Decreased Mortality Rate Among COVID-19 Patients Prescribed Statins: Data From Electronic Health Records in the US
The severe respiratory illness due to SARS-CoV-2, the virus responsible for coronavirus disease 2019 (COVID-19), is triggered by an intense pro-inflammatory host response. Statins, prescribed primarily for lipid reduction, are known to have anti-inflammatory and immunomodulatory properties and have...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2021-02-01
|
| Series: | Frontiers in Medicine |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2021.639804/full |
| _version_ | 1818450626619637760 |
|---|---|
| author | Ivana Marić Tomiko Oskotsky Tomiko Oskotsky Idit Kosti Idit Kosti Brian Le Brian Le Ronald J. Wong Gary M. Shaw Marina Sirota Marina Sirota David K. Stevenson |
| author_facet | Ivana Marić Tomiko Oskotsky Tomiko Oskotsky Idit Kosti Idit Kosti Brian Le Brian Le Ronald J. Wong Gary M. Shaw Marina Sirota Marina Sirota David K. Stevenson |
| author_sort | Ivana Marić |
| collection | DOAJ |
| description | The severe respiratory illness due to SARS-CoV-2, the virus responsible for coronavirus disease 2019 (COVID-19), is triggered by an intense pro-inflammatory host response. Statins, prescribed primarily for lipid reduction, are known to have anti-inflammatory and immunomodulatory properties and have been associated with a reduced mortality rate among COVID-19 patients taking statins as reported in two recent retrospective studies. However, a meta-analysis that included nine studies showed that statin use did not improve in-hospital outcomes of those with COVID-19. In addition, concerns regarding the use of statins and an increase in COVID-19 infections have been raised, as statins may increase the expression of angiotensin-converting enzyme 2 (ACE2), the primary receptor for the SARS-CoV-2 virus. Our goal was to investigate the effect of statins in COVID-19 patients in a large, diverse patient population across the United States containing nearly 120,000 patients diagnosed with COVID-19. We used propensity score matching of demographics, comorbidities, and medication indication to compare statin-treated patients (N = 2,297) with matched controls (N = 4,594). We observed a small, but statistically significant, decrease in mortality among patients prescribed statins (16.1%) when compared with matched COVID-19-positive controls (18.0 to 20.6%). These results support previous evidence that statins do not increase COVID-19-related mortality and may, in fact, have a mitigating effect on severity of the disease reflected in a slight reduction in mortality. Mixed findings on effects of statins in COVID-19 patients reported in the literature should prompt prospective randomized controlled trials in order to define better who might be advantaged with respect to clinical outcomes. |
| first_indexed | 2024-12-14T20:54:18Z |
| format | Article |
| id | doaj.art-b27d3b64e0a542d680e23916fc1d9f04 |
| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-12-14T20:54:18Z |
| publishDate | 2021-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj.art-b27d3b64e0a542d680e23916fc1d9f042022-12-21T22:47:44ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2021-02-01810.3389/fmed.2021.639804639804Decreased Mortality Rate Among COVID-19 Patients Prescribed Statins: Data From Electronic Health Records in the USIvana Marić0Tomiko Oskotsky1Tomiko Oskotsky2Idit Kosti3Idit Kosti4Brian Le5Brian Le6Ronald J. Wong7Gary M. Shaw8Marina Sirota9Marina Sirota10David K. Stevenson11Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, United StatesDepartment of Pediatrics, UCSF, San Francisco, CA, United StatesBakar Computational Health Sciences Institute, UCSF, San Francisco, CA, United StatesDepartment of Pediatrics, UCSF, San Francisco, CA, United StatesBakar Computational Health Sciences Institute, UCSF, San Francisco, CA, United StatesDepartment of Pediatrics, UCSF, San Francisco, CA, United StatesBakar Computational Health Sciences Institute, UCSF, San Francisco, CA, United StatesDepartment of Pediatrics, Stanford University School of Medicine, Stanford, CA, United StatesDepartment of Pediatrics, Stanford University School of Medicine, Stanford, CA, United StatesDepartment of Pediatrics, UCSF, San Francisco, CA, United StatesBakar Computational Health Sciences Institute, UCSF, San Francisco, CA, United StatesDepartment of Pediatrics, Stanford University School of Medicine, Stanford, CA, United StatesThe severe respiratory illness due to SARS-CoV-2, the virus responsible for coronavirus disease 2019 (COVID-19), is