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Disclosures: The authors report no relevant financial disclosers.
August 02, 2021
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Statins may increase chance of COVID-19 survival among those with heart disease

Disclosures: The authors report no relevant financial disclosers.
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Individuals with heart disease or high blood pressure may be less likely to die from the COVID-19 virus if they use statins, according to findings published in PLOS ONE.

“Because CVD and hypertension are both prominent risk factors for developing severe COVID-19 and are also conditions commonly treated with statins and antihypertensive medications, there is a complex interplay between the effects of these conditions and medications. Most patients had CVD, hypertension, or both conditions, and the large majority of these patients were taking at least one relevant medication; for patients with neither condition, the proportion was less than 20%,” Lori Daniels, MD, MAS, professor and director of the Cardiovascular Intensive Care Unit at UC San Diego Health, and colleagues wrote. “We attempted to disentangle these interactions by using propensity-score matched analyses stratified by comorbidity status.”

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Daniels and colleagues analyzed data from 10,541 patients at 104 U.S. hospitals from January 2020 through September 2020 (mean age, 66 years; 55% men; 66% with a history of hypertension; 41% with obesity; 40% with diabetes; 40% with dyslipidemia; 32% with CVD). All subjects were hospitalized with COVID-19 and prior to hospitalization, 42% of patients used statins (7% on statins alone, 35% on statins plus antihypertensive agents).

Data were derived from The American Heart Association COVID-19 CVD Registry between January and September 2020. Patients were excluded if they were under 40 years old, diagnosed with COVID-19 after their discharge, transferred from another hospital or had an unknown final disposition.

The primary outcome of death or discharge to hospice occurred in 21% of patients. The researchers found compared with nonuse, that outpatient use of statins, used alone or with antihypertensives, was associated with reduced risk for death (adjusted OR = 0.59; 95% CI, 0.5-0.69) and that the use of statins and/or antihypertensives was correlated with reduced risk for death from COVID-19 among those with CVD and/or hypertension (aOR = 0.68; 95% CI, 0.58-0.81).

The secondary outcome of development of severe disease, defined as ICU admission, need for intubation and/or mechanical ventilation, in-hospital death or discharge to hospice occurred in 39% of patients. Compared with nonuse, use of statins and antihypertensives (aOR = 0.73; 95% CI, 0.63-0.84) and use of statins alone (aOR = 0.74; 95% CI, 0.61-0.89) were associated with reduced risk for severe COVID-19.

“Our study reinforces the AHA and others’ recommendations that not only is it safe to remain on these medications, but they may substantially reduce risk of severe COVID-19 and especially death from COVID-19, particularly statins, and particularly among those with associated underlying conditions,” Daniels and colleagues wrote. “Whether these medications are also protective among individuals without underlying indications for taking them such as CVD or hypertension is less clear and merits further study. Several randomized trials are currently underway evaluating the use of these medications for treatment of COVID-19.”