Association of statin and/or renin-angiotensin-aldosterone system modulating therapy with mortality in adults with diabetes admitted to hospital with COVID-19: A retrospective multicentre European study.
Harris, Sophie Ruan, Yue Wild, Sarah H Wargny, Matthieu Hadjadj, Samy Delasalle, Béatrice Saignes, Maëva Ryder, Robert Field, Benjamin C T Narendran, Parth
Harris, Sophie
Ruan, Yue
Wild, Sarah H
Wargny, Matthieu
Hadjadj, Samy
Delasalle, Béatrice
Saignes, Maëva
Ryder, Robert
Field, Benjamin C T
Narendran, Parth
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Affiliation
King's College Hospital NHS Foundation Trust; Oxford University Hospitals NHS Foundation Trust; University of Edinburgh; Sandwell and West Birmingham NHS Trust; et al.
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Publication date
2022-04-11
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Abstract
Background & aims: To assess the impact of pre-admission renin-angiotensin-aldosterone system inhibitor (RAASi) and statin use on mortality following COVID-19 hospitalization in adults with pre-existing diabetes.
Methods: Retrospective cohort study of adults with diabetes admitted to ninety-nine participating hospitals in the United Kingdom, France and Spain during the first wave of the COVID-19 pandemic. Logistic regression models adjusted for demographic factors and comorbidity were used to describe associations with mortality in hospital or within 28 days of admission and individual or combined RAASi and statin therapy prescription followed by a country level meta-analysis.
Results: Complete data were available for 3474 (42.6%) individuals. Prescribing patterns varied by country: 25-50% neither RAASi nor statin therapy, 14-36% both RAASi and statin therapy, 9-24% RAASi therapy alone, 12-36% statin alone. Overall, 20-37% of patients died within 28 days. Meta-analysis found no evidence of an association between mortality and prescription of RAASi therapy (OR 1.09, CI 0.78-1.52 (I2 22.2%)), statin (OR 0.97, CI 0.59-1.61 (I2 72.9%)) or both (OR 1.14, CI 0.67-1.92 (I2 78.3%)) compared to those prescribed neither drug class.
Conclusions: This large multicentre, multinational study found no evidence of an association between mortality from COVID-19 infection in people with diabetes and use of either RAASi, statin or combination therapy. This provides reassurance that clinicians should not change their RAASi and statin therapy prescribing practice in people with diabetes during the COVID-19 pandemic.
Citation
Harris S, Ruan Y, Wild SH, Wargny M, Hadjadj S, Delasalle B, Saignes M, Ryder RE, Field BCT, Narendran P, Zaccardi F, Wilmot EG, Vlacho B, Llauradó G, Mauricio D, Nagi D, Patel D, Várnai KA, Davies J, Gourdy P, Cariou B, Rea R, Khunti K; CORONADO, the ABCD COVID-19 diabetes national audit and HM Hospitales investigators. Association of statin and/or renin-angiotensin-aldosterone system modulating therapy with mortality in adults with diabetes admitted to hospital with COVID-19: A retrospective multicentre European study. Diabetes Metab Syndr. 2022 May;16(5):102484. doi: 10.1016/j.dsx.2022.102484.
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Article