Abstract 060: Association Of Antecedent Statin Use With Outcomes Of People With Covid-19 Admitted At Northwestern Medicine Health System

Abstract

Background: Several observational studies have found that antecedent statin use (i.e., use prior to getting admitted) was associated with lower mortality risk in hospitalized COVID-19 patients, but this is not a consistent finding. Differences maybe due to covariate imbalance, model misspecification, or selection bias. Objective: Estimate the association of antecedent statin use with adverse outcomes (in-hospital death, intubation, ICU admission) in patients admitted for COVID-19 in an academic health system in Chicago. Methods: We analyzed electronic health records from an academic health system in Chicago (Mar ‘20-Mar ‘21) comparing rates of adverse events (composite and per outcome) between antecedent users and non-users. Eligible individuals were ≥40 years old in Illinois, admitted for ≥24 hours, and tested positive for COVID-19 in the 30 days before to 7 days after admission. Antecedent use is defined as existence of statins prescription ≥30 days before admission. We used augmented inverse probability weighting (AIPW) with targeted maximum likelihood estimation to improve covariate balance and estimate the risk difference. Compared to standard methods, this approach allowed use of machine learning models and is doubly robust to misspecification. Results: Of 6267 admitted, 1337 (20%) were antecedent users. Users tend to be older, male, White, smoke, and have a comorbidity. Unadjusted analysis showed significantly higher rates of negative outcomes in non-users except in-hospital death. Analysis using AIPW improved covariate balance and showed that users had significantly lower rates of the composite outcome (RD: -3.9%, 95%CI: -6.0, -1.9) and ICU admissions (RD: -4.0, 95%CI: -7.0, -1.0). No differences in intubation and mortality rates were detected. Conclusion: Antecedent statin use is associated with lower risk of ICU admissions but not with intubation or in-hospital mortality. We were not able to confirm the mortality benefit detected by prior studies nor any differences in rates of intubations.

American Heart Association EPI|Lifestyle Scientific Sessions: 2022 Meeting Highlights

“…Antecedent statin use was associated with a lower risk of intensive care unit admissions but not with intubation or in‐hospital mortality. 59 …”