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Alshaalan KS, Alkahtani RF, Althobaiti RF, Aldhahi RA, Rebh FZ, Algezlan SS, Alanazi SM, Alrumaih SS, Alturki BA, Alahmadi AS, Alanazi RA, Al Ali AH, Alshabanah OM. Statin use and clinical outcomes in hospitalized COVID-19 patients: A retrospective analysis in Riyadh, Saudi Arabia. Saudi Med J 2024; 45:171-178. [PMID: 38309726 PMCID: PMC11115412 DOI: 10.15537/smj.2024.45.2.20230589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 01/02/2024] [Indexed: 02/05/2024] Open
Abstract
OBJECTIVES To investigate the relationship between statin use and coronavirus disease-19 (COVID-19) severity. METHODS This was a retrospective study of adult patients with confirmed COVID-19 who were hospitalized at Prince Mohammed Bin Abdulaziz Hospital, Riyadh, Saudi Arabia. The study was carried out from July - September 2020. Antecedent statin use was evaluated using medication information available in the electronic medical records. RESULTS In this retrospective study, we collected data from 689 patients hospitalized with COVID-19. Among the patients, 56.2% of them were non-Saudi and 67.3% were males. The mean age of the patients was 53.7 years. The most common comorbidities among patients with COVID-19 at admission were hypertension (65.2%) and diabetes mellitus (65%). Among these patients, 155 (22.5%) patients received statins during hospitalization and 79.7% of them received corticosteroids. Receiving statins significantly increased the risk of intensive care unit's admission by 1.64 times, intubation by 1.76 times, developing complications by 2.48 times, and mortality by 3.16 times. CONCLUSION Statins are associated with a higher risk of mortality and morbidity among patients hospitalized for COVID-19.
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Affiliation(s)
- Khalid S. Alshaalan
- From the Department of Dermatology (Alshaalan); from the Department of Family Medicine (Alahmadi); from the Department of Internal Medicine and Adult Infectious Diseases (Rebh); from the Department of of Intensive Care Unit (Alshabanah), Prince Mohammad Bin Abdul-Aziz Hospital, from the College of Medicine (Alkahtani, Althobaiti, Aldhahi, Algezlan, M. Alanazi, Alrumaih, Alturki, A. Alanazi), Al Imam Muhammad Ibn Saud Islamic University, and from the Department of Internal Medicine and Infectious Diseases (Al Ali), King Saud Medical City, Riyadh, Kingdom of Saudi Arabia.
| | - Rahaf F. Alkahtani
- From the Department of Dermatology (Alshaalan); from the Department of Family Medicine (Alahmadi); from the Department of Internal Medicine and Adult Infectious Diseases (Rebh); from the Department of of Intensive Care Unit (Alshabanah), Prince Mohammad Bin Abdul-Aziz Hospital, from the College of Medicine (Alkahtani, Althobaiti, Aldhahi, Algezlan, M. Alanazi, Alrumaih, Alturki, A. Alanazi), Al Imam Muhammad Ibn Saud Islamic University, and from the Department of Internal Medicine and Infectious Diseases (Al Ali), King Saud Medical City, Riyadh, Kingdom of Saudi Arabia.
| | - Renad F. Althobaiti
- From the Department of Dermatology (Alshaalan); from the Department of Family Medicine (Alahmadi); from the Department of Internal Medicine and Adult Infectious Diseases (Rebh); from the Department of of Intensive Care Unit (Alshabanah), Prince Mohammad Bin Abdul-Aziz Hospital, from the College of Medicine (Alkahtani, Althobaiti, Aldhahi, Algezlan, M. Alanazi, Alrumaih, Alturki, A. Alanazi), Al Imam Muhammad Ibn Saud Islamic University, and from the Department of Internal Medicine and Infectious Diseases (Al Ali), King Saud Medical City, Riyadh, Kingdom of Saudi Arabia.
| | - Rana A. Aldhahi
- From the Department of Dermatology (Alshaalan); from the Department of Family Medicine (Alahmadi); from the Department of Internal Medicine and Adult Infectious Diseases (Rebh); from the Department of of Intensive Care Unit (Alshabanah), Prince Mohammad Bin Abdul-Aziz Hospital, from the College of Medicine (Alkahtani, Althobaiti, Aldhahi, Algezlan, M. Alanazi, Alrumaih, Alturki, A. Alanazi), Al Imam Muhammad Ibn Saud Islamic University, and from the Department of Internal Medicine and Infectious Diseases (Al Ali), King Saud Medical City, Riyadh, Kingdom of Saudi Arabia.
| | - Fatimah Z. Rebh
- From the Department of Dermatology (Alshaalan); from the Department of Family Medicine (Alahmadi); from the Department of Internal Medicine and Adult Infectious Diseases (Rebh); from the Department of of Intensive Care Unit (Alshabanah), Prince Mohammad Bin Abdul-Aziz Hospital, from the College of Medicine (Alkahtani, Althobaiti, Aldhahi, Algezlan, M. Alanazi, Alrumaih, Alturki, A. Alanazi), Al Imam Muhammad Ibn Saud Islamic University, and from the Department of Internal Medicine and Infectious Diseases (Al Ali), King Saud Medical City, Riyadh, Kingdom of Saudi Arabia.
| | - Sarah S. Algezlan
- From the Department of Dermatology (Alshaalan); from the Department of Family Medicine (Alahmadi); from the Department of Internal Medicine and Adult Infectious Diseases (Rebh); from the Department of of Intensive Care Unit (Alshabanah), Prince Mohammad Bin Abdul-Aziz Hospital, from the College of Medicine (Alkahtani, Althobaiti, Aldhahi, Algezlan, M. Alanazi, Alrumaih, Alturki, A. Alanazi), Al Imam Muhammad Ibn Saud Islamic University, and from the Department of Internal Medicine and Infectious Diseases (Al Ali), King Saud Medical City, Riyadh, Kingdom of Saudi Arabia.
| | - Salma M. Alanazi
- From the Department of Dermatology (Alshaalan); from the Department of Family Medicine (Alahmadi); from the Department of Internal Medicine and Adult Infectious Diseases (Rebh); from the Department of of Intensive Care Unit (Alshabanah), Prince Mohammad Bin Abdul-Aziz Hospital, from the College of Medicine (Alkahtani, Althobaiti, Aldhahi, Algezlan, M. Alanazi, Alrumaih, Alturki, A. Alanazi), Al Imam Muhammad Ibn Saud Islamic University, and from the Department of Internal Medicine and Infectious Diseases (Al Ali), King Saud Medical City, Riyadh, Kingdom of Saudi Arabia.
| | - Shawg S. Alrumaih
- From the Department of Dermatology (Alshaalan); from the Department of Family Medicine (Alahmadi); from the Department of Internal Medicine and Adult Infectious Diseases (Rebh); from the Department of of Intensive Care Unit (Alshabanah), Prince Mohammad Bin Abdul-Aziz Hospital, from the College of Medicine (Alkahtani, Althobaiti, Aldhahi, Algezlan, M. Alanazi, Alrumaih, Alturki, A. Alanazi), Al Imam Muhammad Ibn Saud Islamic University, and from the Department of Internal Medicine and Infectious Diseases (Al Ali), King Saud Medical City, Riyadh, Kingdom of Saudi Arabia.
| | - Basma A. Alturki
- From the Department of Dermatology (Alshaalan); from the Department of Family Medicine (Alahmadi); from the Department of Internal Medicine and Adult Infectious Diseases (Rebh); from the Department of of Intensive Care Unit (Alshabanah), Prince Mohammad Bin Abdul-Aziz Hospital, from the College of Medicine (Alkahtani, Althobaiti, Aldhahi, Algezlan, M. Alanazi, Alrumaih, Alturki, A. Alanazi), Al Imam Muhammad Ibn Saud Islamic University, and from the Department of Internal Medicine and Infectious Diseases (Al Ali), King Saud Medical City, Riyadh, Kingdom of Saudi Arabia.
| | - Abdullah S. Alahmadi
- From the Department of Dermatology (Alshaalan); from the Department of Family Medicine (Alahmadi); from the Department of Internal Medicine and Adult Infectious Diseases (Rebh); from the Department of of Intensive Care Unit (Alshabanah), Prince Mohammad Bin Abdul-Aziz Hospital, from the College of Medicine (Alkahtani, Althobaiti, Aldhahi, Algezlan, M. Alanazi, Alrumaih, Alturki, A. Alanazi), Al Imam Muhammad Ibn Saud Islamic University, and from the Department of Internal Medicine and Infectious Diseases (Al Ali), King Saud Medical City, Riyadh, Kingdom of Saudi Arabia.
| | - Raneem A. Alanazi
- From the Department of Dermatology (Alshaalan); from the Department of Family Medicine (Alahmadi); from the Department of Internal Medicine and Adult Infectious Diseases (Rebh); from the Department of of Intensive Care Unit (Alshabanah), Prince Mohammad Bin Abdul-Aziz Hospital, from the College of Medicine (Alkahtani, Althobaiti, Aldhahi, Algezlan, M. Alanazi, Alrumaih, Alturki, A. Alanazi), Al Imam Muhammad Ibn Saud Islamic University, and from the Department of Internal Medicine and Infectious Diseases (Al Ali), King Saud Medical City, Riyadh, Kingdom of Saudi Arabia.
| | - Alaa H. Al Ali
- From the Department of Dermatology (Alshaalan); from the Department of Family Medicine (Alahmadi); from the Department of Internal Medicine and Adult Infectious Diseases (Rebh); from the Department of of Intensive Care Unit (Alshabanah), Prince Mohammad Bin Abdul-Aziz Hospital, from the College of Medicine (Alkahtani, Althobaiti, Aldhahi, Algezlan, M. Alanazi, Alrumaih, Alturki, A. Alanazi), Al Imam Muhammad Ibn Saud Islamic University, and from the Department of Internal Medicine and Infectious Diseases (Al Ali), King Saud Medical City, Riyadh, Kingdom of Saudi Arabia.
| | - Othman M. Alshabanah
- From the Department of Dermatology (Alshaalan); from the Department of Family Medicine (Alahmadi); from the Department of Internal Medicine and Adult Infectious Diseases (Rebh); from the Department of of Intensive Care Unit (Alshabanah), Prince Mohammad Bin Abdul-Aziz Hospital, from the College of Medicine (Alkahtani, Althobaiti, Aldhahi, Algezlan, M. Alanazi, Alrumaih, Alturki, A. Alanazi), Al Imam Muhammad Ibn Saud Islamic University, and from the Department of Internal Medicine and Infectious Diseases (Al Ali), King Saud Medical City, Riyadh, Kingdom of Saudi Arabia.
