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

Bertrand Cariou (1) , Thomas Goronflot (2) , Antoine Rimbert (1) , Sandrine Boullu (3) , Cedric Le May (1) , Philippe Moulin (4) , Matthieu Pichelin (1) , Louis Potier (5) , Sarra Smati (1) , Ariane Sultan (6) , Blandine Tramunt (7) , Matthieu Wargny (1, 2) , Pierre Gourdy (7) , Samy Hadjadj (1)

1 ITX - ITX - unité de recherche de l'institut du thorax
2 CIC Nantes - Centre d’Investigation Clinique de Nantes
3 LA CONCEPTION - Hôpital de la Conception [CHU - APHM]
4 CarMeN - Cardiovasculaire, métabolisme, diabétologie et nutrition
5 AP-HP - Hôpital Bichat - Claude Bernard [Paris]
6 CIC Montpellier
7 I2MC - Institut des Maladies Métaboliques et Cardiovasculaires

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 scoreweighting approach. Results.-Of the 2449 patients with T2DM (881 women, 1568 men; aged 70.9 AE 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.

Domaines: Endocrinologie et métabolisme; Cardiologie et système cardiovasculaire; Pharmacologie; Maladies infectieuses; Maladies émergentes; Santé publique et épidémiologie

Bertrand Cariou, Thomas Goronflot, Antoine Rimbert, Sandrine Boullu, Cedric Le May, et al.. Routine use of statins and increased COVID-19 related mortality in inpatients with type 2 diabetes: Results from the CORONADO study. Journal of Diabetes & Metabolism, 2021, 47 (2), pp.101202. ⟨10.1016/j.diabet.2020.10.001⟩. ⟨hal-03100948⟩