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

L'Institut du Thorax, Université de Nantes, CHU Nantes, CNRS, Inserm, Nantes, France. Electronic address: bertrand.cariou@univ-nantes.fr. CHU de Nantes, CIC Inserm1413, Clinique des Données, Nantes, France. L'Institut du Thorax, Université de Nantes, CHU Nantes, CNRS, Inserm, Nantes, France. Département d'Endocrinologie et de Diabétologie, Hôpital de la Conception, Assistance Publique Hôpitaux de Marseille, Marseille, France. Hôpital Cardiovasculaire Louis Pradel, Hospices Civils de Lyon, INSERM UMR 1060 Carmen, Université Claude Bernard Lyon 1, Lyon, France. Département de Diabétologie, Endocrinologie et Nutrition, CHU Bichat, APHP, Paris, France. Département d'Endocrinologie, Diabète, Nutrition et CIC INSERM 1411, CHU de Montpellier, Montpellier, France. CHU de Toulouse et UMR1048/I2MC, Université de Toulouse, Toulouse, France. L'Institut du Thorax, Université de Nantes, CHU Nantes, CNRS, Inserm, Nantes, France; CHU de Nantes, CIC Inserm1413, Clinique des Données, Nantes, France.

Diabetes & metabolism. 2021;(2):101202
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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.

Methodological quality

Publication Type : Observational Study

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