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Treating COVID-19: Targeting the Host Response, Not the Virus. Life (Basel) 2023; 13:life13030712. [PMID: 36983871 PMCID: PMC10054780 DOI: 10.3390/life13030712] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/19/2023] [Accepted: 01/31/2023] [Indexed: 03/09/2023] Open
Abstract
In low- and middle-income countries (LMICs), inexpensive generic drugs like statins, ACE inhibitors, and ARBs, especially if used in combination, might be the only practical way to save the lives of patients with severe COVID-19. These drugs will already be available in all countries on the first pandemic day. Because they target the host response to infection instead of the virus, they could be used to save lives during any pandemic. Observational studies show that inpatient statin treatment reduces 28–30-day mortality but randomized controlled trials have failed to show this benefit. Combination treatment has been tested for antivirals and dexamethasone but, with the exception of one observational study in Belgium, not for inexpensive generic drugs. Future pandemic research must include testing combination generic drug treatments that could be used in LMICs.
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Essalmani R, Andréo U, Evagelidis A, Le Dévéhat M, Pereira Ramos OH, Fruchart Gaillard C, Susan-Resiga D, Cohen ÉA, Seidah NG. SKI-1/S1P Facilitates SARS-CoV-2 Spike Induced Cell-to-Cell Fusion via Activation of SREBP-2 and Metalloproteases, Whereas PCSK9 Enhances the Degradation of ACE2. Viruses 2023; 15:v15020360. [PMID: 36851576 PMCID: PMC9959508 DOI: 10.3390/v15020360] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 01/23/2023] [Accepted: 01/24/2023] [Indexed: 01/31/2023] Open
Abstract
Proprotein convertases activate various envelope glycoproteins and participate in cellular entry of many viruses. We recently showed that the convertase furin is critical for the infectivity of SARS-CoV-2, which requires cleavage of its spike protein (S) at two sites: S1/S2 and S2'. This study investigates the implication of the two cholesterol-regulating convertases SKI-1 and PCSK9 in SARS-CoV-2 entry. The assays used were cell-to-cell fusion in HeLa cells and pseudoparticle entry into Calu-3 cells. SKI-1 increased cell-to-cell fusion by enhancing the activation of SREBP-2, whereas PCSK9 reduced cell-to-cell fusion by promoting the cellular degradation of ACE2. SKI-1 activity led to enhanced S2' formation, which was attributed to increased metalloprotease activity as a response to enhanced cholesterol levels via activated SREBP-2. However, high metalloprotease activity resulted in the shedding of S2' into a new C-terminal fragment (S2″), leading to reduced cell-to-cell fusion. Indeed, S-mutants that increase S2″ formation abolished S2' and cell-to-cell fusion, as well as pseudoparticle entry, indicating that the formation of S2″ prevents SARS-CoV-2 cell-to-cell fusion and entry. We next demonstrated that PCSK9 enhanced the cellular degradation of ACE2, thereby reducing cell-to-cell fusion. However, different from the LDLR, a canonical target of PCSK9, the C-terminal CHRD domain of PCSK9 is dispensable for the PCSK9-induced degradation of ACE2. Molecular modeling suggested the binding of ACE2 to the Pro/Catalytic domains of mature PCSK9. Thus, both cholesterol-regulating convertases SKI-1 and PCSK9 can modulate SARS-CoV-2 entry via two independent mechanisms.
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Affiliation(s)
- Rachid Essalmani
- Laboratory of Biochemical Neuroendocrinology, Montreal Clinical Research Institute (IRCM), Université de Montréal, Montreal, QC H2W 1R7, Canada
| | - Ursula Andréo
- Laboratory of Biochemical Neuroendocrinology, Montreal Clinical Research Institute (IRCM), Université de Montréal, Montreal, QC H2W 1R7, Canada
| | - Alexandra Evagelidis
- Laboratory of Biochemical Neuroendocrinology, Montreal Clinical Research Institute (IRCM), Université de Montréal, Montreal, QC H2W 1R7, Canada
| | - Maïlys Le Dévéhat
- Laboratory of Biochemical Neuroendocrinology, Montreal Clinical Research Institute (IRCM), Université de Montréal, Montreal, QC H2W 1R7, Canada
| | - Oscar Henrique Pereira Ramos
- Département Médicaments et Technologies pour la Santé (DMTS), Université Paris-Saclay, CEA, INRAE, SI-MoS, 91191 Gif-sur-Yvette, France
| | - Carole Fruchart Gaillard
- Département Médicaments et Technologies pour la Santé (DMTS), Université Paris-Saclay, CEA, INRAE, SI-MoS, 91191 Gif-sur-Yvette, France
| | - Delia Susan-Resiga
- Laboratory of Biochemical Neuroendocrinology, Montreal Clinical Research Institute (IRCM), Université de Montréal, Montreal, QC H2W 1R7, Canada
| | - Éric A. Cohen
- Laboratory of Human Retrovirology, Montreal Clinical Research Institute (IRCM), Université de Montréal, 110 Pine Ave West, Montreal, QC H2W 1R7, Canada
- Department of Microbiology, Infectiology and Immunology, Université de Montréal, Montreal, QC H3C 3J7, Canada
| | - Nabil G. Seidah
- Laboratory of Biochemical Neuroendocrinology, Montreal Clinical Research Institute (IRCM), Université de Montréal, Montreal, QC H2W 1R7, Canada
- Correspondence: ; Tel.: +1-514-987-5609
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Blanchard F, James A, Assefi M, Kapandji N, Constantin JM. Personalized medicine targeting different ARDS phenotypes: The future of pharmacotherapy for ARDS? Expert Rev Respir Med 2023; 17:41-52. [PMID: 36724878 DOI: 10.1080/17476348.2023.2176302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Acute respiratory distress syndrome (ARDS) still represents a major challenge with high mortality rates and altered quality of life. Many well-designed studies have failed to improve ARDS outcomes. Heterogeneity of etiologies, mechanisms of lung damage, different lung mechanics, and different treatment approaches may explain these failures. At the era of personalized medicine, ARDS phenotyping is not only a field of research, but a bedside consideration when implementing therapy. ARDS has moved from being a simple syndrome to a more complex area of subgrouping. Intensivists must understand these phenotypes and therapies associated with a better outcome. AREAS COVERED After a brief sum-up of the different type of ARDS phenotypes, we will present some relevant therapy that may be impacted by phenotyping. A focus on pharmacotherapy will be realized before a section on non-pharmaceutical strategies. Eventually, we will highlight the limits of our knowledge of phenotyping and the pitfalls of personalized medicine. EXPERT OPINION Biological and morphological ARDS phenotypes are now well studied. The future of ARDS therapy will go through phenotyping that allows a personalized medication for each patient. However, a better assessment of these phenotypes is required, and clinical trials should be conducted with an ad-hoc phenotyping before randomization.
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Affiliation(s)
- Florian Blanchard
- Department of Anesthesiology and Critical Care, Pitié-Salpêtrière Hospital, Paris, France.,Antimicrobial Stewardship Team GH Paris Centre, Cochin Hospital, APHP, Paris, France
| | - Arthur James
- Department of Anesthesiology and Critical Care, Pitié-Salpêtrière Hospital, Paris, France
| | - Mona Assefi
- Department of Anesthesiology and Critical Care, Pitié-Salpêtrière Hospital, Paris, France
| | - Natacha Kapandji
- Department of Anesthesiology and Critical Care, Pitié-Salpêtrière Hospital, Paris, France
| | - Jean-Michel Constantin
- Department of Anesthesiology and Critical Care, Pitié-Salpêtrière Hospital, Paris, France
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Lao US, Law CF, Baptista-Hon DT, Tomlinson B. Systematic Review and Meta-Analysis of Statin Use and Mortality, Intensive Care Unit Admission and Requirement for Mechanical Ventilation in COVID-19 Patients. J Clin Med 2022; 11:5454. [PMID: 36143101 PMCID: PMC9501062 DOI: 10.3390/jcm11185454] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 09/04/2022] [Accepted: 09/14/2022] [Indexed: 11/26/2022] Open
Abstract
There is mounting evidence that statin use is beneficial for COVID-19 outcomes. We performed a systematic review and meta-analysis to evaluate the association between statin use and mortality, intensive care unit (ICU) admission and mechanical ventilation in COVID-19 patients, on studies which provided covariate adjusted effect estimates, or performed propensity score matching. We searched PubMed, Embase, Web of Science and Scopus for studies and extracted odds or hazard ratios for specified outcome measures. Data synthesis was performed using a random-effects inverse variance method. Risk of bias, heterogeneity and publication bias were analyzed using standard methods. Our results show that statin use was associated with significant reductions in mortality (OR = 0.72, 95% CI: 0.67-0.77; HR = 0.74, 95% CI: 0.69, 0.79), ICU admission (OR = 0.94, 95% CI: 0.89-0.99; HR = 0.76, 95% CI: 0.60-0.96) and mechanical ventilation (OR = 0.84, 95% CI: 0.78-0.92; HR = 0.67, 95% CI: 0.47-0.97). Nevertheless, current retrospective studies are based on the antecedent use of statins prior to infection and/or continued use of statin after hospital admission. The results may not apply to the de novo commencement of statin treatment after developing COVID-19 infection. Prospective studies are lacking and necessary.
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Affiliation(s)
- Ut-Sam Lao
- Center for Biomedicine and Innovations, Faculty of Medicine, Macau University Science and Technology, Taipa, Macau SAR 999078, China
| | - Chak-Fun Law
- Center for Biomedicine and Innovations, Faculty of Medicine, Macau University Science and Technology, Taipa, Macau SAR 999078, China
| | - Daniel T. Baptista-Hon
- Center for Biomedicine and Innovations, Faculty of Medicine, Macau University Science and Technology, Taipa, Macau SAR 999078, China
- Division of Systems Medicine, School of Medicine, University of Dundee, Dundee DD1 4HN, UK
| | - Brian Tomlinson
- Center for Biomedicine and Innovations, Faculty of Medicine, Macau University Science and Technology, Taipa, Macau SAR 999078, China
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Khalafi S, Evans J, Lumbreras T, Tiula K, Helmsdoerfer K, Dwivedi AK, Dihowm F. Effects of statins on outcomes in Hispanic patients with COVID-19. J Investig Med 2022; 70:1697-1703. [PMID: 35973730 DOI: 10.1136/jim-2022-002487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2022] [Indexed: 11/03/2022]
Abstract
The Hispanic population is regarded among those who are at greater risk of adverse prognoses due to higher rates of diabetes and obesity in the USA during the COVID-19 pandemic. Statin medications are speculated to help treat the infection by decreasing inflammation caused by COVID-19. In this retrospective, observational study, outcomes of statin use were assessed among Hispanic patients with COVID-19 by screening all patients hospitalized between March, 2020 and March, 2021 at a tertiary care hospital in El Paso, Texas, resulting in a total of 1039 patients. The patients were categorized into a group of either being on statins or not. The considered outcomes were mechanical ventilation, intensive care unit (ICU) hospitalization, oxygen supplementation at discharge, hospital length of stay, and mortality. Patients receiving statins were observed to be older with more comorbidities. In the propensity-scores adjusted analysis, no association was found between statin use and: mortality (adjusted risk ratio (aRR)=0.96, p=0.754), mechanical ventilation (aRR=0.91, p=0.503), ICU transfer (aRR=0.96, p=0.395), and O2 supplementation at discharge (aRR=1.03, p=0.729). These outcomes were also evaluated in patients who had myocardial infarction and stroke with COVID-19. Among these patients, association was found between statin use and: a reduced risk of mortality (aRR=0.61, p=0.005), mechanical ventilation (aRR=0.53, p=0.012) and ICU transfers (aRR=0.81, p=0.005). These results may not give us a reason to start patients on statins for the specific treatment of COVID-19, but it may be sufficient evidence to suggest statins should not be discontinued during hospitalization due to COVID-19.
