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

doi:10.2196/29379

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

Department of Pediatrics

Research output: Contribution to journal › Article › peer-review

6 Citations (Scopus)

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 language	English
Article number	e29379
Journal	JMIR Public Health and Surveillance
Volume	7
Issue number	10
DOIs	https://doi.org/10.2196/29379
Publication status	Published - 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

Health Informatics
Public Health, Environmental and Occupational Health

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.2196/29379

Cite this

@article{480a6fc480ad49038fc7946e1597dd65,

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

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.",

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

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: {\textcopyright} 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.",

year = "2021",

month = oct,

doi = "10.2196/29379",

language = "English",

volume = "7",

journal = "JMIR Public Health and Surveillance",

issn = "2369-2960",

publisher = "JMIR Publications Inc.",

number = "10",

}

TY - JOUR

T1 - Statin use and COVID-19 infectivity and severity in South Korea

T2 - Two population-based nationwide cohort studies

AU - Lee, Seung Won

AU - Kim, So Young

AU - Moon, Sung Yong

AU - Yoo, In Kyung

AU - Yoo, Eun Gyong

AU - Eom, Gwang Hyeon

AU - Kim, Jae Min

AU - Il Shin, Jae

AU - Jeong, Myung Ho

AU - Yang, Jee Myung

AU - Yon, Dong Keon

N1 - 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.

PY - 2021/10

Y1 - 2021/10

N2 - 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.

AB - 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.

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

Abstract

Bibliographical note

All Science Journal Classification (ASJC) codes

UN SDGs

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