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2020 ; 21
(7
): 909-914.e2
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The Effects of ARBs, ACEis, and Statins on Clinical Outcomes of COVID-19
Infection Among Nursing Home Residents
#MMPMID32674818
De Spiegeleer A
; Bronselaer A
; Teo JT
; Byttebier G
; De Tré G
; Belmans L
; Dobson R
; Wynendaele E
; Van De Wiele C
; Vandaele F
; Van Dijck D
; Bean D
; Fedson D
; De Spiegeleer B
J Am Med Dir Assoc
2020[Jul]; 21
(7
): 909-914.e2
PMID32674818
show ga
OBJECTIVES: Angiotensin-converting enzyme inhibitors (ACEi), angiotensin II
receptor blockers (ARBs), and HMG-CoA reductase inhibitors ("statins") have been
hypothesized to affect COVID-19 severity. However, up to now, no studies
investigating this association have been conducted in the most vulnerable and
affected population groups (ie, older adults residing in nursing homes). The
objective of this study was to explore the association of ACEi/ARB and/or statins
with clinical manifestations in COVID-19-infected older adults residing in
nursing homes. DESIGN: We undertook a retrospective multicenter cohort study to
analyze the association between ACEi/ARB and/or statin use with clinical outcome
of COVID-19. The outcomes were (1) serious COVID-19 defined as long-stay hospital
admission or death within 14 days of disease onset, and (2) asymptomatic (ie, no
disease symptoms in the whole study period while still being diagnosed by
polymerase chain reaction). SETTING AND PARTICIPANTS: A total of 154
COVID-19-positive subjects were identified, residing in 1 of 2 Belgian nursing
homes that experienced similar COVID-19 outbreaks. MEASURES: Logistic regression
models were applied with age, sex, functional status, diabetes, and hypertension
as covariates. RESULTS: We found a statistically significant association between
statin intake and the absence of symptoms during COVID-19 (odds ratio [OR] 2.91;
confidence interval [CI] 1.27-6.71), which remained statistically significant
after adjusting for covariates (OR 2.65; CI 1.13-6.68). Although the effects of
statin intake on serious clinical outcome were in the same beneficial direction,
these were not statistically significant (OR 0.75; CI 0.24-1.87). There was also
no statistically significant association between ACEi/ARB and asymptomatic status
(OR 2.72; CI 0.59-25.1) or serious clinical outcome (OR 0.48; CI 0.10-1.97).
CONCLUSIONS AND IMPLICATIONS: Our data indicate that statin intake in older,
frail adults could be associated with a considerable beneficial effect on
COVID-19 clinical symptoms. The role of statins and renin-angiotensin system
drugs needs to be further explored in larger observational studies as well as
randomized clinical trials.
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