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Affiliation(s)
- Seyed Khalafi
- Internal Medicine Department, Texas Tech University Health Sciences Center El Paso, El Paso, Texas, USA
| | - Justin Evans
- Internal Medicine Department, Texas Tech University Health Sciences Center El Paso, El Paso, Texas, USA
| | - Tyson Lumbreras
- Internal Medicine Department, Texas Tech University Health Sciences Center El Paso, El Paso, Texas, USA
| | - Kira Tiula
- Internal Medicine Department, Texas Tech University Health Sciences Center El Paso, El Paso, Texas, USA
| | - Kristen Helmsdoerfer
- Internal Medicine Department, Texas Tech University Health Sciences Center El Paso, El Paso, Texas, USA
| | - Alok Kumar Dwivedi
- Department of Molecular and Transnational Medicine, Division of Biostatistics & Epidemiology, Texas Tech University Health Sciences Center El Paso, El Paso, Texas, USA
| | - Fatma Dihowm
- Internal Medicine Department, Texas Tech University Health Sciences Center El Paso, El Paso, Texas, USA
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Umakanthan S, Senthil S, John S, Madhavan MK, Das J, Patil S, Rameshwaram R, Cintham A, Subramaniam V, Yogi M, Bansal A, Achutham S, Shekar C, Murthy V, Selvaraj R. The Effect of Statins on Clinical Outcome Among Hospitalized Patients With COVID-19: A Multi-Centric Cohort Study. Front Pharmacol 2022; 13:742273. [PMID: 35865966 PMCID: PMC9294274 DOI: 10.3389/fphar.2022.742273] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 06/14/2022] [Indexed: 01/08/2023] Open
Abstract
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.
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Affiliation(s)
- Srikanth Umakanthan
- Department of Para-clinical sciences, Faculty of Medical Sciences, The University of the West Indies, St Augustine, Trinidad, Trinidad and Tobago
- *Correspondence: Srikanth Umakanthan,
| | - Sanjum Senthil
- Project Lead and Research Programmee Committee Member, International Research Association Unit, India
- Director and Consultant in Emergency Medicine, Department of Medicine, RRN Multispeciality Hospital, India
| | - Stanley John
- Project Lead and Research Programmee Committee Member, International Research Association Unit, India
- Consultant Pulmonologist, Department of Medicine, Holy Cross Hospital, Nagercoil, India
| | - Mahesh K. Madhavan
- Consultant Pulmonologist, Department of Medicine, Holy Cross Hospital, Nagercoil, India
- National Regional Collaboration for Medical Research Foundation, India
| | - Jessica Das
- National Regional Collaboration for Medical Research Foundation, India
| | - Sonal Patil
- National Regional Collaboration for Medical Research Foundation, India
| | - Raghunath Rameshwaram
- National Regional Collaboration for Medical Research Foundation, India
- Department of Biostatistics, Epidemiology, and Informatics, Piramal Research Centre, Gujarat, India
| | - Ananya Cintham
- National Regional Collaboration for Medical Research Foundation, India
- Medical Residents, Swaminathan Multispecialty Hospital, Chennai, India
| | - Venkatesh Subramaniam
- National Regional Collaboration for Medical Research Foundation, India
- Medical Residents, Swaminathan Multispecialty Hospital, Chennai, India
| | - Madhusudan Yogi
- National Regional Collaboration for Medical Research Foundation, India
- Medical Residents, Swaminathan Multispecialty Hospital, Chennai, India
| | - Abhishek Bansal
- National Regional Collaboration for Medical Research Foundation, India
- Medical Residents, Swaminathan Multispecialty Hospital, Chennai, India
| | - Sumesh Achutham
- National Regional Collaboration for Medical Research Foundation, India
- Medical Residents, Swaminathan Multispecialty Hospital, Chennai, India
| | - Chandini Shekar
- National Regional Collaboration for Medical Research Foundation, India
- Medical Residents, Swaminathan Multispecialty Hospital, Chennai, India
| | - Vijay Murthy
- National Regional Collaboration for Medical Research Foundation, India
- Medical Residents, Swaminathan Multispecialty Hospital, Chennai, India
| | - Robbin Selvaraj
- National Regional Collaboration for Medical Research Foundation, India
- Medical Residents, Swaminathan Multispecialty Hospital, Chennai, India
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Zein AFMZ, Sulistiyana CS, Khasanah U, Wibowo A, Lim MA, Pranata R. Statin and mortality in COVID-19: a systematic review and meta-analysis of pooled adjusted effect estimates from propensity-matched cohorts. Postgrad Med J 2022; 98:503-508. [PMID: 34193549 PMCID: PMC8249178 DOI: 10.1136/postgradmedj-2021-140409] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 05/30/2021] [Indexed: 01/08/2023]
Abstract
PURPOSE Statin potentially improved outcome in patients with COVID-19. Patients who receive statin generally have a higher proportion of comorbidities than those who did not, which may introduce bias. In this meta-analysis, we aimed to investigate the association between statin use and mortality in patients with COVID-19 by pooling the adjusted effect estimates from propensity-score matching (PSM) matched studies or randomised controlled trials to reduce bias. METHODS A systematic literature search using the PubMed, Scopus and Embase databases were performed up until 1 March 2021. Studies that were designed the study to assess statin and mortality using PSM with the addition of Inverse Probability Treatment Weighting or multivariable regression analysis on top of PSM-matched cohorts were included. The effect estimate was reported in term of relative risk (RR). RESULTS 14 446 patients were included in the eight PSM-matched studies. Statin was associated with decreased mortality in patients with COVID-19 (RR 0.72 (0.55, 0.95), p=0.018; I2: 84.3%, p<0.001). Subgroup analysis in patients receiving statin in-hospital showed that it was associated with lower mortality (RR 0.71 (0.54, 0.94), p=0.030; I2: 64.1%, p<0.025). The association of statin and mortality was not significantly affected by age (coefficient: -0.04, p=0.382), male gender (RR 0.96 (0.95, 1.02), p=0.456), diabetes (RR 1.02 (0.99, 1.04), p=0.271) and hypertension (RR 1.01 (0.97, 1.04), p=0.732) in this pooled analysis. CONCLUSION In this meta-analysis of PSM-matched cohorts with adjusted analysis, statin was shown to decrease the risk of mortality in patients with COVID-19. PROSPERO REGISTRATION NUMBER CRD42021240137.
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Affiliation(s)
- Ahmad Fariz Malvi Zamzam Zein
- Department of Internal Medicine, Faculty of Medicine, Universitas Swadaya Gunung Jati, Cirebon, Jawa Barat, Indonesia
- Department of Internal Medicine, Waled General Hospital, Cirebon, Jawa Barat, Indonesia
| | - Catur Setiya Sulistiyana
- Department of Medical Education, Faculty of Medicine, Universitas Swadaya Gunung Jati, Cirebon, Jawa Barat, Indonesia
| | - Uswatun Khasanah
- Department of Biostatistics and Epidemiology, Faculty of Medicine, Universitas Swadaya Gunung Jati, Cirebon, Jawa Barat, Indonesia
| | - Arief Wibowo
- Department of Cardiology and Vascular Medicine, Universitas Padjadjaran, Bandung, Jawa Barat, Indonesia
| | | | - Raymond Pranata
- Medicine, Universitas Pelita Harapan Fakultas Kedokteran, Tangerang, Indonesia
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9
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Bouillon K, Baricault B, Semenzato L, Botton J, Bertrand M, Drouin J, Dray‐Spira R, Weill A, Zureik M. Association of Statins for Primary Prevention of Cardiovascular Diseases With Hospitalization for COVID-19: A Nationwide Matched Population-Based Cohort Study. J Am Heart Assoc 2022; 11:e023357. [PMID: 35699173 PMCID: PMC9238639 DOI: 10.1161/jaha.121.023357] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 05/03/2022] [Indexed: 12/22/2022]
Abstract
Background There is little evidence on the relationship between statin use and the risk of hospitalization attributable to COVID-19. Methods and Results The French National Healthcare Data System database was used to conduct a matched-cohort study. For each adult aged ≥40 years receiving statins for the primary prevention of cardiovascular diseases, one nonuser was randomly selected and matched for year of birth, sex, residence area, and comorbidities. The association between statin use and hospitalization for COVID-19 was examined using conditional Cox proportional hazards models, adjusted for baseline characteristics, comorbidities, and long-term medications. Its association with in-hospital death from COVID-19 was also explored. All participants were followed up from February 15, 2020, to June 15, 2020. The matching procedure generated 2 058 249 adults in the statin group and 2 058 249 in the control group, composed of 46.6% of men with a mean age of 68.7 years. Statin users had a 16% lower risk of hospitalization for COVID-19 than nonusers (adjusted hazard ratio [HR], 0.84; 95% CI, 0.81-0.88). All types of statins were significantly associated with a lower risk of hospitalization, with the adjusted HR ranging from 0.75 for fluvastatin to 0.89 for atorvastatin. Low- and moderate-intensity statins also showed a lower risk compared with nonusers (HR, 0.78 [95% CI, 0.71-0.86] and HR, 0.84 [95% CI, 0.80-0.89], respectively), whereas high-intensity statins did not (HR, 1.01; 95% CI, 0.86-1.18). We found similar results with in-hospital death from COVID-19. Conclusions Our findings support that the use of statins for primary prevention is associated with lower risks of hospitalization for COVID-19 and of in-hospital death from COVID-19.
