Shmeylan Al Harbi1,2,3, Raed Kensara1,3, Ohoud Aljuhani4, Ghazwa B Korayem5, Ali F Altebainawi6, Abdullah Al Harthi1,3, Ramesh Vishwakarma7, Alaa M Alenazi8, Abdulmajed Almutairi9, Omar Alshaya1,2,3, Sultan Alraddadi1,2,3, Tareq Al Sulaiman10, Latifah Aldakkan11, Reem Mahboob12, Kholoud Alaamer1,2,3, Abdulrahman Alissa13, Awatif Hafiz4, Nada Aldhayyan2, Sara Althewaibi2, Farhan Alenezi3,9, Nadeen Y Alkhotani4, Sara A Alghamdi4, Abeer A Alenazi14, Khalid Al Sulaiman1,2,3,15. 1. Pharmaceutical Care Department, 48168King Abdulaziz Medical City, Riyadh, Saudi Arabia. 2. College of Pharmacy, 48149King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. 3. 309817King Abdullah International Medical Research Center-King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia. 4. Department of Pharmacy Practice, Faculty of Pharmacy, 108781King Abdulaziz University, Jeddah, Saudi Arabia. 5. Department of Pharmacy Practice, College of Pharmacy, 112893Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia. 6. Pharmaceutical Care Services, King Salman Specialist Hospital, Hail Health Cluster, Hail, Saudi Arabia. 7. Statistics Department, 81977European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium. 8. Pharmaceutical care department, 37849King Fahad Medical City, Riyadh, Saudi Arabia. 9. Intensive Care Department, 48168King Abdulaziz Medical City, Riyadh, Saudi Arabia. 10. Department of Orthopedic Surgery, 48179Imam Abdulrahman Al Faisal Hospital, Riyadh, Saudi Arabia. 11. Pharmaceutical Care Department, 48077Prince Sultan Cardiac Center, Riyadh, Saudi Arabia. 12. Pharmaceutical care department, 327149King Abdulaziz Hospital, Jeddah, Saudi Arabia. 13. Pharmaceutical Care Department, 430300King Abdullah bin Abdulaziz University Hospital, Riyadh, Saudi Arabia. 14. Pharmaceutical Care Department, 37853Prince Sultan Military Medical City, Riyadh, Saudi Arabia. 15. Saudi Critical Care Pharmacy Research (SCAPE) Platform. Riyadh, Saudi Arabia.
Abstract
PURPOSE: Coagulation abnormalities are one of the most important complications of severe COVID-19, which might lead to venous thromboembolism (VTE). Hypercoagulability with hyperfibrinogenemia causes large vessel thrombosis and major thromboembolic sequelae. Statins are potentially a potent adjuvant therapy in COVID-19 infection due to their pleiotropic effect. This study aims to evaluate the effectiveness of statins in reducing the risk of thrombosis among hospitalized critically ill patients with COVID-19. METHODS: A multicenter, retrospective cohort study of all critically ill adult patients with confirmed COVID-19 admitted to Intensive Care Units (ICUs) between March 1, 2020, and March 31, 2021. Eligible patients were categorized based on their usage of statins throughout their ICU stay and were matched with a propensity score. The primary endpoint was the odds of all cases of thrombosis; other outcomes were considered secondary. RESULTS: A total of 1039 patients were eligible; following propensity score matching, 396 patients were included (1:1 ratio). The odds of all thrombosis cases and VTE events did not differ significantly between the two groups (OR 0.84 (95% CI 0.43, 1.66), P = 0.62 and OR 1.13 (95% CI 0.43, 2.98), P = 0.81, respectively. On multivariable Cox proportional hazards regression analysis, patients who received statin therapy had lower 30-day (HR 0.72 (95 % CI 0.54, 0.97), P = 0.03) and in-hospital mortality (HR 0.67 (95 % CI 0.51, 0.89), P = 0.007). Other secondary outcomes were not statistically significant between the two groups except for D-dimer levels (peak) during ICU stay. CONCLUSION: The use of statin therapy during ICU stay was not associated with thrombosis reduction in critically ill patients with COVID-19; however, it has been associated with survival benefits.
PURPOSE: Coagulation abnormalities are one of the most important complications of severe COVID-19, which might lead to venous thromboembolism (VTE). Hypercoagulability with hyperfibrinogenemia causes large vessel thrombosis and major thromboembolic sequelae. Statins are potentially a potent adjuvant therapy in COVID-19 infection due to their pleiotropic effect. This study aims to evaluate the effectiveness of statins in reducing the risk of thrombosis among hospitalized critically ill patients with COVID-19. METHODS: A multicenter, retrospective cohort study of all critically ill adult patients with confirmed COVID-19 admitted to Intensive Care Units (ICUs) between March 1, 2020, and March 31, 2021. Eligible patients were categorized based on their usage of statins throughout their ICU stay and were matched with a propensity score. The primary endpoint was the odds of all cases of thrombosis; other outcomes were considered secondary. RESULTS: A total of 1039 patients were eligible; following propensity score matching, 396 patients were included (1:1 ratio). The odds of all thrombosis cases and VTE events did not differ significantly between the two groups (OR 0.84 (95% CI 0.43, 1.66), P = 0.62 and OR 1.13 (95% CI 0.43, 2.98), P = 0.81, respectively. On multivariable Cox proportional hazards regression analysis, patients who received statin therapy had lower 30-day (HR 0.72 (95 % CI 0.54, 0.97), P = 0.03) and in-hospital mortality (HR 0.67 (95 % CI 0.51, 0.89), P = 0.007). Other secondary outcomes were not statistically significant between the two groups except for D-dimer levels (peak) during ICU stay. CONCLUSION: The use of statin therapy during ICU stay was not associated with thrombosis reduction in critically ill patients with COVID-19; however, it has been associated with survival benefits.
