% CI, 0.88–1.14], 1.00 [0.91–1.09], and 1.06 [0.82–1.38], respectively). In individuals younger than 75 years with SARS‐CoV‐2 infection, statin users were more likely to visit an emergency department, be hospitalized, be admitted to the intensive care unit, or to die of any cause within 30 days of their positive swab result than nonusers, but none of these associations were significant after multivariable adjustment. In individuals older than 75 years with SARS‐CoV‐2, statin users were more likely to visit an emergency department (28.2% versus 17.9%, adjusted odds ratio 1.41 [1.23–1.61]) or be hospitalized (32.7% versus 21.9%, adjusted odds ratio 1.19 [1.05–1.36]), but were less likely to die (26.9% versus 31.3%, adjusted odds ratio 0.76 [0.67–0.86]) of any cause within 30 days of their positive swab result than nonusers. Conclusions Compared with statin nonusers, patients taking statins exhibit the same risk of testing positive for SARS‐CoV‐2 and those younger than 75 years exhibit similar outcomes within 30 days of a positive test. Patients older than 75 years with a positive SARS‐CoV‐2 test and who were taking statins had more emergency department visits and hospitalizations, but exhibited lower 30‐day all‐cause mortality risk. |
| first_indexed | 2024-04-10T04:06:31Z |
| format | Article |
| id | doaj.art-2cca71e6f3f941a6b85aea3a4c4af4c9 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-10T04:06:31Z |
| publishDate | 2021-11-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-2cca71e6f3f941a6b85aea3a4c4af4c92023-03-13T05:24:49ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802021-11-01102110.1161/JAHA.121.022330Statins and SARS‐CoV‐2 Infection: Results of a Population‐Based Prospective Cohort Study of 469 749 Adults From 2 Canadian ProvincesFinlay A. McAlister0Ting Wang1Xuesong Wang2Anna Chu3Shaun G. Goodman4Sean van Diepen5Cynthia A. Jackevicius6Padma Kaul7Jacob Udell8Dennis T. Ko9Jeffrey C. Kwong10Peter C. Austin11Douglas S. Lee12The Department of Medicine Faculty of Medicine and Dentistry University of Alberta Edmonton Alberta CanadaThe Alberta Strategy for Patient Oriented Research Support Unit Edmonton CanadaICES (formerly Institute for Clinical Evaluative Sciences) Toronto CanadaICES (formerly Institute for Clinical Evaluative Sciences) Toronto CanadaThe Department of Medicine Faculty of Medicine and Dentistry University of Alberta Edmonton Alberta CanadaThe Canadian VIGOUR Centre University of Alberta Edmonton CanadaICES (formerly Institute for Clinical Evaluative Sciences) Toronto CanadaThe Department of Medicine Faculty of Medicine and Dentistry University of Alberta Edmonton Alberta CanadaICES (formerly Institute for Clinical Evaluative Sciences) Toronto CanadaICES (formerly Institute for Clinical Evaluative Sciences) Toronto CanadaICES (formerly Institute for Clinical Evaluative Sciences) Toronto CanadaICES (formerly Institute for Clinical Evaluative Sciences) Toronto CanadaICES (formerly Institute for Clinical Evaluative Sciences) Toronto CanadaBackground Small observational studies have suggested that statin users have a lower risk of dying with COVID‐19. We tested this hypothesis in a large, population‐based cohort of adults in 2 of Canada’s most populous provinces: Ontario and Alberta. Methods and Results We examined reverse transcriptase–polymerase chain reaction swab positivity rates for SARS‐CoV‐2 in adults using statins compared with nonusers. In patients with SARS‐CoV‐2 infection, we compared 30‐day risk of all‐cause emergency department visit, hospitalization, intensive care unit admission, or death in statin users versus nonusers, adjusting for baseline differences in demographics, clinical comorbidities, and prior health care use, as well as propensity for statin use. Between January and June 2020, 2.4% of 226 142 tested individuals aged 18 to 65 years, 2.7% of 88 387 people aged 66 to 75 years, and 4.1% of 154 950 people older than 75 years had a positive reverse transcriptase–polymerase chain reaction swab for SARS‐CoV‐2. Compared with 353 878 nonusers, the 115 871 statin users were more likely to test positive for SARS‐CoV‐2 (3.6% versus 2.8%, P<0.001), but this difference was not significant after adjustment for baseline differences and propensity for statin use in each age stratum (adjusted odds ratio 1.00 [95% CI, 0.88–1.14], 1.00 [0.91–1.09], and 1.06 [0.82–1.38], respectively). In