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Affiliation(s)
- Kim Bouillon
- EPI‐PHARE Scientific Interest Group in Epidemiology of Health ProductsSaint‐DenisFrance
| | - Bérangère Baricault
- EPI‐PHARE Scientific Interest Group in Epidemiology of Health ProductsSaint‐DenisFrance
| | - Laura Semenzato
- EPI‐PHARE Scientific Interest Group in Epidemiology of Health ProductsSaint‐DenisFrance
| | - Jérémie Botton
- EPI‐PHARE Scientific Interest Group in Epidemiology of Health ProductsSaint‐DenisFrance
- Faculty of PharmacyParis‐Saclay UniversityChâtenay‐MalabryFrance
| | - Marion Bertrand
- EPI‐PHARE Scientific Interest Group in Epidemiology of Health ProductsSaint‐DenisFrance
| | - Jérôme Drouin
- EPI‐PHARE Scientific Interest Group in Epidemiology of Health ProductsSaint‐DenisFrance
| | - Rosemary Dray‐Spira
- EPI‐PHARE Scientific Interest Group in Epidemiology of Health ProductsSaint‐DenisFrance
| | - Alain Weill
- EPI‐PHARE Scientific Interest Group in Epidemiology of Health ProductsSaint‐DenisFrance
| | - Mahmoud Zureik
- EPI‐PHARE Scientific Interest Group in Epidemiology of Health ProductsSaint‐DenisFrance
- Paris‐Saclay UniversityUVSQCESP‐Inserm, Anti‐infective evasion and pharmacoepidemiologyMontigny le BretonneuxFrance
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10
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Rasmi Y, Heidari N, Kübra Kırboğa K, Hatamkhani S, Tekin B, Alipour S, Naderi R, Farnamian Y, Akca I. The importance of neopterin in COVID-19: The prognostic value and relation with the disease severity. Clin Biochem 2022; 104:1-12. [PMID: 35307400 PMCID: PMC8929545 DOI: 10.1016/j.clinbiochem.2022.03.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 03/10/2022] [Accepted: 03/12/2022] [Indexed: 02/07/2023]
Abstract
Coronavirus Disease 2019 [COVID-19], caused by severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2], has rapidly evolved into a global health emergency. Neopterin [NPT], produced by macrophages when stimulated with interferon [IFN-]gamma, is an essential cytokine in the antiviral immune response. NPT has been used as a marker for the early assessment of disease severity in different diseases. The leading cause of NPT production is the pro-inflammatory cytokine IFN-. Macrophage activation has also been revealed to be linked with disease severity in SARS-CoV-2 patients. We demonstrate the importance of NPT in the pathogenesis of SARS-CoV-2 and suggest that targeting NPT in SARS-CoV-2 infection may be critical in the early prediction of disease progression and provision of timely management of infected individuals.
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Affiliation(s)
- Yousef Rasmi
- Cellular and Molecular Research Center, Cellular and Molecular Medicine Institute, Urmia University of Medical Sciences, Urmia, Iran; Department of Biochemistry, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Nadia Heidari
- Department of Biochemistry, School of Medicine, Gorgan University of Medical Sciences, Urmia, Iran
| | | | - Shima Hatamkhani
- Experimental and Applied Pharmaceutical Sciences Research Center, Department of Clinical Pharmacy, School of Pharmacy, Urmia University of Medical Sciences, Urmia, Iran
| | - Burcu Tekin
- Izmir Institute of Technology, Biotechnology Department, Izmir, Turkey
| | - Shahryar Alipour
- Department of Biochemistry and Applied Cell, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Roya Naderi
- Department of Physiology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Yeghaneh Farnamian
- Student Research Center, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Ilknur Akca
- Mersin University, Faculty of Sciences, Department of Biotechnology, Mersin, Turkey
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11
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Wilk-Sledziewska K, Sielatycki PJ, Uscinska N, Bujno E, Rosolowski M, Kakareko K, Sledziewski R, Rydzewska-Rosolowska A, Hryszko T, Zbroch E. The Impact of Cardiovascular Risk Factors on the Course of COVID-19. J Clin Med 2022; 11:2250. [PMID: 35456343 PMCID: PMC9026388 DOI: 10.3390/jcm11082250] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 04/07/2022] [Accepted: 04/13/2022] [Indexed: 02/06/2023] Open
Abstract
AIM OF THE STUDY The aim of our review is to indicate and discuss the impact of cardiovascular risk factors, such as obesity, diabetes, lipid profile, hypertension and smoking on the course and mortality of COVID-19 infection. BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic is spreading around the world and becoming a major public health crisis. All coronaviruses are known to affect the cardiovascular system. There is a strong correlation between cardiovascular risk factors and severe clinical complications, including death in COVID-19 patients. All the above-mentioned risk factors are widespread and constitute a significant worldwide health problem. Some of them are modifiable and the awareness of their connection with the COVID-19 progress may have a crucial impact on the current and possible upcoming infection. DATA COLLECTION We searched for research papers describing the impact of selected cardiovascular risk factors on the course, severity, complications and mortality of COVID-19 infection form PubMed and Google Scholar databases. Using terms, for example: "COVID-19 cardiovascular disease mortality", "COVID-19 hypertension/diabetes mellitus/obesity/dyslipidemia", "cardiovascular risk factors COVID-19 mortality" and other related terms listed in each subtitle. The publications were selected according to the time of their publications between January 2020 and December 2021. From the PubMed database we obtain 1552 results. Further studies were sought by manually searching reference lists of the relevant articles. Relevant articles were selected based on their title, abstract or full text. Articles were excluded if they were clearly related to another subject matter or were not published in English. The types of articles are mainly randomized controlled trial and systematic review. An additional criterion used by researchers was co-morbidities and age of patients in study groups. From a review of the publications, 105 of them were selected for this work with all subheadings included. Findings and Results: The intention of this review was to summarize current knowledge about comorbidities and development of COVID-19 infection. We tried to focus on the course and mortality of the abovementioned virus disease in patients with concomitant CV risk factors. Unfortunately, we were unable to assess the quality of data in screened papers and studies we choose because of the heterogenicity of the groups. The conducted studies had different endpoints and included different groups of patients in terms of nationality, age, race and clinical status. We decide to divide the main subjects of the research into separately described subtitles such as obesity, lipid profile, hypertension, diabetes, smoking. We believe that the studies we included and gathered are very interesting and show modern and present-day clinical data and approaches to COVID-19 infection in specific divisions of patients.
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Affiliation(s)
- Katarzyna Wilk-Sledziewska
- Department of Internal Medicine and Hypertension, Medical University of Bialystok, 15-540 Bialystok, Poland; (K.W.-S.); (P.J.S.); (N.U.); (E.B.); (M.R.)
| | - Piotr Jan Sielatycki
- Department of Internal Medicine and Hypertension, Medical University of Bialystok, 15-540 Bialystok, Poland; (K.W.-S.); (P.J.S.); (N.U.); (E.B.); (M.R.)
| | - Natalia Uscinska
- Department of Internal Medicine and Hypertension, Medical University of Bialystok, 15-540 Bialystok, Poland; (K.W.-S.); (P.J.S.); (N.U.); (E.B.); (M.R.)
| | - Elżbieta Bujno
- Department of Internal Medicine and Hypertension, Medical University of Bialystok, 15-540 Bialystok, Poland; (K.W.-S.); (P.J.S.); (N.U.); (E.B.); (M.R.)
| | - Mariusz Rosolowski
- Department of Internal Medicine and Hypertension, Medical University of Bialystok, 15-540 Bialystok, Poland; (K.W.-S.); (P.J.S.); (N.U.); (E.B.); (M.R.)
| | - Katarzyna Kakareko
- 2nd Department of Nephrology and Hypertension with Dialysis Unit, Medical University of Bialystok, 15-276 Bialystok, Poland; (K.K.); (A.R.-R.); (T.H.)
| | - Rafal Sledziewski
- Department of Radiology, Medical University of Bialystok, 15-276 Bialystok, Poland;
| | - Alicja Rydzewska-Rosolowska
- 2nd Department of Nephrology and Hypertension with Dialysis Unit, Medical University of Bialystok, 15-276 Bialystok, Poland; (K.K.); (A.R.-R.); (T.H.)
| | - Tomasz Hryszko
- 2nd Department of Nephrology and Hypertension with Dialysis Unit, Medical University of Bialystok, 15-276 Bialystok, Poland; (K.K.); (A.R.-R.); (T.H.)
| | - Edyta Zbroch
- Department of Internal Medicine and Hypertension, Medical University of Bialystok, 15-540 Bialystok, Poland; (K.W.-S.); (P.J.S.); (N.U.); (E.B.); (M.R.)
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12
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Kow CS, Hasan SS. The Association Between the Use of Statins and Clinical Outcomes in Patients with COVID-19: A Systematic Review and Meta-analysis. Am J Cardiovasc Drugs 2022; 22:167-181. [PMID: 34341972 PMCID: PMC8328743 DOI: 10.1007/s40256-021-00490-w] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/27/2021] [Indexed: 02/06/2023]
Abstract
Purpose Previously, we have reported potential clinical benefits with the use of statins in patients with coronavirus disease 2019 (COVID-19) in a meta-analysis, where there was a significantly reduced hazard for a fatal or severe course of illness with the use of statins, but the meta-analysis was limited by the small number of studies included, with small heterogeneity among studies, due to the unavailability of more studies at the point of literature search. We aimed to perform an updated systematic review and meta-analysis to summarize the existing evidence on the effect of statins on the clinical outcomes of patients with COVID-19. Methods Electronic databases, including PubMed, Google Scholar, and Scopus, and preprint servers were searched (last updated June 3, 2021) to identify studies investigating the association between the use of statins in patients with COVID-19 and the development of severe disease and/or mortality. Random-effects model meta-analyses were performed to estimate the pooled odds ratio (OR) or hazard ratio (HR) with 95% confidence intervals (CIs). The outcomes of interest were (1) all-cause mortality and (2) a composite endpoint of severe illness of COVID-19. Results Upon systematic literature search, we identified 35 studies, of which 32 studies reported the outcome of all-cause mortality and 15 studies reported the composite endpoint of severe COVID-19 illness between statin users versus non-statin users with COVID-19. Our meta-analysis revealed that the use of statins was associated with a significantly lower risks of all-cause mortality (HR = 0.70, 95% CI 0.58–0.84, n = 21,127, and OR = 0.63, 95% CI 0.51–0.79, n = 115,097) and the composite endpoint of severe illness (OR = 0.80, 95% CI 0.73–0.88, n = 10,081) in patients with COVID-19, compared to non-use of statins, at the current sample size. Conclusion Statin use is associated with a better prognosis in patients with COVID-19. Our findings provide a rationale to investigate the use of statins among patients with COVID-19 in large scale clinical trials.
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Affiliation(s)
- Chia Siang Kow
- School of Postgraduate Studies, International Medical University, Kuala Lumpur, Malaysia.
