Clinical comorbidities, characteristics, and outcomes of mechanically ventilated patients in the State of Michigan with SARS-CoV-2 pneumonia

Krishnan, Sandeep; Patel, Kinjal; Desai, Ronak; Sule, Anupam A; Paik, Peter; Miller, Allison N.; Barclay, Alicia; Cassella, Adam N.; Lucaj, Jon; Royster, Yvonne; Hakim, Joffer; Ahmed, Zulfiqar; Ghoddoussi, Farhad

doi:10.1016/j.jclinane.2020.110005

Cited by 44 publications

(41 citation statements)

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“…[4][5][6][7][8][9] The data are, however, limited and contradictory with some studies reporting no difference while others showing adverse outcomes in statin users compared with non-users. [10][11][12][13] In the present meta-analysis, we found that statin use was associated with improved clinical outcomes in patients with COVID-19. The benefit was observed even though statin users were more likely to be old and likely to suffer from comorbid conditions, notably, hypertension, diabetes mellitus and ischaemic heart disease, all of which are known to independently increase the risk of adverse outcomes and mortality in COVID-19.…”

Section: Discussionmentioning

confidence: 48%

“…[4][5][6][7][8][9] On the contrary, other studies showed either no differences in outcomes [10][11][12] or even adverse outcomes in statin users. 13 There exist two metaanalyses in this regard; while one showed that statin use did not improve the in-hospital outcomes, 14 the other reported a 30% reduction in fatal or severe disease. 3 Although the two meta-analyses were conducted at an almost similar time period, the studies included were highly variable.…”

Section: Introductionmentioning

confidence: 99%

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Statin use and clinical outcomes in patients with COVID-19: An updated systematic review and meta-analysis

Pal

Banerjee

Yadav

et al. 2021

Postgraduate Medical Journal

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PurposeObservations studies have shown that prior use of statins is associated with a reduced risk of adverse clinical outcomes in patients with COVID-19. However, the available data are limited, inconsistent and conflicting. Besides, no randomised controlled trial exists in this regard. Hence, the present meta-analysis was conducted to provide an updated summary and collate the effect of statin use on clinical outcomes in COVID-19 using unadjusted and adjusted risk estimates.MethodsPubMed, Scopus and Web of Science databases were systematically searched using appropriate keywords till December 18 2020, to identify observational studies reporting clinical outcomes in COVID-19 patients using statins versus those not using statins. Prior and in-hospital use of statins were considered. Study quality was assessed using the Newcastle-Ottawa Scale. Unadjusted and adjusted pooled odds ratio (OR) with 95% CIs were calculated.ResultsWe included 14 observational studies pooling data retrieved from 19 988 patients with COVID-19. All the studies were of high/moderate quality. Pooled analysis of unadjusted data showed that statin use was not associated with improved clinical outcomes (OR 1.02; 95% CI 0.69 to 1.50, p=0.94, I2=94%, random-effects model). However, on pooling adjusted risk estimates, the use of statin was found to significantly reduce the risk of adverse outcomes (OR 0.51; 95% CI 0.41 to 0.63, p<0.0005, I2=0%, fixed-effects model).ConclusionsStatin use is associated with improved clinical outcomes in patients with COVID-19. Individuals with multiple comorbidities on statin therapy should be encouraged to continue the drug amid the ongoing pandemic.

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Section: Discussionmentioning

confidence: 48%

Section: Introductionmentioning

confidence: 99%

Statin use and clinical outcomes in patients with COVID-19: An updated systematic review and meta-analysis

Pal

Banerjee

Yadav

et al. 2021

Postgraduate Medical Journal

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“…Initially, 24 eligible observational studies were identified that reported valuable data on in-hospital mortality and/or COVID-19 disease severity, including three studies of patients with diabetes [14] , [15] , [17] . Of these selected studies, 14 provided data on in-hospital mortality [15] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] ( Table 1 )—although one reported only adjusted hazard ratios (HRs) with no crude numbers of deaths in statin users vs non-users and, therefore, could not be included in the meta-analysis (authors were contacted, but did not communicate their results) [26] —while 11 studies reported data on COVID-19 severity (as determined by ICU, IMV; Table 2 ) [18] , [22] , [23] , [27] , [28] , [30] , [31] , [32] , [33] , [34] , [35] . Also, a study by Tan et al [36] collected very few events in a Chinese population (personal communication from the authors), thereby preventing the use of this study in the final analysis.…”

Section: Resultsmentioning

confidence: 99%

“…The included observational studies reporting data on in-hospital mortality are listed in Table 1 [15] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] . Results of the corresponding meta-analysis are illustrated in Fig.…”

