Statin use and COVID-19 infectivity and severity in South Korea: Two population-based nationwide cohort studies

Seung Won Lee, So Young Kim, Sung Yong Moon, In Kyung Yoo, Eun Gyong Yoo, Gwang Hyeon Eom, Jae Min Kim, Jae Il Shin, Myung Ho Jeong, Jee Myung Yang, Dong Keon Yon

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Basic studies suggest that statins as add-on therapy may benefit patients with COVID-19; however, real-world evidence of such a beneficial association is lacking. Objective: We investigated differences in SARS-CoV-2 test positivity and clinical outcomes of COVID-19 (composite endpoint: admission to intensive care unit, invasive ventilation, or death) between statin users and nonusers. Methods: Two independent population-based cohorts were analyzed, and we investigated the differences in SARS-CoV-2 test positivity and severe clinical outcomes of COVID-19, such as admission to the intensive care unit, invasive ventilation, or death, between statin users and nonusers. One group comprised an unmatched cohort of 214,207 patients who underwent SARS-CoV-2 testing from the Global Research Collaboration Project (GRCP)-COVID cohort, and the other group comprised an unmatched cohort of 74,866 patients who underwent SARS-CoV-2 testing from the National Health Insurance Service (NHIS)-COVID cohort. Results: The GRCP-COVID cohort with propensity score matching had 29,701 statin users and 29,701 matched nonusers. The SARS-CoV-2 test positivity rate was not associated with statin use (statin users, 2.82% [837/29,701]; nonusers, 2.65% [787/29,701]; adjusted relative risk [aRR] 0.97; 95% CI 0.88-1.07). Among patients with confirmed COVID-19 in the GRCP-COVID cohort, 804 were statin users and 1573 were matched nonusers. Statin users were associated with a decreased likelihood of severe clinical outcomes (statin users, 3.98% [32/804]; nonusers, 5.40% [85/1573]; aRR 0.62; 95% CI 0.41-0.91) and length of hospital stay (statin users, 23.8 days; nonusers, 26.3 days; adjusted mean difference –2.87; 95% CI –5.68 to –0.93) than nonusers. The results of the NHIS-COVID cohort were similar to the primary results of the GRCP-COVID cohort. Conclusions: Our findings indicate that prior statin use is related to a decreased risk of worsening clinical outcomes of COVID-19 and length of hospital stay but not to that of SARS-CoV-2 infection.

Original languageEnglish
Article numbere29379
JournalJMIR Public Health and Surveillance
Volume7
Issue number10
DOIs
Publication statusPublished - 2021 Oct

Bibliographical note

Funding Information:
The authors appreciate health care professionals dedicated to treating patients with COVID-19 in Korea, the Ministry of Health and Welfare, the Health Insurance Review & Assessment Service of Korea, and the National Health Insurance Service of Korea for sharing invaluable national cohorts in a prompt manner. This work was supported by an Institute of Information and Communications Technology Planning & Evaluation (IITP) grant funded by the Korean Government (Ministry of Science and ICT [MSIT]; No. 2020-0-01969; Development of HW/SW platform for interactive self-monitoring in real-time addressing the mental health problems based on brain-cognitive behavioral data). The funders had no role in study design, data collection, data analysis, data interpretation, or writing of the report.

Publisher Copyright:
© Seung Won Lee, So Young Kim, Sung Yong Moon, In Kyung Yoo, Eun-Gyong Yoo, Gwang Hyeon Eom, Jae-Min Kim, Jae Il Shin, Myung Ho Jeong, Jee Myung Yang, Dong Keon Yon.

All Science Journal Classification (ASJC) codes

  • Public Health, Environmental and Occupational Health
  • Health Informatics
  • Medicine(all)

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