The coronavirus disease-2019 (COVID-19) is caused by SARS-CoV-2, leading to acute respiratory distress syndrome (ARDS), thrombotic complications, and myocardial injury. Statins, prescribed for lipid reduction, have anti-inflammatory, anti-thrombotic, and immunomodulatory properties and are associated with reduced mortality rates in COVID-19 patients. Our goal was to investigate the beneficial effects of statins in hospitalized COVID-19 patients admitted to three multi-specialty hospitals in India from 1 June 2020, to 30 April 2021. This retrospective study included 1,626 patients, of which 524 (32.2%) were antecedent statin users among 768 patients (384 statin users, 384 non-statin users) identified with 1:1 propensity-score matching. We established a multivariable logistic regression model to identify the patients’ demographics and adjust the baseline clinical and laboratory characteristics and co-morbidities. Statin users showed a lower mean of white blood cell count (7.6 × 103/µL vs. 8.1 × 103/µL, p < 0.01), and C-reactive protein (100 mg/L vs. 120.7 mg/L, p < 0.001) compared to non-statin COVID-19 patients. The same positive results followed in lipid profiles for patients on statins. Cox proportional-hazards regression models evaluated the association between statin use and mortality rate. The primary endpoint involved mortality during the hospital stay. Statin use was associated with lower odds of mortality in the propensity-matched cohort (OR 0.52, 95% CI 0.33-0.64, p < 0.001). These results support the previous evidence of the beneficial effects of statins in reducing mortality in hospitalized COVID-19 patients.
Background
To evaluate and determine the protective role of statins in COVID-19 patients.
Methods
This is a retrospective cohort study conducted across five hospitals in India. Patients diagnosed with COVID-19 and hospitalized with existing and valid medical documentation were included.
Results
This study comprised 3252 COVID-19 patients, of whom 1048 (32.2%) were on statins, with 52.4% being males. The comorbidity prevalence of hypertension was 75%, followed by diabetes 62.51% and coronary artery disease being 47.5%. At the time of hospitalization, statin users had a higher incidence of dyspnea, cough, and fatigue (95.8, 93.3, and 92.7%). The laboratory results revealed a lower mean of WBC count (7.8 × 103/μL), D-dimer (2.4 μg/mL), and C-reactive protein (103 mg/L) among statin users. They also had lower mortality rates (17.1%), a lesser requirement for mechanical ventilation (20%), and hemodialysis (5.4%).
Conclusion
This observation study elaborates on the beneficial effects of statins in COVID-19 patients. However, the inferences from this study should be viewed with caution due to the impending effect of confounding factors on its statistical results.
SEASONAL INFLUENZA IN THE MIDST OF COVID-19The World Health Organization (WHO) named the disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as coronavirus disease 2019 and declared the outbreak a Public Health Emergency of International Concern (PHEIC) on January 30, 2020 and a pandemic on March 11, 2020. Globally, there have been 239,437,517 confirmed cases of COVID-19 reported to WHO, including 4,879,235 (2.1%) deaths as of October 15, 2021 (1). The COVID-19 pandemic continues to cause an unparalleled impact on global public health security and economic well-being in the context of previous influenza pandemics as well as other emerging infectious diseases in history (2). As the epidemiology, clinical presentations, and control measures for SARS-CoV-2 and influenza share many features, there is a need to develop strategies to address additional challenges arising in the continued surveillance, prevention, and clinical management of influenza in conjunction with COVID-19 pandemic responses. SARS-CoV-2 and influenza are expected to be circulating during the upcoming influenza season and may lead to situation where an amplified respiratory disease burden occurs due to both viruses spreading, causing overlapping symptoms or severe clinical illness particularly in the case of co-infections (3). Therefore, it is essential that effective public health control measures are in place for the forthcoming influenza season to protect those at risk (e.g., the elderly and patients with underlying chronic diseases), prevent severe illness, and minimize additional impact on the healthcare system and a surge in hospital admissions.
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