The impact of statin therapy on in-hospital prognosis and endothelial function of patients at high-to-very high cardiovascular risk admitted for COVID-19: Statins, endothelial function, and COVID-19 outcomes.

BACKGROUND: Statins may protect against adverse outcomes from Coronavirus disease 2019 (COVID-19) through their pleiotropic effects. Endothelial dysfunction seems to be implicated in the pathophysiology of COVID-19, and can be attenuated by statins. This study assessed the role of preadmission statin therapy and its interaction with endothelial function, measured using flow-mediated dilation (FMD) at hospital admission, in predicting in-hospital outcomes among patients with COVID-19 having high-to-very high cardiovascular risk.

METHODS: We conducted a retrospective cohort study of hospitalized patients with COVID-19 having high-to-very high cardiovascular risk, including a subgroup of patients who underwent FMD assessment.

RESULTS: Among 342 patients, 119 (35%) were treated with statins at study baseline. Preadmission statin therapy was independently associated with a 75% risk reduction of ICU admission/in-hospital death (adjusted HR 0.252, 95% CI 0.122-0.521, p < 0.001). In the subgroup of patients with an FMD assessment (245 patients, 40% statin-treated), preadmission statin therapy was independently associated with higher FMD values (β = 0.159, p = 0.013). However, preadmission statin therapy × FMD interaction was not associated with in-hospital outcomes (F = 0.002, p interaction = 0.960).

CONCLUSIONS: Preadmission statin therapy is associated with better in-hospital outcomes among patients with COVID-19 having high-to-very high cardiovascular risk, independent of the endothelium-protective effects of these drugs. This article is protected by copyright. All rights reserved.