Routine use of statins and increased COVID-19 related mortality in inpatients with type 2 diabetes: Results from the CORONADO study.

Abstract

AIM:

Patients with type 2 diabetes mellitus (T2DM) represent a high-risk population for both cardiovascular diseases and severe coronavirus disease 2019 (COVID-19). Recent studies have reported interactions between statin treatment and COVID-19-related outcomes. The study reported here specifically assessed the association between routine statin use and COVID-19-related outcomes in inpatients with T2DM.

METHODS:

The Coronavirus-SARS-CoV-2 and Diabetes Outcomes (CORONADO) study was a nationwide observational study aiming to describe the phenotypic characteristics and prognosis of T2DM patients with COVID-19 admitted to 68 French hospitals between 10 March and 10 April 2020. The composite primary outcome comprised tracheal intubation and/or death within 7 and 28 days of admission. The association between statin use and outcomes was estimated by logistic regression analysis after applying inverse probability of treatment weighting (IPTW) using a propensity score-weighting approach.

RESULTS:

Of the 2449 patients with T2DM (881 women, 1568 men; aged 70.9 ± 12.5 years) suitable for analysis, 1192 (49%) were using statin treatment before admission. In unadjusted analyses, patients using statins had rates of the primary outcome similar to those of non-users within both 7 (29.8% vs 27.0%, respectively; P = 0.1338) and 28 days (36.2% vs 33.8%, respectively; P = 0.2191) of admission. However, mortality rates were significantly higher in statin users within 7 (12.8% vs 9.8%, respectively; P = 0.02) and 28 days (23.9% vs 18.2%, respectively; P < 0.001). After applying IPTW, significant associations were observed with statin use and the primary outcome within 7 days (OR [95% CI]: 1.38 [1.04-1.83]) and with death within both 7 (OR [95% CI]: 1.74 [1.13-2.65]) and 28 days (OR [95% CI]: 1.46 [1.08-1.95]).

CONCLUSION:

Routine statin treatment is significantly associated with increased mortality in T2DM patients hospitalized for COVID-19.

• Authors: Bertrand Cariou, Thomas Goronflot, Antoine Rimbert, Sandrine Boullu, Cédric Le May, Philippe Moulin, Matthieu Pichelin, Louis Potier, Sarra Smati, Ariane Sultan, Blandine Tramunt, Matthieu Wargny, Pierre Gourdy, Samy Hadjadj, CORONADO investigators
• Journal: Diabetes & metabolism (Diabetes Metab) Vol. 47 Issue 2 Pg. 101202 (03 2021) ISSN: 1878-1780 [Electronic] France
• PMID: 33091555 (Publication Type: Journal Article, Observational Study, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2020 Elsevier Masson SAS. All rights reserved.

Chemical References

• Hydroxymethylglutaryl-CoA Reductase Inhibitors

Topics

• Aged
• Aged, 80 and over
• COVID-19 (complications, mortality)
• Diabetes Mellitus, Type 2 (complications, mortality)
• Female
• Humans
• Hydroxymethylglutaryl-CoA Reductase Inhibitors (therapeutic use)
• Inpatients
• Male
• SARS-CoV-2