The Effects of ARBs, ACEis, and Statins on Clinical Outcomes of COVID-19 Infection Among Nursing Home Residents.
Anton De Spiegeleer, Antoon Bronselaer, James T Teo and 11 others
PMID 32674818WHAT IT FOUND
Neither ACEi/ARBs nor statins were clearly linked to fewer serious outcomes in nursing home residents with COVID-19.
Statin use was associated with more residents remaining asymptomatic (14 of 31 vs 27 of 123).
Key findings
01Statin use was associated with remaining asymptomatic: 14 of 31 statin users stayed asymptomatic, compared with 27 of 123 non-users.
02ACEi/ARB use was not clearly associated with asymptomatic status: 10 of 30 users stayed asymptomatic, compared with 31 of 124 non-users.
03Serious COVID-19 (hospital stay of at least 7 days or death within 14 days) was not clearly different by drug use: ACEi/ARB 6 of 30 vs 31 of 124; statin 6 of 31 vs 31 of 123.
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How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was observational and small, with only 154 residents from two nursing homes, so it cannot prove that a drug caused any outcome. Important confounders such as chronic kidney injury and body mass index were not available, so residents taking statins or ACEi/ARBs may have differed in other ways. Some residents were diagnosed clinically without PCR confirmation, and diagnosis method was treated as a possible confounder. The combined ACEi/ARB plus statin group had only 8 residents, so apparent benefits in that group cannot be interpreted. The serious outcome was not statistically significant, and the positive statin finding was for asymptomatic status, not for reducing hospitalization or death. Results apply only to nursing home residents with mean age 86 ± 7 years, not to younger or hospitalized people.
The easy way to misread this
Do not conclude that statins or ACEi/ARBs prevent serious COVID-19. The serious outcome was not statistically significant, the study is observational, and the statin finding was for remaining asymptomatic, not for reducing hospitalization or death. The combined ACEi/ARB plus statin group included only 8 residents.