- School of Pharmacy, Monash University Malaysia, Bandar Sunway, Petaling Jaya, Selangor, Malaysia.
| | - Syed Shahzad Hasan
- School of Applied Sciences, University of Huddersfield, Huddersfield, United Kingdom
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, Australia
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13
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Teixeira L, Temerozo JR, Pereira-Dutra FS, Ferreira AC, Mattos M, Gonçalves BS, Sacramento CQ, Palhinha L, Cunha-Fernandes T, Dias SSG, Soares VC, Barreto EA, Cesar-Silva D, Fintelman-Rodrigues N, Pão CRR, de Freitas CS, Reis PA, Hottz ED, Bozza FA, Bou-Habib DC, Saraiva EM, de Almeida CJG, Viola JPB, Souza TML, Bozza PT. Simvastatin Downregulates the SARS-CoV-2-Induced Inflammatory Response and Impairs Viral Infection Through Disruption of Lipid Rafts. Front Immunol 2022; 13:820131. [PMID: 35251001 PMCID: PMC8895251 DOI: 10.3389/fimmu.2022.820131] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 01/25/2022] [Indexed: 12/11/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) is currently a worldwide emergency caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). In observational clinical studies, statins have been identified as beneficial to hospitalized patients with COVID-19. However, experimental evidence of underlying statins protection against SARS-CoV-2 remains elusive. Here we reported for the first-time experimental evidence of the protective effects of simvastatin treatment both in vitro and in vivo. We found that treatment with simvastatin significantly reduced the viral replication and lung damage in vivo, delaying SARS-CoV-2-associated physiopathology and mortality in the K18-hACE2-transgenic mice model. Moreover, simvastatin also downregulated the inflammation triggered by SARS-CoV-2 infection in pulmonary tissue and in human neutrophils, peripheral blood monocytes, and lung epithelial Calu-3 cells in vitro, showing its potential to modulate the inflammatory response both at the site of infection and systemically. Additionally, we also observed that simvastatin affected the course of SARS-CoV-2 infection through displacing ACE2 on cell membrane lipid rafts. In conclusion, our results show that simvastatin exhibits early protective effects on SARS-CoV-2 infection by inhibiting virus cell entry and inflammatory cytokine production, through mechanisms at least in part dependent on lipid rafts disruption.
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Affiliation(s)
- Lívia Teixeira
- Laboratory of Immunopharmacology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
| | - Jairo R. Temerozo
- Laboratory on Thymus Research, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
- National Institute for Science and Technology on Neuroimmunomodulation, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
- National Institute for Science and Technology on Innovation on Neglected Diseases (INCT/IDN), Center for Technological Development in Health (CDTS), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
| | - Filipe S. Pereira-Dutra
- Laboratory of Immunopharmacology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
| | - André Costa Ferreira
- Laboratory of Immunopharmacology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
- National Institute for Science and Technology on Innovation on Neglected Diseases (INCT/IDN), Center for Technological Development in Health (CDTS), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
- Preclinical Research Laboratory, Universidade Iguaçu (UNIG), Nova Iguaçu, Brazil
| | - Mayara Mattos
- Laboratory of Immunopharmacology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
- National Institute for Science and Technology on Innovation on Neglected Diseases (INCT/IDN), Center for Technological Development in Health (CDTS), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
| | - Barbara Simonson Gonçalves
- Laboratory on Thymus Research, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
| | - Carolina Q. Sacramento
- Laboratory of Immunopharmacology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
- National Institute for Science and Technology on Innovation on Neglected Diseases (INCT/IDN), Center for Technological Development in Health (CDTS), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
| | - Lohanna Palhinha
- Laboratory of Immunopharmacology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
| | - Tamires Cunha-Fernandes
- Laboratory of Immunopharmacology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
| | - Suelen S. G. Dias
- Laboratory of Immunopharmacology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
| | - Vinicius Cardoso Soares
- Laboratory of Immunopharmacology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
- Program of Immunology and Inflammation, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Ester A. Barreto
- Laboratory of Immunopharmacology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
| | - Daniella Cesar-Silva
- Laboratory of Immunopharmacology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
| | - Natalia Fintelman-Rodrigues
- Laboratory of Immunopharmacology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
- National Institute for Science and Technology on Innovation on Neglected Diseases (INCT/IDN), Center for Technological Development in Health (CDTS), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
| | - Camila R. R. Pão
- Laboratory of Immunopharmacology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
| | - Caroline S. de Freitas
- Laboratory of Immunopharmacology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
- National Institute for Science and Technology on Innovation on Neglected Diseases (INCT/IDN), Center for Technological Development in Health (CDTS), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
| | - Patrícia A. Reis
- Laboratory of Immunopharmacology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
- Biochemistry Department, Roberto Alcântara Gomes Biology Institute, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Eugenio D. Hottz
- Laboratory of Immunothrombosis, Department of Biochemistry, Federal University of Juiz de Fora (UFJF), Minas Gerais, Brazil
| | - Fernando A. Bozza
- National Institute of Infectious Disease Evandro Chagas, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
- D’Or Institute for Research and Education, Rio de Janeiro, Brazil
| | - Dumith C. Bou-Habib
- Laboratory on Thymus Research, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
- National Institute for Science and Technology on Neuroimmunomodulation, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
| | - Elvira M. Saraiva
- Laboratory of Immunobiology of Leishmaniasis, Department of Immunology, Paulo de Goes Institute of Microbiology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Cecília J. G. de Almeida
- Laboratory of Immunopharmacology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
| | - João P. B. Viola
- Program of Immunology and Tumor Biology, Brazilian National Cancer Institute (INCA), Rio de Janeiro, Brazil
| | - Thiago Moreno L. Souza
- Laboratory of Immunopharmacology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
- National Institute for Science and Technology on Innovation on Neglected Diseases (INCT/IDN), Center for Technological Development in Health (CDTS), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
| | - Patricia T. Bozza
- Laboratory of Immunopharmacology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
- *Correspondence: Patrícia T. Bozza, ;
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14
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Vahedian-Azimi A, Mohammadi SM, Banach M, Beni FH, Guest PC, Al-Rasadi K, Jamialahmadi T, Sahebkar A. Improved COVID-19 Outcomes following Statin Therapy: An Updated Systematic Review and Meta-analysis. BIOMED RESEARCH INTERNATIONAL 2021; 2021:1901772. [PMID: 34568488 PMCID: PMC8463212 DOI: 10.1155/2021/1901772] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 09/03/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Although vaccine rollout for COVID-19 has been effective in some countries, there is still an urgent need to reduce disease transmission and severity. We recently carried out a meta-analysis and found that pre- and in-hospital use of statins may improve COVID-19 mortality outcomes. Here, we provide an updated meta-analysis in an attempt to validate these results and increase the statistical power of these potentially important findings. METHODS The meta-analysis investigated the effect of observational and randomized clinical studies on intensive care unit (ICU) admission, tracheal intubation, and death outcomes in COVID-19 cases involving statin treatment, by searching the scientific literature up to April 23, 2021. Statistical analysis and random effect modeling were performed to assess the combined effects of the updated and previous findings on the outcome measures. Findings. The updated literature search led to the identification of 23 additional studies on statin use in COVID-19 patients. Analysis of the combined studies (n = 47; 3,238,508 subjects) showed no significant effect of statin treatment on ICU admission and all-cause mortality but a significant reduction in tracheal intubation (OR = 0.73, 95% CI: 0.54-0.99, p = 0.04, n = 10 studies). The further analysis showed that death outcomes were significantly reduced in the patients who received statins during hospitalization (OR = 0.54, 95% CI: 0.50-0.58, p < 0.001, n = 7 studies), with no such effect of statin therapy before hospital admission (OR = 1.06, 95% CI = 0.82-1.37, p = 0.670, n = 29 studies). CONCLUSION Taken together, this updated meta-analysis extends and confirms the findings of our previous study, suggesting that in-hospital statin use leads to significant reduction of all-cause mortality in COVID-19 cases. Considering these results, statin therapy during hospitalization, while indicated, should be recommended.
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Affiliation(s)
- Amir Vahedian-Azimi
- Student Research Committee, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Seyede Momeneh Mohammadi
- Department of Anatomical Sciences, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Maciej Banach
- Department of Hypertension, Medical University of Lodz (MUL), Poland
- Cardiovascular Research Centre, University of Zielona-Gora, Zielona-Gora, Poland
| | - Farshad Heidari Beni
- Nursing Care Research Center (NCRC), School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Paul C. Guest
- Laboratory of Neuroproteomics, Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas (UNICAMP), Campinas, Brazil
| | | | - Tannaz Jamialahmadi
- Department of Food Science and Technology, Quchan Branch, Islamic Azad University, Quchan, Iran
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amirhossein Sahebkar
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
- School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
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15
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Diaz-Arocutipa C, Melgar-Talavera B, Alvarado-Yarasca Á, Saravia-Bartra MM, Cazorla P, Belzusarri I, Hernandez AV. Statins reduce mortality in patients with COVID-19: an updated meta-analysis of 147 824 patients. Int J Infect Dis 2021; 110:374-381. [PMID: 34375760 PMCID: PMC8349445 DOI: 10.1016/j.ijid.2021.08.004] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 07/22/2021] [Accepted: 08/04/2021] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES There is conflicting evidence about the efficacy of statin use in regard to clinical outcomes in patients with coronavirus disease 2019 (COVID-19). A systematic review and meta-analysis was performed to examine the effect of statin use on mortality in COVID-19 patients. METHODS The electronic databases were searched, from inception to March 3, 2021. Unadjusted and adjusted effect estimates with their 95% confidence intervals (95% CI) were pooled using random-effects models. RESULTS Twenty-five cohort studies involving 147 824 patients were included. The mean age of the patients ranged from 44.9 to 70.9 years; 57% of patients were male and 43% were female. The use of statins was not associated with mortality when applying the unadjusted risk ratio (uRR 1.16, 95% CI 0.86-1.57; 19 studies). In contrast, meta-analyses of the adjusted odds ratio (aOR 0.67, 95% CI 0.52-0.86; 11 studies) and adjusted hazard ratio (aHR 0.73, 95% CI 0.58-0.91; 10 studies) showed that statins were independently associated with a significant reduction in mortality. Subgroup analyses showed that only chronic use of statins significantly reduced mortality according to the adjusted models. CONCLUSIONS The use of statins was found to be associated with a lower risk of mortality in COVID-19 patients based on adjusted effects of cohort studies. However, randomized controlled trials are still needed to confirm these findings.
