Statins, ACE inhibitors lower risk of death from COVID-19—hydroxychloroquine increases that risk
Certain medications are associated with a lower risk of in-hospital mortality among COVID-19 patients in the United States, according to new findings published in JAMA Network Open.
“The pandemic has affected the lives of all U.S. residents, disrupted business operations, and overwhelmed hospitals,” wrote lead author Ning Rosenthal, MD, PhD, of Premier Applied Sciences in Charlotte, North Carolina, and colleagues. “Despite its tremendous impact, there is a dearth of research on the epidemiology and clinical outcomes of patients with COVID-19 in the United States.”
Rosenthal et al. hoped to provide some new insight in this area, tracking more than 64,000 COVID-19 patients who received care from 592 different U.S. acute care hospitals. All patients were treated in the early stages of the pandemic, from April 1 to May 31, 2020, and 54.5% were inpatients. The median age was 46 years old for outpatients and 65 years old for inpatients.
Overall, the team found, in-hospital mortality was 11.4% for the entire study population and 20.3% for inpatients. Also, 15.9% of patients received invasive mechanical ventilation and 19.4% were admitted to the ICU. The median length of stay for all inpatients was six days.
In addition, the most common complications among inpatients were acute respiratory failure (55.8%), acute kidney failure (33.9%) and sepsis (33.7%).
Looking closer at specific risk factors associated with in-hospital mortality, the team noted that patient age was a key detail to consider. In fact, the chance of in-hospital mortality for inpatients 80 years old or older was 16.2 times higher than it was for inpatients between the ages of 18 and 34.
Statins, angiotensin-converting enzyme (ACE) inhibitors and calcium channel blockers were all associated with decreasing an inpatient’s odds of mortality.
“Such protective associations in multiple drug classes could be an indicator of enhanced accessibility to these drugs among patients who might be socially advantaged compared with those who did not have access to these drugs,” the authors wrote. “Further studies are needed to explore the mechanisms behind the protective associations of these drugs. Meanwhile, it may be important to continue these antihypertensive and antilipidemic treatments in patients with hypertension, hyperlipidemia, or other cardiovascular conditions.”
Patients treated with hydroxychloroquine or azithromycin, on the other hand, actually saw their odds of death rise.
“These findings are not only consistent with what was observed in other observational studies conducted in the earlier stage of the COVID-19 pandemic but also similar to results of recently published clinical trials in the United States and other countries,” Rosenthal and colleagues explained.
Read the full analysis from JAMA Network Open here.
Michael has more than 18 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.