Cost-Effectiveness Analysis of Statins for Treatment of Hospitalized COVID-19 Patients

Chow, Ronald; Prsic, Elizabeth Horn; Shin, Hyun Joon

doi:10.1101/2021.04.29.21256335

Cited by 4 publications

(2 citation statements)

References 14 publications

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“…Further investigation is needed since statins may be cost-effective with the potential benefit outweighing any potential toxicities (32). Mechanistically, statins are postulated to upregulate ACE2, countering the effect of SARS-CoV-2, where ACE2 is downregulated and thereby facilitates the infiltration of SARS-CoV-2 (7).…”

Section: Discussionmentioning

confidence: 99%

The association between statin and COVID-19 adverse outcomes: national COVID-19 cohort in South Korea

Chow¹,

Lee

Noh³

et al. 2022

Ann Palliat Med

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Background: There currently exist limited and conflicting clinical data on the use of statins in coronavirus disease 2019 patients. The aim of this paper was to compare hospitalized patients with COVID-19 who did and did not receive statins. Methods: We performed a population-based retrospective cohort study using South Korea's nationwide healthcare claim database. We identified consecutive patients hospitalized with COVID-19 and aged 40 years or older. Statin users were individuals with inpatient and outpatient prescription records of statins in the 240 days before cohort entry to capture patients who are chronic statin users and, therefore, receive statin prescriptions as infrequently as every 8 months. Our primary endpoint was a composite of all-cause death, intensive care unit (ICU) admission, mechanical ventilation use and cardiovascular outcomes [myocardial infarction (MI), transient cerebral ischemic attacks (TIA) or stroke]. We compared the risk of outcomes between statin users and non-users using logistic regression models after inverse probability of treatment weighting (IPTW) adjustment. Results: Of 234,427 subjects in the database, 4,349 patients were hospitalized with COVID-19 and aged 40+ years. In total, 1,115 patients were statin users (mean age =65.9 years; 60% female), and 3,234 were nonusers (mean age =58.3 years; 64% female). Pre-hospitalization statin use was not significantly associated with increased risk of the primary endpoint [IPTW odds ratio (OR) 0.82; 95% confidence interval (CI): 0.60-1.11]. Subgroup analysis showed a protective role of antecedent statin use for individuals with hypertension (IPTW OR 0.40; 95% CI: 0.23-0.69, P for interaction: 0.0087). Conclusions: Pre-hospitalization statin use is not detrimental and may be beneficial amongst hypertensive COVID-19 patients. Further investigation into statin is needed for more conclusive effects of statins for treatment of COVID-19.

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Section: Discussionmentioning

confidence: 99%

The association between statin and COVID-19 adverse outcomes: national COVID-19 cohort in South Korea

Chow¹,

Lee

Noh³

et al. 2022

Ann Palliat Med

Self Cite

View full text Add to dashboard Cite

show abstract

“…Further investigation is needed since statins may be cost-effective, with the potential benefit outweighing any potential toxicities 27 . Mechanistically, statins is postulated to upregulate ACE2, countering the effect of SARS-CoV-2 where ACE2 is downregulated and thereby facilitates the infiltration of SARS-CoV-2 7 .…”

Section: Discussionmentioning

confidence: 99%

The association between statin and COVID-19 adverse outcomes: National COVID-19 cohort in South Korea

Chow¹,

Lee

Noh

et al. 2021

Preprint

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Background: There currently exists limited and conflicting clinical data on the use of statins amongst COVID-19 patients. Given the both paucity and lack of consensus among data on statin's efficacy and safety amongst COVID-19 patients, the current guideline is to continue statin in COVID-19 patients, who have previously been treated with statins. The aim of this paper was to compare hospitalized patients with COVID-19 who did and did not receive statins, in terms of COVID-19 outcomes. Methods: We conducted population-based retrospective study using South Korea's nationwide healthcare database as of May 15 2020. We identified 4,349 patients hospitalized with COVID-19 and aged 40 years or older. The cohort entry was defined as the date of hospitalization. Statin users were individuals with inpatient and outpatient prescription records of statins in the 240 days before cohort entry, and non-users were those without such records during this period. Our primary outcome was a composite endpoint of all-cause death, intensive care unit (ICU) admission, mechanical ventilation use and cardiovascular outcomes (myocardial infarction (MI), transient cerebral ischemic attacks (TIA) or stroke). We conducted inverse probability of treatment weighting (IPTW)-adjusted logistic regression analysis to estimate odds ratio (OR) and corresponding 95% confidence intervals (CI), to compare outcomes between statin users and non-users. Findings: 1,115 patients were statin users (mean age = 65.9 years; 60% female), and 3,234 were non-users (mean age = 58.3 years; 64% female). Statin use was not associated with increased risk of the primary outcome (IPTW OR 0.82; 95% CI: 0.60-1.11). Subgroup analysis showed a protective role of statins, for individuals with hypertension (IPTW OR 0.40; 95% CI: 0.23-0.69, p for interaction: 0.0087). Interpretation: Given that statins are not detrimental and that it may be beneficial amongst hypertensive patients and relatively cheap, we would encourage further investigation into statin for the prevention and treatment of COVID-19.

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Impact of P-selectin–PSGL-1 Axis on Platelet-Endothelium-Leukocyte Interactions in Fatal COVID-19

Granai

Warm

Vogelsberg

et al. 2023

Laboratory Investigation

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Cost-Effectiveness Analysis of Statins for Treatment of Hospitalized COVID-19 Patients

Cited by 4 publications

References 14 publications

The association between statin and COVID-19 adverse outcomes: national COVID-19 cohort in South Korea

The association between statin and COVID-19 adverse outcomes: national COVID-19 cohort in South Korea

The association between statin and COVID-19 adverse outcomes: National COVID-19 cohort in South Korea

Impact of P-selectin–PSGL-1 Axis on Platelet-Endothelium-Leukocyte Interactions in Fatal COVID-19

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