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Affiliation(s)
- Carlos Diaz-Arocutipa
- Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru; Programa de Atencion Domiciliaria - EsSalud, Lima, Peru; Asociación para el Desarrollo de la Investigación Estudiantil en Ciencias de la Salud (ADIECS), Lima, Peru.
| | | | - Ángel Alvarado-Yarasca
- International Research Network in Pharmacology and Precision Medicine, Human Medicine, Universidad San Ignacio de Loyola, Lima, Peru
| | - María M Saravia-Bartra
- International Research Network in Pharmacology and Precision Medicine, Human Medicine, Universidad San Ignacio de Loyola, Lima, Peru
| | - Pedro Cazorla
- International Research Network in Pharmacology and Precision Medicine, Human Medicine, Universidad San Ignacio de Loyola, Lima, Peru; Servicio de Pediatria, Hospital III Suarez-Angamos - EsSalud, Lima, Peru
| | - Iván Belzusarri
- International Research Network in Pharmacology and Precision Medicine, Human Medicine, Universidad San Ignacio de Loyola, Lima, Peru
| | - Adrian V Hernandez
- Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru; Health Outcomes, Policy, and Evidence Synthesis (HOPES) Group, University of Connecticut School of Pharmacy, Storrs, Connecticut, USA
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16
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Alves M, Fernandes MA, Bahat G, Benetos A, Clemente H, Grodzicki T, Martínez-Sellés M, Mattace-Raso F, Rajkumar C, Ungar A, Werner N, Strandberg TE. Protecting older patients with cardiovascular diseases from COVID-19 complications using current medications. Eur Geriatr Med 2021; 12:725-739. [PMID: 34031865 PMCID: PMC8143992 DOI: 10.1007/s41999-021-00504-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 04/15/2021] [Indexed: 12/17/2022]
Abstract
PURPOSE In the pathogenesis of severe COVID-19 complications, derangements of renin-angiotensin-aldosterone system (RAAS), vascular endothelial dysfunction leading to inflammation and coagulopathy, and arrhythmias play an important role. Therefore, it is worth considering the use of currently available drugs to protect COVID-19 patients with cardiovascular diseases. METHODS We review the current experience of conventional cardiovascular drugs [angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers, anticoagulants, acetosalicylic acid, antiarrhythmic drugs, statins] as well as some other drug classes (antidiabetic drugs, vitamin D and NSAIDs) frequently used by older patients with cardiovascular diseases. Data were sought from clinical databases for COVID-19 and appropriate key words. Conclusions and recommendations are based on a consensus among all authors. RESULTS Several cardiovascular drugs have a potential to protect patients with COVID-19, although evidence is largely based on retrospective, observational studies. Despite propensity score adjustments used in many analyses observational studies are not equivalent to randomised controlled trials (RCTs). Ongoing RCTs include treatment with antithrombotics, pulmonary vasodilators, RAAS-related drugs, and colchicine. RCTs in the acute phase of COVID-19 may not, however, recognise the benefits of long term anti-atherogenic therapies, such as statins. CONCLUSIONS Most current cardiovascular drugs can be safely continued during COVID-19. Some drug classes may even be protective. Age-specific data are scarce, though, and conditions which are common in older patients (frailty, comorbidities, polypharmacy) must be individually considered for each drug group.
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Affiliation(s)
- Mariana Alves
- Faculty of Medicine, Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Serviço de Medicina III, Hospital Pulido Valente, CHULNUniversity of LisbonUniversidade de Lisboa, Lisbon, Portugal
| | - Marília Andreia Fernandes
- Department of Internal Medicine, Hospital Curry Cabral, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal
| | - Gülistan Bahat
- Istanbul Medical School, Department of Internal Medicine, Division of Geriatrics, Istanbul University, Capa, 34093, Istanbul, Turkey
| | - Athanase Benetos
- Department of Geriatrics and FHU CARTAGE-PROFILES, CHRU de Nancy and INSERM 1116, Université de Lorraine, Vandoeuvre-lès-Nancy, France
| | - Hugo Clemente
- Department of Geriatrics, Centre Hospitalier de Wallonie Picarde, Tournai, Belgium
| | - Tomasz Grodzicki
- Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Cracow, Poland
| | - Manuel Martínez-Sellés
- Department of Cardiology, Hospital General Universitario Gregorio Marañón, CIBER-CV. Universidad Europea, Universidad Complutense, Madrid, Spain
| | - Francesco Mattace-Raso
- Division of Geriatrics, Department of Internal Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | | | - Andrea Ungar
- Department of Geriatrics and Intensive Care Unit, University of Florence and Azienda Ospedaliero Universitaria Careggi, Firenze, Italy
| | - Nikos Werner
- Heart Center Trier, Krankenhaus der Barmherzigen Brüder, Trier, Germany
| | - Timo E Strandberg
- Helsinki University and Helsinki University Hospital, Haartmaninkatu 4, PO Box 340, N00029, Helsinki, Finland.
- University of Oulu, Center for Life Course Health Research, Oulu, Finland.
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17
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Zhu H, Zhang H, Zhou N, Ding J, Jiang J, Liu T, Liu Z, Wang F, Zhang Q, Zhang Z, Yan S, Li L, Benabdallah N, Jin H, Liu Z, Cai L, Thorek DLJ, Yang X, Yang Z. Molecular PET/CT Profiling of ACE2 Expression In Vivo: Implications for Infection and Outcome from SARS-CoV-2. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2021; 8:e2100965. [PMID: 34174177 PMCID: PMC8373167 DOI: 10.1002/advs.202100965] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 05/14/2021] [Indexed: 06/07/2023]
Abstract
Rapid progress has been made to identify and study the causative agent leading to coronavirus disease 2019 (COVID-19) but many questions including who is most susceptible and what determines severity remain unanswered. Angiotensin-converting enzyme 2 (ACE2) is a key factor in the infection process of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). In this study, molecularly specific positron emission tomography imaging agents for targeting ACE2 are first developed, and these novel agents are evaluated in vitro, in preclinical model systems, and in a first-in-human translational ACE2 imaging of healthy volunteers and a SARS-CoV-2 recovered patient (NCT04422457). ACE2 expression levels in different organs in live subjects are quantitatively delineated and observable differences are measured in the patient recovered from COVID-19. Surprising sites of uptake in the breast, reproductive system and very low uptake in pulmonary tissues are reported. This novel method can add a unique tool to facilitate SARS-CoV-2 related research and improve understanding of this enigmatic disease. Molecular imaging provides quantitative annotation of ACE2, the SARS-CoV-2 entry receptor, to noninvasively monitor organs impacted by the COVID-19.
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Affiliation(s)
- Hua Zhu
- Key Laboratory of Carcinogenesis and Translational Research, NMPA Key Laboratory for Research Evaluation of Radiopharmaceuticals (Ministry of Education/Beijing)Department of Nuclear MedicinePeking University Cancer Hospital and InstituteBeijing100142China
| | - Hanwen Zhang
- Department of RadiologyWashington University in St. Louis School of MedicineSt. LouisMO63110USA
- Program in Quantitative Molecular TherapeuticsWashington University in St. Louis School of MedicineSt. LouisMO63110USA
| | - Nina Zhou
- Key Laboratory of Carcinogenesis and Translational Research, NMPA Key Laboratory for Research Evaluation of Radiopharmaceuticals (Ministry of Education/Beijing)Department of Nuclear MedicinePeking University Cancer Hospital and InstituteBeijing100142China
| | - Jin Ding
- Key Laboratory of Carcinogenesis and Translational Research, NMPA Key Laboratory for Research Evaluation of Radiopharmaceuticals (Ministry of Education/Beijing)Department of Nuclear MedicinePeking University Cancer Hospital and InstituteBeijing100142China
| | - Jinquan Jiang
- Key Laboratory of Carcinogenesis and Translational Research, NMPA Key Laboratory for Research Evaluation of Radiopharmaceuticals (Ministry of Education/Beijing)Department of Nuclear MedicinePeking University Cancer Hospital and InstituteBeijing100142China
| | - Teli Liu
- Key Laboratory of Carcinogenesis and Translational Research, NMPA Key Laboratory for Research Evaluation of Radiopharmaceuticals (Ministry of Education/Beijing)Department of Nuclear MedicinePeking University Cancer Hospital and InstituteBeijing100142China
| | - Ziyu Liu
- Key Laboratory of Carcinogenesis and Translational Research, NMPA Key Laboratory for Research Evaluation of Radiopharmaceuticals (Ministry of Education/Beijing)Department of Nuclear MedicinePeking University Cancer Hospital and InstituteBeijing100142China
- Department of Nuclear MedicineThe Affiliated Hospital of Inner Mongolia Medical UniversityHohhot010050China
| | - Feng Wang
- Key Laboratory of Carcinogenesis and Translational Research, NMPA Key Laboratory for Research Evaluation of Radiopharmaceuticals (Ministry of Education/Beijing)Department of Nuclear MedicinePeking University Cancer Hospital and InstituteBeijing100142China
| | - Qian Zhang
- Key Laboratory of Carcinogenesis and Translational Research, NMPA Key Laboratory for Research Evaluation of Radiopharmaceuticals (Ministry of Education/Beijing)Department of Nuclear MedicinePeking University Cancer Hospital and InstituteBeijing100142China
| | - Zhuochen Zhang
- Department of Nuclear MedicinePeking University First HospitalBeijing100034China
| | - Shi Yan
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing)Department of Thoracic Surgery IIPeking University Cancer Hospital and InstituteBeijing100142China
| | - Lei Li
- Beijing Tongren Eye CenterBeijing Tongren HospitalCapital Medical UniversityBeijing Ophthalmology and Visual Scientific Key LabBeijing100730China
| | - Nadia Benabdallah
- Department of RadiologyWashington University in St. Louis School of MedicineSt. LouisMO63110USA
- Program in Quantitative Molecular TherapeuticsWashington University in St. Louis School of MedicineSt. LouisMO63110USA
| | - Hongjun Jin
- Guangdong Provincial Key Laboratory of Biomedical ImagingFifth Affiliated HospitalSun Yat‐sen UniversityZhuhaiGuangdong Province519000China
| | - Zhaofei Liu
- Medical Isotopes Research Center and Department of Radiation MedicineSchool of Basic Medical SciencesPeking University Health Science CenterBeijing100191China
| | - Lisheng Cai
- Molecular Imaging BranchNational Institute of Mental HealthNational Institutes of HealthBethesdaMD20892USA
| | - Daniel L. J. Thorek
- Department of RadiologyWashington University in St. Louis School of MedicineSt. LouisMO63110USA
- Program in Quantitative Molecular TherapeuticsWashington University in St. Louis School of MedicineSt. LouisMO63110USA
- Department of Biomedical EngineeringWashington University in St. LouisSt. LouisMO63110USA
| | - Xing Yang
- Department of Nuclear MedicinePeking University First HospitalBeijing100034China
| | - Zhi Yang
- Key Laboratory of Carcinogenesis and Translational Research, NMPA Key Laboratory for Research Evaluation of Radiopharmaceuticals (Ministry of Education/Beijing)Department of Nuclear MedicinePeking University Cancer Hospital and InstituteBeijing100142China
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18
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Yetmar ZA, Chesdachai S, Kashour T, Riaz M, Gerberi DJ, Badley AD, Berbari EF, Tleyjeh IM. Prior Statin Use and Risk of Mortality and Severe Disease From Coronavirus Disease 2019: A Systematic Review and Meta-analysis. Open Forum Infect Dis 2021; 8:ofab284. [PMID: 34258316 PMCID: PMC8244756 DOI: 10.1093/ofid/ofab284] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 05/26/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Statins up-regulate angiotensin-converting enzyme 2, the receptor of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), while also exhibiting pleiotropic antiviral, antithrombotic, and anti-inflammatory properties. Uncertainties exist about their effect on the course of SARS-CoV-2 infection. We sought to systematically review the literature and perform a meta-analysis to examine the association between prior statin use and outcomes of patients with coronavirus disease 2019 (COVID-19). METHODS We searched Ovid Medline, Web of Science, Scopus, and the preprint server medRxiv from inception to December 2020. We assessed the quality of eligible studies with the Newcastle-Ottawa quality scale. We pooled adjusted relative risk (aRRs) of the association between prior statin use and outcomes of patients with COVID-19 using the DerSimonian-Laird random-effects model and assessed heterogeneity using the I 2 index. RESULTS Overall, 19 (16 cohorts and 3 case-control) studies were eligible, with a total of 395 513 patients. Sixteen of 19 studies had low or moderate risk of bias. Among 109 080 patients enrolled in 13 separate studies, prior statin use was associated with a lower risk of mortality (pooled aRR, 0.65 [95% confidence interval {CI}, .56-.77], I 2 = 84.1%) and a reduced risk of severe COVID-19 was also observed in 48 110 patients enrolled in 9 studies (pooled aRR, 0.73 [95% CI, .57-.94], I 2 = 82.8%), with no evidence of publication bias. CONCLUSIONS Cumulative evidence suggests that prior statin use is associated with lower risks of mortality or severe disease in patients with COVID-19. These data support the continued use of statins medications in patients with an indication for lipid-lowering therapy during the COVID-19 pandemic.
