Evidence mapPaperPMID 39353689Full record

Observational studyBMJ open2024

Association of early statin initiation during COVID-19 admission with inpatient mortality at an academic health system in Illinois, March 2020 to September 2022: a target trial emulation using observational data.

Adovich Rivera, Omar Al-Heeti, Matthew J Feinstein, Janna Williams, Babafemi Taiwo, Chad Achenbach, Lucia Petito

Abstract readObservational Study
In one paragraph

Observational study in BMJ open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Adovich RiveraDepartment of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California, USA.ORCID 0000-0003-2533-0818
Omar Al-HeetiDepartment of Medicine, Division of Infectious Diseases, Southern Illinois University System, Carbondale, Illinois, USA.
Matthew J FeinsteinDepartment of Medicine, Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Janna WilliamsDepartment of Medicine, Division of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Babafemi TaiwoDepartment of Medicine, Division of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Chad AchenbachDepartment of Medicine, Division of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Lucia PetitoDepartment of Preventive Medicine, Division of Biostatistics and Informatics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA lucia.petito@northwestern.edu.

Funding

NCATS NIH HHS UL1 TR001422
6 · The paper itself

Abstract

objectiveWe assessed the association of early statin initiation with inpatient mortality among hospitalised COVID-19 patients. DESIGN, SETTING AND

participantsThis observational study emulated a hypothetical target trial using electronic health records data from Northwestern Medicine Health System, Illinois, 2020-2022. We included patients who were ≥40 years, admitted ≥48 hours for COVID-19 from March 2020 to August 2022 and had no evidence of statin use before admission.

interventionsIndividuals who initiated any statins within 48 hours of admission were compared with individuals who did not initiate statins during this period. PRIMARY OUTCOME MEASURES: Inpatient mortality at hospital days 7, 14, 21 and 28 were determined using hospital records. Risk differences between exposure groups were calculated using augmented inverse propensity weighting (AIPW) with SuperLearner.

resultsA total of 8893 individuals (24.5% early statin initiators) were included. Early initiators tended to be older, male and have higher comorbidity burdens. Unadjusted day 28 mortality was higher in early initiators (6.0% vs 3.6%). Adjusted analysis showed slightly higher inpatient mortality risk at days 7 (RD: 0.5%, 95% CI: 0.2 to 0.8) and 21 (RD: 0.6%, 95% CI: 0.04 to 1.1), but not days 14 (RD: 0.4%, 95% CI: -0.03 to 0.9) and 28 (RD: 0.4%, 95% CI: -0.2 to 1.1). Sensitivity analyses using alternative modelling approaches showed no difference between groups.

conclusionsEarly statin initiation was not associated with lower mortality contrasting with findings of previous observational studies. Trial emulation helped in identifying and addressing sources of bias incompletely addressed by previous work. Statin use may be indicated for other conditions but not COVID-19.

Indexed as

COVID-19Hospital MortalityHydroxymethylglutaryl-CoA Reductase InhibitorsAdultAgedAged, 80 and overCOVID-19 Drug TreatmentElectronic Health RecordsFemaleHospitalizationHumansIllinoisMaleMiddle AgedSARS-CoV-2Hydroxymethylglutaryl-CoA Reductase InhibitorsCOVID-19epidemiologic studiesinpatientsmortalitystatistics & research methods

Identifiers

PMID39353689
PMCPMC11448146

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.