Authors: Sefer Elezkurtaj; Selina Greuel; Jana Ihlow; Edward Georg Michaelis; Philip Bischoff; Catarina Alisa Kunze; Bruno Valentin Sinn; Manuela Gerhold; Kathrin Hauptmann; Barbara Ingold-Heppner; Florian Miller; Hermann Herbst; Victor Max Corman; Hubert Martin; Helena Radbruch; Frank L Heppner; David Horst Journal: Sci Rep Date: 2021-02-19 Impact factor: 4.379
Authors: Zachary A Yetmar; Supavit Chesdachai; Tarek Kashour; Muhammad Riaz; Danielle J Gerberi; Andrew D Badley; Elie F Berbari; Imad M Tleyjeh Journal: Open Forum Infect Dis Date: 2021-05-28 Impact factor: 3.835
Authors: Patrick R Lawler; Ewan C Goligher; Jeffrey S Berger; Matthew D Neal; Bryan J McVerry; Jose C Nicolau; Michelle N Gong; Marc Carrier; Robert S Rosenson; Harmony R Reynolds; Alexis F Turgeon; Jorge Escobedo; David T Huang; Charlotte A Bradbury; Brett L Houston; Lucy Z Kornblith; Anand Kumar; Susan R Kahn; Mary Cushman; Zoe McQuilten; Arthur S Slutsky; Keri S Kim; Anthony C Gordon; Bridget-Anne Kirwan; Maria M Brooks; Alisa M Higgins; Roger J Lewis; Elizabeth Lorenzi; Scott M Berry; Lindsay R Berry; Aaron W Aday; Farah Al-Beidh; Djillali Annane; Yaseen M Arabi; Diptesh Aryal; Lisa Baumann Kreuziger; Abi Beane; Zahra Bhimani; Shailesh Bihari; Henny H Billett; Lindsay Bond; Marc Bonten; Frank Brunkhorst; Meredith Buxton; Adrian Buzgau; Lana A Castellucci; Sweta Chekuri; Jen-Ting Chen; Allen C Cheng; Tamta Chkhikvadze; Benjamin Coiffard; Todd W Costantini; Sophie de Brouwer; Lennie P G Derde; Michelle A Detry; Abhijit Duggal; Vladimír Džavík; Mark B Effron; Lise J Estcourt; Brendan M Everett; Dean A Fergusson; Mark Fitzgerald; Robert A Fowler; Jean P Galanaud; Benjamin T Galen; Sheetal Gandotra; Sebastian García-Madrona; Timothy D Girard; Lucas C Godoy; Andrew L Goodman; Herman Goossens; Cameron Green; Yonatan Y Greenstein; Peter L Gross; Naomi M Hamburg; Rashan Haniffa; George Hanna; Nicholas Hanna; Sheila M Hegde; Carolyn M Hendrickson; R Duncan Hite; Alexander A Hindenburg; Aluko A Hope; James M Horowitz; Christopher M Horvat; Kristin Hudock; Beverley J Hunt; Mansoor Husain; Robert C Hyzy; Vivek N Iyer; Jeffrey R Jacobson; Devachandran Jayakumar; Norma M Keller; Akram Khan; Yuri Kim; Andrei L Kindzelski; Andrew J King; M Margaret Knudson; Aaron E Kornblith; Vidya Krishnan; Matthew E Kutcher; Michael A Laffan; Francois Lamontagne; Grégoire Le Gal; Christine M Leeper; Eric S Leifer; George Lim; Felipe Gallego Lima; Kelsey Linstrum; Edward Litton; Jose Lopez-Sendon; Jose L Lopez-Sendon Moreno; Sylvain A Lother; Saurabh Malhotra; Miguel Marcos; Andréa Saud Marinez; John C Marshall; Nicole Marten; Michael A Matthay; Daniel F McAuley; Emily G McDonald; Anna McGlothlin; Shay P McGuinness; Saskia Middeldorp; Stephanie K Montgomery; Steven C Moore; Raquel Morillo Guerrero; Paul R Mouncey; Srinivas Murthy; Girish B Nair; Rahul Nair; Alistair D Nichol; Brenda Nunez-Garcia; Ambarish Pandey; Pauline K Park; Rachael L Parke; Jane C Parker; Sam Parnia; Jonathan D Paul; Yessica S Pérez González; Mauricio Pompilio; Matthew E Prekker; John G Quigley; Natalia S Rost; Kathryn Rowan; Fernanda O Santos; Marlene Santos; Mayler Olombrada Santos; Lewis Satterwhite; Christina T Saunders; Roger E G Schutgens; Christopher W Seymour; Deborah M Siegal; Delcio G Silva; Manu Shankar-Hari; John P Sheehan; Aneesh B Singhal; Dayna Solvason; Simon J Stanworth; Tobias Tritschler; Anne M Turner; Wilma van Bentum-Puijk; Frank L van de Veerdonk; Sean van Diepen; Gloria Vazquez-Grande; Lana Wahid; Vanessa Wareham; Bryan J Wells; R Jay Widmer; Jennifer G Wilson; Eugene Yuriditsky; Fernando G Zampieri; Derek C Angus; Colin J McArthur; Steven A Webb; Michael E Farkouh; Judith S Hochman; Ryan Zarychanski Journal: N Engl J Med Date: 2021-08-04 Impact factor: 176.079