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Affiliation(s)
- Zachary A Yetmar
- Division of Infectious Diseases, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Tarek Kashour
- Department of Cardiac Sciences, King Fahad Cardiac Center, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Muhammad Riaz
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | | | - Andrew D Badley
- Division of Infectious Diseases, Mayo Clinic, Rochester, Minnesota, USA
- Department of Molecular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Elie F Berbari
- Division of Infectious Diseases, Mayo Clinic, Rochester, Minnesota, USA
| | - Imad M Tleyjeh
- Division of Infectious Diseases, Mayo Clinic, Rochester, Minnesota, USA
- Division of Epidemiology, Mayo Clinic, Rochester, Minnesota, USA
- Infectious Diseases Section, Department of Medical Specialties, King Fahad Medical City, Riyadh, Saudi Arabia
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
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19
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Kollias A, Kyriakoulis KG, Kyriakoulis IG, Nitsotolis T, Poulakou G, Stergiou GS, Syrigos K. Statin use and mortality in COVID-19 patients: Updated systematic review and meta-analysis. Atherosclerosis 2021; 330:114-121. [PMID: 34243953 PMCID: PMC8233054 DOI: 10.1016/j.atherosclerosis.2021.06.911] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 06/02/2021] [Accepted: 06/24/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIMS Statin therapy is administered to patients with high cardiovascular risk. These patients are also at risk for severe course of coronavirus disease 2019 (COVID-19). Statins exhibit not only cardioprotective but also immunomodulatory and anti-inflammatory effects. This study performed a systematic review of published evidence regarding statin treatment and COVID-19 related mortality. METHODS A systematic PubMed/Embase search was performed from February 10, 2020 until March 05, 2021 for studies in COVID-19 patients that reported adjusted hazard or odds ratio for death in statin users versus non-users. RESULTS 22 studies fulfilled the inclusion criteria and were included in the systematic review. Meta-analysis of 10 studies (n = 41,807, weighted age 56 ± 8 years, men 51%, hypertension 34%, diabetes 21%, statin users 14%) that reported adjusted hazard ratios for mortality in statin users versus non-users showed pooled estimate at 0.65 (95% confidence intervals [CI] 0.53, 0.81). Meta-analysis of 6 studies that reported continuation of statin therapy during hospitalization (58-100% of patients) revealed a pooled hazard ratio of 0.54 (95% CI 0.47, 0.62). Meta-analysis of 12 studies (n = 72,881, weighted age 65 ± 2 years, men 54%, hypertension 66%, diabetes 43%, statin users 30%) that reported adjusted odds ratios for mortality showed pooled estimate at 0.65 (95% CI 0.55, 0.78). Multivariable meta-regression analysis did not reveal any significant association of hazard or odds ratios with anthropometric characteristics or comorbidities. CONCLUSIONS This meta-analysis of retrospective observational studies showed that statin therapy was associated with an about 35% decrease in the adjusted risk of mortality in hospitalized COVID-19 patients.
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Affiliation(s)
- Anastasios Kollias
- Third Department of Medicine, National and Kapodistrian University of Athens, School of Medicine, Sotiria Hospital, Athens, Greece.
| | - Konstantinos G Kyriakoulis
- Third Department of Medicine, National and Kapodistrian University of Athens, School of Medicine, Sotiria Hospital, Athens, Greece
| | - Ioannis G Kyriakoulis
- Third Department of Medicine, National and Kapodistrian University of Athens, School of Medicine, Sotiria Hospital, Athens, Greece
| | - Thomas Nitsotolis
- Third Department of Medicine, National and Kapodistrian University of Athens, School of Medicine, Sotiria Hospital, Athens, Greece
| | - Garyphallia Poulakou
- Third Department of Medicine, National and Kapodistrian University of Athens, School of Medicine, Sotiria Hospital, Athens, Greece
| | - George S Stergiou
- Third Department of Medicine, National and Kapodistrian University of Athens, School of Medicine, Sotiria Hospital, Athens, Greece
| | - Konstantinos Syrigos
- Third Department of Medicine, National and Kapodistrian University of Athens, School of Medicine, Sotiria Hospital, Athens, Greece
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20
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Orlowski S, Mourad JJ, Gallo A, Bruckert E. Coronaviruses, cholesterol and statins: Involvement and application for Covid-19. Biochimie 2021; 189:51-64. [PMID: 34153377 PMCID: PMC8213520 DOI: 10.1016/j.biochi.2021.06.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 06/01/2021] [Accepted: 06/14/2021] [Indexed: 12/17/2022]
Abstract
The infectious power of coronaviruses is dependent on cholesterol present in the membranes of their target cells. Indeed, the virus enters the infected cell either by fusion or by endocytosis, in both cases involving cholesterol-enriched membrane microdomains. These membrane domains can be disorganized in-vitro by various cholesterol-altering agents, including statins that inhibit cell cholesterol biosynthesis. As a consequence, numerous cell physiology processes, such as signaling cascades, can be compromised. Also, some examples of anti-bacterial and anti-viral effects of statins have been observed for infectious agents known to be cholesterol dependent. In-vivo, besides their widely-reported hypocholesterolemic effect, statins display various pleiotropic effects mediated, at least partially, by perturbation of membrane microdomains as a consequence of the alteration of endogenous cholesterol synthesis. It should thus be worth considering a high, but clinically well-tolerated, dose of statin to treat Covid-19 patients, in the early phase of infection, to inhibit virus entry into the target cells, in order to control the viral charge and hence avoid severe clinical complications. Based on its efficacy and favorable biodisposition, an option would be considering Atorvastatin, but randomized controlled clinical trials are required to test this hypothesis. This new therapeutic proposal takes benefit from being a drug repurposing, applied to a widely-used drug presenting a high efficiency-to-toxicity ratio. Additionally, this therapeutic strategy avoids any risk of drug resistance by viral mutation since it is host-targeted. Noteworthy, the same pharmacological approach could also be proposed to address different animal coronavirus endemic infections that are responsible for heavy economic losses.
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Affiliation(s)
- Stéphane Orlowski
- Institute for Integrative Biology of the Cell (I2BC), CNRS UMR 9198, and CEA / DRF / Institut des Sciences du Vivant Frédéric-Joliot / SB2SM, and Université Paris-Saclay, 91191, Gif-sur-Yvette, Cedex, France.
| | - Jean-Jacques Mourad
- Department of Internal Medicine and ESH Excellence Centre, Groupe Hospitalier Paris Saint-Joseph, Paris, France.
| | - Antonio Gallo
- Department of Endocrinology and Prevention of Cardiovascular Diseases, Institute of Cardiometabolism and Nutrition (ICAN), La Pitié-Salpêtrière Hospital, AP-HP, Paris, France.
| | - Eric Bruckert
- Department of Endocrinology and Prevention of Cardiovascular Diseases, Institute of Cardiometabolism and Nutrition (ICAN), La Pitié-Salpêtrière Hospital, AP-HP, Paris, France.
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21
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Byttebier G, Belmans L, Alexander M, Saxberg BEH, De Spiegeleer B, De Spiegeleer A, Devreker N, Van Praet JT, Vanhove K, Reybrouck R, Wynendaele E, Fedson DS. Hospital mortality in COVID-19 patients in Belgium treated with statins, ACE inhibitors and/or ARBs. Hum Vaccin Immunother 2021; 17:2841-2850. [PMID: 34047686 PMCID: PMC8171011 DOI: 10.1080/21645515.2021.1920271] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
The COVID-19 pandemic has disrupted life throughout the world. Newly developed vaccines promise relief to people who live in high-income countries, although vaccines and expensive new treatments are unlikely to arrive in time to help people who live in low-and middle-income countries. The pathogenesis of COVID-19 is characterized by endothelial dysfunction. Several widely available drugs like statins, ACE inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) have immunometabolic activities that (among other things) maintain or restore endothelial cell function. For this reason, we undertook an observational study in four Belgian hospitals to determine whether in-hospital treatment with these drugs could improve survival in 959 COVID-19 patients. We found that treatment with statins and ACEIs/ARBs reduced 28-day mortality in hospitalized COVID-19 patients. Moreover, combination treatment with these drugs resulted in a 3-fold reduction in the odds of hospital mortality (OR = 0.33; 95% CI 0.17–0.69). These findings were in general agreement with other published studies. Additional observational studies and clinical trials are needed to convincingly show that in-hospital treatment with statins, ACEIs/ARBs, and especially their combination saves lives.
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Affiliation(s)
| | - Luc Belmans
- Department of R&D, Medaman BV, Geel, Belgium
| | | | | | | | | | - Nick Devreker
- Department of Medical Data Management, AZ Delta, Roeselare, Belgium
| | - Jens T Van Praet
- Department of Nephrology and Infectious Diseases, AZ Sint-Jan Brugge-Oostende AV, Bruges, Belgium
| | - Karolien Vanhove
- Department of Pneumology and Respiratory Oncology, AZ Vesalius, Tongeren, Belgium
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22
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Cesaro A, Riccio C, Calabrò P. Lipid-lowering therapy in high cardiovascular risk patients during COVID-19 pandemic: keep focused on the target. Monaldi Arch Chest Dis 2021; 91. [PMID: 33942600 DOI: 10.4081/monaldi.2021.1721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Accepted: 01/08/2021] [Indexed: 11/23/2022] Open
Abstract
To the Editor COVID-19 (COrona VIrus Disease) patients with cardiovascular (CV) disease, multiple CV risk factors or comorbidities (i.e., arterial hypertension and diabetes) were shown to be more prone to a worse prognosis. SARS-CoV-2 is a still unknown enemy and the role of concomitant cardiovascular therapies has been controversial in the early stages, particularly with regard to Angiotensin-Converting Enzyme inhibitors...