Section: Resultsmentioning

confidence: 99%

Statins and clinical outcomes with COVID-19: Meta-analyses of observational studies

Scheen

2021

Diabetes & Metabolism

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Aims People with cardiovascular disease or risk factors are at increased risk when exposed to SARS-CoV-2. Most are treated with statins, but the impact of these drugs on clinical outcomes of COVID-19 remains unclear. This report is therefore based on meta-analyses of retrospective observational studies aimed at investigating the impact of previous statin therapy in patients hospitalized for COVID-19. Methods In studies reporting on the clinical outcomes of COVID-19 in statin users vs non-users, two endpoints have been used—in-hospital death rates, and disease severity as assessed by admission to intensive care units (ICUs)—with a special focus on patients with diabetes. Results Regarding mortality, 13 studies were included in the meta-analysis for a total of 10,829 statin users (2517 deaths) and 31,893 non-users (7516 deaths): univariate analysis showed no statistically significant reduction in deaths (OR: 0.97, 95% CI: 0.92–1.03), although between-study heterogeneity was high (I² = 97%). As for disease severity, 11 studies were selected for a total of 3462 statin users (724 endpoints) and 10,560 non-users (1763 endpoints): here again, univariate analysis showed no reduction in severity (OR: 1.09, 95% CI: 0.99–1.22; I² = 93%). Collectively, in 10 studies using multivariable analysis adjusted for the more prevalent baseline risk factors among statin users, lower OR values were reported than with univariate analyses (0.73 ± 0.31 vs 1.44 ± 0.84, respectively; P = 0.0028; adjusted OR: P = 0.0237 vs non-users). Limited but conflicting findings were observed for diabetes patients. Conclusion Although no significant reductions in either in-hospital mortality or COVID-19 severity were reported among statin users compared with non-users after univariate comparisons, such reductions were observed after adjusting for confounding factors. These highly heterogeneous observational findings now require confirmation by ongoing randomized clinical trials.

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“…Subsequently, 44 articles were excluded because of a sample size less than 100, 47 articles were eliminated due to the potential duplicate patients, and two articles were removed because they reported unclear prevalence of asthma in COVID-19 patients (eTable 2). Ultimately, 116 articles (119 studies) 4 , 6 , 7 , 8 , 9 , 10 , 11 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 ,…”

Section: Resultsmentioning

confidence: 99%

Asthma in patients with coronavirus disease 2019

Shi

Xiao

et al. 2021

Annals of Allergy, Asthma & Immunology

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Background It is unclear if there is the influence of asthma on contracting COVID-19, or having worse outcomes from COVID-19 disease. Objective To explore the prevalence of asthma in COVID-19 patients and the relationship between asthma and COVID-19 patients with poor outcomes. Methods The pooled prevalence of asthma in COVID-19 patients and corresponding 95% confidence interval (CI) were estimated. The pooled effect size (ES) was used to evaluate the association between asthma and COVID-19 patients with poor outcomes. Results The pooled prevalence of asthma in COVID-19 patients worldwide was 8.3% (95% CI 7.6-9.0%) based on 116 articles (119 studies) with 403,392 cases. The pooled ES based on unadjusted effect estimates showed that asthma was not associated with the reduced risk of poor outcomes in COVID-19 patients (ES 0.91, 95% CI 0.78-1.06). Similarly, the pooled ES based on unadjusted effect estimates revealed that asthma was not associated with the reduced risk of mortality in COVID19 patients (ES 0.88, 95% CI 0.73-1.05). However, the pooled ES based on adjusted effect estimates indicated that asthma was significantly associated with the reduced risk of mortality in COVID-19 patients (ES 0.80, 95% CI 0.74-0.86). Conclusion The pooled prevalence of asthma in COVID-19 patients was similar to that in the general population, and asthma might be an independent protective factor for the death of COVID-19 patients, which suggests that we should pay high attention to COVID-19 patients with asthma and take locally tailored interventions and treatment. Further well-designed studies with large sample sizes are required to verify our findings.

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Clinical comorbidities, characteristics, and outcomes of mechanically ventilated patients in the State of Michigan with SARS-CoV-2 pneumonia

Cited by 44 publications

References 3 publications

Statin use and clinical outcomes in patients with COVID-19: An updated systematic review and meta-analysis

Statin use and clinical outcomes in patients with COVID-19: An updated systematic review and meta-analysis

Statins and clinical outcomes with COVID-19: Meta-analyses of observational studies

Asthma in patients with coronavirus disease 2019

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