Purpose

Coagulation abnormalities are one of the most important complications of severe COVID-19, which might lead to venous thromboembolism (VTE). Hypercoagulability with hyperfibrinogenemia causes large vessel thrombosis and major thromboembolic sequelae. Statins are potentially a potent adjuvant therapy in COVID-19 infection due to their pleiotropic effect. This study aims to evaluate the effectiveness of statins in reducing the risk of thrombosis among hospitalized critically ill patients with COVID-19.

Methods

A multicenter, retrospective cohort study of all critically ill adult patients with confirmed COVID-19 admitted to Intensive Care Units (ICUs) between March 1, 2020, and March 31, 2021. Eligible patients were categorized based on their usage of statins throughout their ICU stay and were matched with a propensity score. The primary endpoint was the odds of all cases of thrombosis; other outcomes were considered secondary.

Results

A total of 1039 patients were eligible; following propensity score matching, 396 patients were included (1:1 ratio). The odds of all thrombosis cases and VTE events did not differ significantly between the two groups (OR 0.84 (95% CI 0.43, 1.66), P = 0.62 and OR 1.13 (95% CI 0.43, 2.98), P = 0.81, respectively. On multivariable Cox proportional hazards regression analysis, patients who received statin therapy had lower 30-day (HR 0.72 (95 % CI 0.54, 0.97), P = 0.03) and in-hospital mortality (HR 0.67 (95 % CI 0.51, 0.89), P = 0.007). Other secondary outcomes were not statistically significant between the two groups except for D-dimer levels (peak) during ICU stay.

Conclusion

The use of statin therapy during ICU stay was not associated with thrombosis reduction in critically ill patients with COVID-19; however, it has been associated with survival benefits.

中文翻译：

---

他汀类药物和 COVID-19 危重患者的血栓形成风险：一项多中心队列研究

目的

凝血异常是严重 COVID-19 最重要的并发症之一，可能导致静脉血栓栓塞 (VTE)。高纤维蛋白原血症的高凝状态导致大血管血栓形成和主要血栓栓塞后遗症。由于他汀类药物的多效性，他汀类药物可能是 COVID-19 感染的有效辅助疗法。本研究旨在评估他汀类药物在降低 COVID-19 住院重症患者血栓形成风险方面的有效性。

方法

一项多中心、回顾性队列研究，对象为 2020 年 3 月 1 日至 2021 年 3 月 31 日期间入住重症监护病房 (ICU) 的所有确诊为 COVID-19 的重症成年患者。符合条件的患者根据他们在 ICU 中使用他汀类药物的情况进行分类留下来并与倾向得分相匹配。主要终点是所有血栓病例的发生率；其他结果被认为是次要的。

结果

共有 1039 名患者符合条件；倾向评分匹配后，共纳入 396 名患者（比例为 1:1）。所有血栓病例和 VTE 事件的发生率在两组之间没有显着差异（OR 0.84（95% CI 0.43, 1.66），P  = 0.62 和 OR 1.13（95% CI 0.43, 2.98），P  = 0.81。在多变量 Cox 比例风险回归分析中，接受他汀类药物治疗的患者的 30 天（HR 0.72（95 % CI 0.54，0.97），P = 0.03）和住院死亡率（HR 0.67（95 % CI 0.51，0.89）较低） , P = 0.007). 两组之间的其他次要结局无统计学意义，除了在 ICU 住院期间的 D-二聚体水平（峰值）。

结论

在 ICU 住院期间使用他汀类药物治疗与 COVID-19 重症患者血栓形成减少无关；然而，它与生存益处有关。