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Affiliation(s)
- Arturo Cesaro
- Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Naples; Division of Clinical Cardiology, A.O.R.N. "Sant'Anna e San Sebastiano", Caserta.
| | - Carmine Riccio
- Division of Clinical Cardiology, A.O.R.N. "Sant'Anna e San Sebastiano", Caserta.
| | - Paolo Calabrò
- Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Naples; Division of Clinical Cardiology, A.O.R.N. "Sant'Anna e San Sebastiano", Caserta.
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23
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Ikari Y, Matsue Y, Torii S, Hasegawa M, Aihara K, Kuroda S, Sano T, Kitai T, Yonetsu T, Kohsaka S, Kishi T, Komuro I, Hirata KI, Node K, Matsumoto S. Association Between Statin Use Prior to Admission and Lower Coronavirus Disease 2019 (COVID-19) Severity in Patients With Cardiovascular Disease or Risk Factors. Circ J 2021; 85:939-943. [PMID: 33952833 DOI: 10.1253/circj.cj-21-0087] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Cardiovascular diseases and/or risk factors (CVDRF) have been reported as risk factors for severe coronavirus disease 2019 (COVID-19).Methods and Results:In total, we selected 693 patients with CVDRF from the CLAVIS-COVID database of 1,518 cases in Japan. The mean age was 68 years (35% females). Statin use was reported by 31% patients at admission. Statin users exhibited lower incidence of extracorporeal membrane oxygenation (ECMO) insertion (1.4% vs. 4.6%, odds ratio [OR]: 0.295, P=0.037) and septic shock (1.4% vs. 6.5%, OR: 0.205, P=0.004) despite having more comorbidities such as diabetes mellitus. CONCLUSIONS This study suggests the potential benefits of statins use against COVID-19.
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Affiliation(s)
- Yuji Ikari
- Department of Cardiology, Tokai University School of Medicine
| | - Yuya Matsue
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine.,Cardiovascular Respiratory Sleep Medicine, Juntendo University Graduate School of Medicine
| | - Sho Torii
- Department of Cardiology, Tokai University School of Medicine
| | - Misaki Hasegawa
- Department of Cardiology, Tokai University School of Medicine
| | - Kazuki Aihara
- Department of Cardiology, Tokai University School of Medicine
| | - Shunsuke Kuroda
- Department of Cardiology, Kameda Medical Center.,Department of Cardiovascular Medicine, Cleveland Clinic
| | - Takahide Sano
- Department of Cardiovascular Medicine, Toho University Graduate School of Medicine.,Department of Cardiology, Ebara Hospital
| | - Takeshi Kitai
- Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital
| | - Taishi Yonetsu
- Department of Interventional Cardiology, Tokyo Medical and Dental University
| | - Shun Kohsaka
- Department of Cardiology, Keio University School of Medicine
| | - Takuya Kishi
- Department of Graduate School of Medicine (Cardiology), International University of Health and Welfare
| | - Issei Komuro
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo
| | - Ken-Ichi Hirata
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
| | - Koichi Node
- Department of Cardiovascular Medicine, Saga University
| | - Shingo Matsumoto
- Department of Cardiovascular Medicine, Toho University Graduate School of Medicine
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Wu CC, Lee AJ, Su CH, Huang CY, Islam MM, Weng YC. Statin Use Is Associated with a Decreased Risk of Mortality among Patients with COVID-19. J Clin Med 2021. [PMID: 33916281 DOI: 10.3390/jcm1007145] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2023] Open
Abstract
BACKGROUND Recent epidemiological studies remain controversial regarding the association between statin use and reducing the risk of mortality among individuals with COVID-19. OBJECTIVE The objective of this study was to clarify the association between statin use and the risk of mortality among patients with COVID-19. METHODS We conducted a systematic articles search of online databases (PubMed, EMBASE, Scopus, and Web of Science) between 1 February 2020 and 20 February 2021, with no restriction on language. The following search terms were used: "Statins" and "COVID-19 mortality or COVID19 mortality or SARS-CoV-2 related mortality". Two authors individually examined all articles and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for study inclusion and exclusion. The overall risk ratio (RRs) with 95% confidence interval (CI) was calculated to show the strength of the association and the heterogeneity among the studies was presented Q and I2 statistic. RESULTS Twenty-eight studies were assessed for eligibility and 22 studies met the inclusion criteria. Statin use was associated with a significantly decreased risk of mortality among patients with COVID-19 (RR adjusted = 0.64; 95% CI: 0.57-0.72, p < 0.001). Moreover, statin use both before and after the admission was associated with lowering the risk of mortality among the COVID-19 patients (RR adjusted;before = 0.69; 95% CI: 0.56-0.84, p < 0.001 and RR adjusted;after = 0.57; 95% CI: 0.54-0.60, p < 0.001). CONCLUSION This comprehensive study showed that statin use is associated with a decreased risk of mortality among individuals with COVID-19. A randomized control trial is needed to confirm and refute the association between them.
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Affiliation(s)
- Chieh-Chen Wu
- Department of Healthcare Information and Management, School of Health Technology, Ming Chuan University, Taipei 333, Taiwan
- Department of Exercise and Health Promotion, College of Kinesiology and Health, Chinese Culture University, 55 Yangmingshan, Huagang Road, Shilin District, Taipei 11114, Taiwan
| | - An-Jen Lee
- Department of Healthcare Information and Management, School of Health Technology, Ming Chuan University, Taipei 333, Taiwan
- Southeast Asian, Cross-Strait and Overseas Student Institute, Ming Chuan University, Taipei 333, Taiwan
| | - Chun-Hsien Su
- Graduate Institute of Sport Coaching Science, College of Kinesiology and Health, Chinese Culture University, Taipei 11114, Taiwan
| | - Chu-Ya Huang
- Department of Healthcare Information and Management, School of Health Technology, Ming Chuan University, Taipei 333, Taiwan
- Taiwan College of Healthcare Executives, 9F No. 95, Sec. 3, Roosevelt Rd., Da'an District, Taipei City 106607, Taiwan
| | - Md Mohaimenul Islam
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei 11031, Taiwan
| | - Yung-Ching Weng
- Department of Healthcare Information and Management, School of Health Technology, Ming Chuan University, Taipei 333, Taiwan
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Wu CC, Lee AJ, Su CH, Huang CY, Islam MM, Weng YC. Statin Use Is Associated with a Decreased Risk of Mortality among Patients with COVID-19. J Clin Med 2021; 10:1450. [PMID: 33916281 PMCID: PMC8036545 DOI: 10.3390/jcm10071450] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 03/25/2021] [Accepted: 03/26/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Recent epidemiological studies remain controversial regarding the association between statin use and reducing the risk of mortality among individuals with COVID-19. OBJECTIVE The objective of this study was to clarify the association between statin use and the risk of mortality among patients with COVID-19. METHODS We conducted a systematic articles search of online databases (PubMed, EMBASE, Scopus, and Web of Science) between 1 February 2020 and 20 February 2021, with no restriction on language. The following search terms were used: "Statins" and "COVID-19 mortality or COVID19 mortality or SARS-CoV-2 related mortality". Two authors individually examined all articles and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for study inclusion and exclusion. The overall risk ratio (RRs) with 95% confidence interval (CI) was calculated to show the strength of the association and the heterogeneity among the studies was presented Q and I2 statistic. RESULTS Twenty-eight studies were assessed for eligibility and 22 studies met the inclusion criteria. Statin use was associated with a significantly decreased risk of mortality among patients with COVID-19 (RR adjusted = 0.64; 95% CI: 0.57-0.72, p < 0.001). Moreover, statin use both before and after the admission was associated with lowering the risk of mortality among the COVID-19 patients (RR adjusted;before = 0.69; 95% CI: 0.56-0.84, p < 0.001 and RR adjusted;after = 0.57; 95% CI: 0.54-0.60, p < 0.001). CONCLUSION This comprehensive study showed that statin use is associated with a decreased risk of mortality among individuals with COVID-19. A randomized control trial is needed to confirm and refute the association between them.
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Affiliation(s)
- Chieh-Chen Wu
- Department of Healthcare Information and Management, School of Health Technology, Ming Chuan University, Taipei 333, Taiwan; (A.-J.L.); (C.-Y.H.); (Y.-C.W.)
- Department of Exercise and Health Promotion, College of Kinesiology and Health, Chinese Culture University, 55 Yangmingshan, Huagang Road, Shilin District, Taipei 11114, Taiwan
| | - An-Jen Lee
- Department of Healthcare Information and Management, School of Health Technology, Ming Chuan University, Taipei 333, Taiwan; (A.-J.L.); (C.-Y.H.); (Y.-C.W.)
- Southeast Asian, Cross-Strait and Overseas Student Institute, Ming Chuan University, Taipei 333, Taiwan
| | - Chun-Hsien Su
- Graduate Institute of Sport Coaching Science, College of Kinesiology and Health, Chinese Culture University, Taipei 11114, Taiwan;
| | - Chu-Ya Huang
- Department of Healthcare Information and Management, School of Health Technology, Ming Chuan University, Taipei 333, Taiwan; (A.-J.L.); (C.-Y.H.); (Y.-C.W.)
- Taiwan College of Healthcare Executives, 9F No. 95, Sec. 3, Roosevelt Rd., Da’an District, Taipei City 106607, Taiwan
| | - Md. Mohaimenul Islam
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei 11031, Taiwan;
| | - Yung-Ching Weng
- Department of Healthcare Information and Management, School of Health Technology, Ming Chuan University, Taipei 333, Taiwan; (A.-J.L.); (C.-Y.H.); (Y.-C.W.)
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Zuin M, Rigatelli G, Bilato C, Zuliani G, Roncon L. Statin therapy is associated with less ICU admissions in COVID-19 patients. A preliminary analysis of the current observations. Minerva Anestesiol 2021; 87:951-952. [PMID: 33688701 DOI: 10.23736/s0375-9393.21.15600-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Marco Zuin
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy.,Department of Cardiology, Santa Maria della Misericordia Hospital, Rovigo, Italy
| | - Gianluca Rigatelli
- Department of Cardiology, Santa Maria della Misericordia Hospital, Rovigo, Italy -
| | - Claudio Bilato
- Division of Cardiology, West Vicenza General Hospitals, Arzignano, Vicenza, Italy
| | - Giovanni Zuliani
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - Loris Roncon
- Department of Cardiology, Santa Maria della Misericordia Hospital, Rovigo, Italy
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