COVID-19 outcomes in patients taking cardioprotective medications

<h4>Introduction</h4> The coronavirus disease 2019 (COVID-19) caused a worldwide pandemic and has led to over five million deaths. Many cardiovascular risk factors (e.g. obesity or diabetes) are associated with an increased risk of adverse outcomes in COVID-19. On the other hand, it has...

Full description

Bibliographic Details
Main Authors: Fritha J. Morrison, Maxwell Su, Alexander Turchin
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2022-01-01
Series:PLoS ONE
Online Access:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9550077/?tool=EBI
_version_ 1828105879176609792
author Fritha J. Morrison
Maxwell Su
Alexander Turchin
author_facet Fritha J. Morrison
Maxwell Su
Alexander Turchin
author_sort Fritha J. Morrison
collection DOAJ
description <h4>Introduction</h4> The coronavirus disease 2019 (COVID-19) caused a worldwide pandemic and has led to over five million deaths. Many cardiovascular risk factors (e.g. obesity or diabetes) are associated with an increased risk of adverse outcomes in COVID-19. On the other hand, it has been suggested that medications used to treat cardiometabolic conditions may have protective effects for patients with COVID-19. <h4>Objectives</h4> To determine whether patients taking four classes of cardioprotective medications—aspirin, metformin, renin angiotensin aldosterone system inhibitors (RAASi) and statins–have a lower risk of adverse outcomes of COVID-19. <h4>Methods</h4> We conducted a retrospective cohort study of primary care patients at a large integrated healthcare delivery system who had a positive COVID-19 test between March 2020 and March 2021. We compared outcomes of patients who were taking one of the study medications at the time of the COVID-19 test to patients who took a medication from the same class in the past (to minimize bias by indication). The following outcomes were compared: a) hospitalization; b) ICU admission; c) intubation; and d) death. Multivariable analysis was used to adjust for patient demographics and comorbidities. <h4>Results</h4> Among 13,585 study patients, 1,970 (14.5%) were hospitalized; 763 (5.6%) were admitted to an ICU; 373 (2.8%) were intubated and 720 (5.3%) died. In bivariate analyses, patients taking metformin, RAASi and statins had lower risk of hospitalization, ICU admission and death. However, in multivariable analysis, only the lower risk of death remained statistically significant. Patients taking aspirin had a significantly higher risk of hospitalization in both bivariate and multivariable analyses. <h4>Conclusions</h4> Cardioprotective medications were not associated with a consistent benefit in COVID-19. As vaccination and effective treatments are not yet universally accessible worldwide, research should continue to determine whether affordable and widely available medications could be utilized to decrease the risks of this disease.
first_indexed 2024-04-11T10:08:49Z
format Article
id doaj.art-d3e07a1ec2914a8c84648fb22a105ee5
institution Directory Open Access Journal
issn 1932-6203
language English
last_indexed 2024-04-11T10:08:49Z
publishDate 2022-01-01
publisher Public Library of Science (PLoS)
record_format Article
series PLoS ONE
spelling doaj.art-d3e07a1ec2914a8c84648fb22a105ee52022-12-22T04:30:10ZengPublic Library of Science (PLoS)PLoS ONE1932-62032022-01-011710COVID-19 outcomes in patients taking cardioprotective medicationsFritha J. MorrisonMaxwell SuAlexander Turchin<h4>Introduction</h4> The coronavirus disease 2019 (COVID-19) caused a worldwide pandemic and has led to over five million deaths. Many cardiovascular risk factors (e.g. obesity or diabetes) are associated with an increased risk of adverse outcomes in COVID-19. On the other hand, it has been suggested that medications used to treat cardiometabolic conditions may have protective effects for patients with COVID-19. <h4>Objectives</h4> To determine whether patients taking four classes of cardioprotective medications—aspirin, metformin, renin angiotensin aldosterone system inhibitors (RAASi) and statins–have a lower risk of adverse outcomes of COVID-19. <h4>Methods</h4> We conducted a retrospective cohort study of primary care patients at a large integrated healthcare delivery system who had a positive COVID-19 test between March 2020 and March 2021. We compared outcomes of patients who were taking one of the study medications at the time of the COVID-19 test to patients who took a medication from the same class in the past (to minimize bias by indication). The following outcomes were compared: a) hospitalization; b) ICU admission; c) intubation; and d) death. Multivariable analysis was used to adjust for patient demographics and comorbidities. <h4>Results</h4> Among 13,585 study patients, 1,970 (14.5%) were hospitalized; 763 (5.6%) were admitted to an ICU; 373 (2.8%) were intubated and 720 (5.3%) died. In bivariate analyses, patients taking metformin, RAASi and statins had lower risk of hospitalization, ICU admission and death. However, in multivariable analysis, only the lower risk of death remained statistically significant. Patients taking aspirin had a significantly higher risk of hospitalization in both bivariate and multivariable analyses. <h4>Conclusions</h4> Cardioprotective medications were not associated with a consistent benefit in COVID-19. As vaccination and effective treatments are not yet universally accessible worldwide, research should continue to determine whether affordable and widely available medications could be utilized to decrease the risks of this disease.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9550077/?tool=EBI
spellingShingle Fritha J. Morrison
Maxwell Su
Alexander Turchin
COVID-19 outcomes in patients taking cardioprotective medications
PLoS ONE
title COVID-19 outcomes in patients taking cardioprotective medications
title_full COVID-19 outcomes in patients taking cardioprotective medications
title_fullStr COVID-19 outcomes in patients taking cardioprotective medications
title_full_unstemmed COVID-19 outcomes in patients taking cardioprotective medications
title_short COVID-19 outcomes in patients taking cardioprotective medications
title_sort covid 19 outcomes in patients taking cardioprotective medications
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9550077/?tool=EBI
work_keys_str_mv AT frithajmorrison covid19outcomesinpatientstakingcardioprotectivemedications
AT maxwellsu covid19outcomesinpatientstakingcardioprotectivemedications
AT alexanderturchin covid19outcomesinpatientstakingcardioprotectivemedications