triggered by an intense pro-inflammatory host response. Statins, prescribed primarily for lipid reduction, are known to have anti-inflammatory and immunomodulatory properties and have been associated with a reduced mortality rate among COVID-19 patients taking statins as reported in two recent retrospective studies. However, a meta-analysis that included nine studies showed that statin use did not improve in-hospital outcomes of those with COVID-19. In addition, concerns regarding the use of statins and an increase in COVID-19 infections have been raised, as statins may increase the expression of angiotensin-converting enzyme 2 (ACE2), the primary receptor for the SARS-CoV-2 virus. Our goal was to investigate the effect of statins in COVID-19 patients in a large, diverse patient population across the United States containing nearly 120,000 patients diagnosed with COVID-19. We used propensity score matching of demographics, comorbidities, and medication indication to compare statin-treated patients (N = 2,297) with matched controls (N = 4,594). We observed a small, but statistically significant, decrease in mortality among patients prescribed statins (16.1%) when compared with matched COVID-19-positive controls (18.0 to 20.6%). These results support previous evidence that statins do not increase COVID-19-related mortality and may, in fact, have a mitigating effect on severity of the disease reflected in a slight reduction in mortality. Mixed findings on effects of statins in COVID-19 patients reported in the literature should prompt prospective randomized controlled trials in order to define better who might be advantaged with respect to clinical outcomes.https://www.frontiersin.org/articles/10.3389/fmed.2021.639804/fullSARS-CoV-2COVID-19statinselectronic health recordsinflammatory responseoxidative stress |
| spellingShingle | Ivana Marić Tomiko Oskotsky Tomiko Oskotsky Idit Kosti Idit Kosti Brian Le Brian Le Ronald J. Wong Gary M. Shaw Marina Sirota Marina Sirota David K. Stevenson Decreased Mortality Rate Among COVID-19 Patients Prescribed Statins: Data From Electronic Health Records in the US Frontiers in Medicine SARS-CoV-2 COVID-19 statins electronic health records inflammatory response oxidative stress |
| title | Decreased Mortality Rate Among COVID-19 Patients Prescribed Statins: Data From Electronic Health Records in the US |
| title_full | Decreased Mortality Rate Among COVID-19 Patients Prescribed Statins: Data From Electronic Health Records in the US |
| title_fullStr | Decreased Mortality Rate Among COVID-19 Patients Prescribed Statins: Data From Electronic Health Records in the US |
| title_full_unstemmed | Decreased Mortality Rate Among COVID-19 Patients Prescribed Statins: Data From Electronic Health Records in the US |
| title_short | Decreased Mortality Rate Among COVID-19 Patients Prescribed Statins: Data From Electronic Health Records in the US |
| title_sort | decreased mortality rate among covid 19 patients prescribed statins data from electronic health records in the us |
| topic | SARS-CoV-2 COVID-19 statins electronic health records inflammatory response oxidative stress |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2021.639804/full |
| work_keys_str_mv | AT ivanamaric decreasedmortalityrateamongcovid19patientsprescribedstatinsdatafromelectronichealthrecordsintheus AT tomikooskotsky decreasedmortalityrateamongcovid19patientsprescribedstatinsdatafromelectronichealthrecordsintheus AT tomikooskotsky decreasedmortalityrateamongcovid19patientsprescribedstatinsdatafromelectronichealthrecordsintheus AT iditkosti decreasedmortalityrateamongcovid19patientsprescribedstatinsdatafromelectronichealthrecordsintheus AT iditkosti decreasedmortalityrateamongcovid19patientsprescribedstatinsdatafromelectronichealthrecordsintheus AT brianle decreasedmortalityrateamongcovid19patientsprescribedstatinsdatafromelectronichealthrecordsintheus AT brianle decreasedmortalityrateamongcovid19patientsprescribedstatinsdatafromelectronichealthrecordsintheus AT ronaldjwong decreasedmortalityrateamongcovid19patientsprescribedstatinsdatafromelectronichealthrecordsintheus AT garymshaw decreasedmortalityrateamongcovid19patientsprescribedstatinsdatafromelectronichealthrecordsintheus AT marinasirota decreasedmortalityrateamongcovid19patientsprescribedstatinsdatafromelectronichealthrecordsintheus AT marinasirota decreasedmortalityrateamongcovid19patientsprescribedstatinsdatafromelectronichealthrecordsintheus AT davidkstevenson decreasedmortalityrateamongcovid19patientsprescribedstatinsdatafromelectronichealthrecordsintheus |