Association of antecedent statin use on 30-day, 60-day and 90-day mortality among Mississippi Medicaid beneficiaries diagnosed with COVID-19

Yiran Rong; Swarnali Goswami; Omokhodion Eriakha; Sujith Ramachandran; John Bentley; Benjamin F Banahan; Terri Kirby; Dennis Smith; Eric Pittman; Kaustuv Bhattacharya

doi:10.1136/bmjopen-2023-076195

Association of antecedent statin use on 30-day, 60-day and 90-day mortality among Mississippi Medicaid beneficiaries diagnosed with COVID-19

BMJ Open. 2023 Nov 19;13(11):e076195. doi: 10.1136/bmjopen-2023-076195.

Authors

Yiran Rong^{1

2}, Swarnali Goswami^{1

3}, Omokhodion Eriakha¹, Sujith Ramachandran^{1

4}, John Bentley^{1

4}, Benjamin F Banahan^{1

4}, Terri Kirby⁵, Dennis Smith⁵, Eric Pittman^{1

4}, Kaustuv Bhattacharya^{6

4}

Affiliations

¹ Department of Pharmacy Administration, University of Mississippi School of Pharmacy, University, Mississippi, USA.
² MedTech Epidemiology and Real-World Data Sciences, Johnson and Johnson, New Brunswick, New Jersey, USA.
³ Real-World Evidence, Complete Health Economics and Outcomes Solutions, LLC, Chalfont, Pennsylvania, USA.
⁴ Center for Pharmaceutical Marketing and Management, University of Mississippi School of Pharmacy, University, Mississippi, USA.
⁵ Mississippi Division of Medicaid, Office of the Governor, Jackson, Mississippi, USA.
⁶ Department of Pharmacy Administration, University of Mississippi School of Pharmacy, University, Mississippi, USA [email protected].

Abstract

Objective: To assess if the antecedent statin use was associated with all-cause death among COVID-19 patients enrolled in Medicaid.

Design: Cohort study.

Setting: Mississippi Medicaid population.

Participants: This study included 10 792 Mississippi Medicaid-enrolled patients between 18 and 64 years of age with a confirmed COVID-19 diagnosis from March 2020 to June 2021.

Intervention: Antecedent statin use, which was determined by a record of statin prescription in the 90-day period prior to the COVID diagnosis.

Main outcome measures: The outcomes of interest included mortality from all cause within 30 days, 60 days and 90 days after index.

Results: A total of 10 792 patients with COVID-19 met the inclusion and exclusion criteria, with 13.1% of them being antecedent statin users. Statin users were matched 1:1 with non-users based on age, sex, race, comorbidities and medication use by propensity score matching. In total, the matched cohort consisted of 1107 beneficiaries in each group. Multivariable logistic regression showed that statin users were less likely to die within 30 days (adjusted OR: 0.51, 95% CI: 0.32 to 0.83), 60 days (OR: 0.56, 95% CI: 0.37 to 0.85) and 90 days (OR: 0.55, 95% CI: 0.37 to 0.82) after diagnosis of COVID-19. Those with low-intensity/moderate-intensity statin use had significantly lower mortality risk in the 60-day and the 90-day follow-up period, while the high intensity of statin use was only found to be significantly associated with a lower odd of mortality within 30 days post index.

Conclusion: After COVID infection, Medicaid beneficiaries who had taken statins antecedently could be at lower risk for death. For patients with chronic conditions, continuity of care is crucial when interruptions occur in their medical care. Further research is required to further investigate the potential mechanisms and optimal use of statins in COVID-19 treatment.

Keywords: COVID-19; chronic disease; lipid disorders; mortality; retrospective studies.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
COVID-19 Drug Treatment
COVID-19 Testing
COVID-19*
Cohort Studies
Female
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors* / therapeutic use
Male
Medicaid
Middle Aged
Mississippi / epidemiology
Young Adult

Substances

Hydroxymethylglutaryl-CoA Reductase Inhibitors