individuals younger than 75 years with SARS‐CoV‐2 infection, statin users were more likely to visit an emergency department, be hospitalized, be admitted to the intensive care unit, or to die of any cause within 30 days of their positive swab result than nonusers, but none of these associations were significant after multivariable adjustment. In individuals older than 75 years with SARS‐CoV‐2, statin users were more likely to visit an emergency department (28.2% versus 17.9%, adjusted odds ratio 1.41 [1.23–1.61]) or be hospitalized (32.7% versus 21.9%, adjusted odds ratio 1.19 [1.05–1.36]), but were less likely to die (26.9% versus 31.3%, adjusted odds ratio 0.76 [0.67–0.86]) of any cause within 30 days of their positive swab result than nonusers. Conclusions Compared with statin nonusers, patients taking statins exhibit the same risk of testing positive for SARS‐CoV‐2 and those younger than 75 years exhibit similar outcomes within 30 days of a positive test. Patients older than 75 years with a positive SARS‐CoV‐2 test and who were taking statins had more emergency department visits and hospitalizations, but exhibited lower 30‐day all‐cause mortality risk.https://www.ahajournals.org/doi/10.1161/JAHA.121.022330COVID‐19outcomesSARS‐CoV‐2statins |
| spellingShingle | Finlay A. McAlister Ting Wang Xuesong Wang Anna Chu Shaun G. Goodman Sean van Diepen Cynthia A. Jackevicius Padma Kaul Jacob Udell Dennis T. Ko Jeffrey C. Kwong Peter C. Austin Douglas S. Lee Statins and SARS‐CoV‐2 Infection: Results of a Population‐Based Prospective Cohort Study of 469 749 Adults From 2 Canadian Provinces Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease COVID‐19 outcomes SARS‐CoV‐2 statins |
| title | Statins and SARS‐CoV‐2 Infection: Results of a Population‐Based Prospective Cohort Study of 469 749 Adults From 2 Canadian Provinces |
| title_full | Statins and SARS‐CoV‐2 Infection: Results of a Population‐Based Prospective Cohort Study of 469 749 Adults From 2 Canadian Provinces |
| title_fullStr | Statins and SARS‐CoV‐2 Infection: Results of a Population‐Based Prospective Cohort Study of 469 749 Adults From 2 Canadian Provinces |
| title_full_unstemmed | Statins and SARS‐CoV‐2 Infection: Results of a Population‐Based Prospective Cohort Study of 469 749 Adults From 2 Canadian Provinces |
| title_short | Statins and SARS‐CoV‐2 Infection: Results of a Population‐Based Prospective Cohort Study of 469 749 Adults From 2 Canadian Provinces |
| title_sort | statins and sars cov 2 infection results of a population based prospective cohort study of 469 749 adults from 2 canadian provinces |
| topic | COVID‐19 outcomes SARS‐CoV‐2 statins |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.121.022330 |
| work_keys_str_mv | AT finlayamcalister statinsandsarscov2infectionresultsofapopulationbasedprospectivecohortstudyof469749adultsfrom2canadianprovinces AT tingwang statinsandsarscov2infectionresultsofapopulationbasedprospectivecohortstudyof469749adultsfrom2canadianprovinces AT xuesongwang statinsandsarscov2infectionresultsofapopulationbasedprospectivecohortstudyof469749adultsfrom2canadianprovinces AT annachu statinsandsarscov2infectionresultsofapopulationbasedprospectivecohortstudyof469749adultsfrom2canadianprovinces AT shaunggoodman statinsandsarscov2infectionresultsofapopulationbasedprospectivecohortstudyof469749adultsfrom2canadianprovinces AT seanvandiepen statinsandsarscov2infectionresultsofapopulationbasedprospectivecohortstudyof469749adultsfrom2canadianprovinces AT cynthiaajackevicius statinsandsarscov2infectionresultsofapopulationbasedprospectivecohortstudyof469749adultsfrom2canadianprovinces AT padmakaul statinsandsarscov2infectionresultsofapopulationbasedprospectivecohortstudyof469749adultsfrom2canadianprovinces AT jacobudell statinsandsarscov2infectionresultsofapopulationbasedprospectivecohortstudyof469749adultsfrom2canadianprovinces AT dennistko statinsandsarscov2infectionresultsofapopulationbasedprospectivecohortstudyof469749adultsfrom2canadianprovinces AT jeffreyckwong statinsandsarscov2infectionresultsofapopulationbasedprospectivecohortstudyof469749adultsfrom2canadianprovinces AT petercaustin statinsandsarscov2infectionresultsofapopulationbasedprospectivecohortstudyof469749adultsfrom2canadianprovinces AT douglasslee statinsandsarscov2infectionresultsofapopulationbasedprospectivecohortstudyof469749adultsfrom2canadianprovinces |