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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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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 protective role of statins in COVID-19 patients: a retrospective observational study. TRANSLATIONAL MEDICINE COMMUNICATIONS 2021; 6:22. [PMID: 34604534 PMCID: PMC8475829 DOI: 10.1186/s41231-021-00102-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 09/19/2021] [Indexed: 05/06/2023]
Abstract
BACKGROUND To evaluate and determine the protective role of statins in COVID-19 patients. METHODS This is a retrospective cohort study conducted across five hospitals in India. Patients diagnosed with COVID-19 and hospitalized with existing and valid medical documentation were included. RESULTS This study comprised 3252 COVID-19 patients, of whom 1048 (32.2%) were on statins, with 52.4% being males. The comorbidity prevalence of hypertension was 75%, followed by diabetes 62.51% and coronary artery disease being 47.5%. At the time of hospitalization, statin users had a higher incidence of dyspnea, cough, and fatigue (95.8, 93.3, and 92.7%). The laboratory results revealed a lower mean of WBC count (7.8 × 103/μL), D-dimer (2.4 μg/mL), and C-reactive protein (103 mg/L) among statin users. They also had lower mortality rates (17.1%), a lesser requirement for mechanical ventilation (20%), and hemodialysis (5.4%). CONCLUSION This observation study elaborates on the beneficial effects of statins in COVID-19 patients. However, the inferences from this study should be viewed with caution due to the impending effect of confounding factors on its statistical results.
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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
| | - Sanjum Senthil
- International Research Association Unit, New Delhi, India
- Department of Medicine, RRN Multispecialty Hospital, Tamil Nadu, India
| | - Stanley John
- International Research Association Unit, New Delhi, India
- Department of Medicine, Holy Cross Hospital, Tamil Nadu, India
| | - Mahesh K. Madhavan
- Department of Medicine, Holy Cross Hospital, Tamil Nadu, India
- National Regional Collaboration for Medical Research Foundation, New Delhi, India
| | - Jessica Das
- National Regional Collaboration for Medical Research Foundation, New Delhi, India
| | - Sonal Patil
- National Regional Collaboration for Medical Research Foundation, New Delhi, India
| | - Ragunath Rameshwaram
- National Regional Collaboration for Medical Research Foundation, New Delhi, India
- Department of Biostatistics, Epidemiology, and Informatics, Piramal Research Centre, Gujarat, India
| | - Ananya Cintham
- National Regional Collaboration for Medical Research Foundation, New Delhi, India
- Swaminathan Multispecialty Hospital, Chennai, India
| | - Venkatesh Subramaniam
- National Regional Collaboration for Medical Research Foundation, New Delhi, India
- Swaminathan Multispecialty Hospital, Chennai, India
| | - Madhusudan Yogi
- National Regional Collaboration for Medical Research Foundation, New Delhi, India
- Swaminathan Multispecialty Hospital, Chennai, India
| | - Abhishek Bansal
- National Regional Collaboration for Medical Research Foundation, New Delhi, India
- Swaminathan Multispecialty Hospital, Chennai, India
| | - Sumesh Achutham
- National Regional Collaboration for Medical Research Foundation, New Delhi, India
- Swaminathan Multispecialty Hospital, Chennai, India
| | - Chandini Shekar
- National Regional Collaboration for Medical Research Foundation, New Delhi, India
- Swaminathan Multispecialty Hospital, Chennai, India
| | - Vijay Murthy
- National Regional Collaboration for Medical Research Foundation, New Delhi, India
- Swaminathan Multispecialty Hospital, Chennai, India
| | - Robbin Selvaraj
- National Regional Collaboration for Medical Research Foundation, New Delhi, India
- Swaminathan Multispecialty Hospital, Chennai, India
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