Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Apr 5, 2021
Open Peer Review Period: Apr 4, 2021 - May 30, 2021
Date Accepted: Jun 29, 2021
(closed for review but you can still tweet)
Statin use and COVID-19 infectivity and severity in South Korea: Two population-based nationwide cohort studies
ABSTRACT
Background:
Basic studies suggest that statins as add-on therapy may benefit patients with coronavirus disease 2019 (COVID-19); however, real-world evidence of such a beneficial association is lacking.
Objective:
We investigated differences in SARS-CoV-2 test positivity and clinical outcomes of COVID-19 (composite endpoint: admission to intensive care unit, invasive ventilation, or death), between statin users and non-users.
Methods:
Two independent population-based cohorts were analyzed, and we investigated the differences in SARS-CoV-2 test positivity and severe clinical outcomes of COVID-19, such as admission to the intensive care unit, invasive ventilation, or death, between statin users and non-users. One group comprised an unmatched cohort of 214,207 patients who underwent SARS-CoV-2 testing from the GPCR-COVID cohort, and the other group comprised an unmatched cohort of 74,866 patients who underwent SARS-CoV-2 testing from the NHIS-COVID cohort.
Results:
The GPCR-COVID cohort with propensity-score matching had 29,701 statin users and 29,701 matched non-users. The SARS-CoV-2 test positivity rate was not associated with statin use (statin users, 2.8%; non-users, 2.7%; adjusted odds ratio [aOR], 0.97; 95% CI, 0.88–1.07). Among patients with confirmed COVID-19 in the GPCR-COVID cohort, 804 were statin users and 1573 were matched non-users. Statin users were associated with a decreased likelihood of severe clinical outcomes (statin users, 4.0%; non-users, 5.4%; aOR, 0.61; 95% CI, 0.40–0.91) and length of hospital stay (statin users, 23.8 days; non-users, 26.3 days; adjusted mean difference, -2.87; 95% CI, -5.68 to -0.93) than non-users. The results of the NHIS-COVID cohort were similar to the primary results of the GPCR-COVID cohort.
Conclusions:
Our findings indicate that statin use is related to a decreased risk of worsening clinical outcomes of COVID-19 and length of hospital stay but not to that of SARS-CoV-2 infection. Clinical Trial: None
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