Background Statins may be protective in severe acute respiratory syndrome coronavirus 2 SARS-CoV-2 infection. The aim of the current study was to evaluate the effect of in-hospital statin use on 28-day mortality rates and intensive care unit (ICU) admission among patients with SARS-CoV-2, stratified into 4 groups: those who used statins before hospitalization (treatment continued or discontinued in the hospital) and those who did not (treatment newly initiated in the hospital or never initiated). Methods In a cohort study of 1179 patients with SARS-CoV-2, record review was used to assess demographics, laboratory measurements, comorbid conditions, and time from admission to death, ICU admission, or discharge. Using marginal structural Cox models, we estimated hazard ratios (HRs) for death and ICU admission. Results Among 1179 patients, 676 (57%) were male, 443 (37%) were >65 years old, and 493 (46%) had a body mass index ≥30 (calculated as weight in kilograms divided by height in meters squared). Inpatient statin use reduced the hazard of death (HR, 0.566; P=.008). This association held among patients who did and those who did not use statins before hospitalization (HR, 0.270 [P=.003] and 0.493 [P=.04], respectively). Statin use was associated with improved time to death for patients aged >65 years but not for those ≤65 years old. Conclusion Statin use during hospitalization for SARS-CoV-2 infection was associated with reduced 28-day mortality rates. Well-designed randomized control trials are needed to better define this relationship.

中文翻译：

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他汀类药物与严重急性呼吸系统综合症冠状病毒 2 感染住院患者的 28 天死亡率之间的关系

背景 他汀类药物可能对严重急性呼吸综合征冠状病毒 2 SARS-CoV-2 感染具有保护作用。本研究的目的是评估院内使用他汀类药物对 SARS-CoV-2 患者 28 天死亡率和重症监护病房 (ICU) 入住的影响，分为 4 组：之前使用过他汀类药物的患者住院治疗（在医院继续治疗或停止治疗）和未住院治疗（在医院新开始治疗或从未开始治疗）。方法 在 1179 名 SARS-CoV-2 患者的队列研究中，使用记录审查来评估人口统计学、实验室测量、合并症以及从入院到死亡、入住 ICU 或出院的时间。使用边际结构 Cox 模型，我们估计了死亡和 ICU 入住的风险比 (HR)。结果 1179 名患者中，676 名患者（57%）为男性，443 名患者（37%）年龄>65 岁，493 名患者（46%）体重指数≥30（计算方法为体重公斤数除以身高米数平方） ）。住院患者使用他汀类药物可降低死亡风险（HR，0.566；P=.008）。住院前使用他汀类药物和未使用他汀类药物的患者之间存在这种关联（HR 分别为 0.270 [P=.003] 和 0.493 [P=.04]）。他汀类药物的使用与年龄>65岁的患者的死亡时间改善相关，但与≤65岁的患者无关。结论 SARS-CoV-2 感染住院期间使用他汀类药物与降低 28 天死亡率相关。需要精心设计的随机对照试验来更好地定义这种关系。