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      The Effect of Statins on Clinical Outcome Among Hospitalized Patients With COVID-19: A Multi-Centric Cohort Study

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          Abstract

          The coronavirus disease-2019 (COVID-19) is caused by SARS-CoV-2, leading to acute respiratory distress syndrome (ARDS), thrombotic complications, and myocardial injury. Statins, prescribed for lipid reduction, have anti-inflammatory, anti-thrombotic, and immunomodulatory properties and are associated with reduced mortality rates in COVID-19 patients. Our goal was to investigate the beneficial effects of statins in hospitalized COVID-19 patients admitted to three multi-specialty hospitals in India from 1 June 2020, to 30 April 2021. This retrospective study included 1,626 patients, of which 524 (32.2%) were antecedent statin users among 768 patients (384 statin users, 384 non-statin users) identified with 1:1 propensity-score matching. We established a multivariable logistic regression model to identify the patients’ demographics and adjust the baseline clinical and laboratory characteristics and co-morbidities. Statin users showed a lower mean of white blood cell count (7.6 × 10 3/µL vs. 8.1 × 10 3/µL, p < 0.01), and C-reactive protein (100 mg/L vs. 120.7 mg/L, p < 0.001) compared to non-statin COVID-19 patients. The same positive results followed in lipid profiles for patients on statins. Cox proportional-hazards regression models evaluated the association between statin use and mortality rate. The primary endpoint involved mortality during the hospital stay. Statin use was associated with lower odds of mortality in the propensity-matched cohort (OR 0.52, 95% CI 0.33-0.64, p < 0.001). These results support the previous evidence of the beneficial effects of statins in reducing mortality in hospitalized COVID-19 patients.

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          Clinical Characteristics of Coronavirus Disease 2019 in China

          Abstract Background Since December 2019, when coronavirus disease 2019 (Covid-19) emerged in Wuhan city and rapidly spread throughout China, data have been needed on the clinical characteristics of the affected patients. Methods We extracted data regarding 1099 patients with laboratory-confirmed Covid-19 from 552 hospitals in 30 provinces, autonomous regions, and municipalities in mainland China through January 29, 2020. The primary composite end point was admission to an intensive care unit (ICU), the use of mechanical ventilation, or death. Results The median age of the patients was 47 years; 41.9% of the patients were female. The primary composite end point occurred in 67 patients (6.1%), including 5.0% who were admitted to the ICU, 2.3% who underwent invasive mechanical ventilation, and 1.4% who died. Only 1.9% of the patients had a history of direct contact with wildlife. Among nonresidents of Wuhan, 72.3% had contact with residents of Wuhan, including 31.3% who had visited the city. The most common symptoms were fever (43.8% on admission and 88.7% during hospitalization) and cough (67.8%). Diarrhea was uncommon (3.8%). The median incubation period was 4 days (interquartile range, 2 to 7). On admission, ground-glass opacity was the most common radiologic finding on chest computed tomography (CT) (56.4%). No radiographic or CT abnormality was found in 157 of 877 patients (17.9%) with nonsevere disease and in 5 of 173 patients (2.9%) with severe disease. Lymphocytopenia was present in 83.2% of the patients on admission. Conclusions During the first 2 months of the current outbreak, Covid-19 spread rapidly throughout China and caused varying degrees of illness. Patients often presented without fever, and many did not have abnormal radiologic findings. (Funded by the National Health Commission of China and others.)
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            Potential Effects of Coronaviruses on the Cardiovascular System: A Review

            Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19) has reached a pandemic level. Coronaviruses are known to affect the cardiovascular system. We review the basics of coronaviruses, with a focus on COVID-19, along with their effects on the cardiovascular system.
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              The Cytokine storm in COVID-19: An overview of the involvement of the chemokine/chemokine-receptor system

              Highlights • COVID-19 pandemic is raging worldwide and is putting health-care systems under severe strain. • The “cytokine storm” and the subsequent Acute Respiratory Distress Syndrome results from the effects of a combination of several immune-active molecules. • the “cytokine storm” appears as one of the most dangerous and potentially life-threatening event related to COVID-19 sustaining its major clinical consequences. • The chemokine system appears to be deeply involved in the pathogenesis of severe clinical sequelae of COVID-19, similarly to what was observed in SARS and MERS epidemics.
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                Author and article information

                Contributors
                Journal
                Front Pharmacol
                Front Pharmacol
                Front. Pharmacol.
                Frontiers in Pharmacology
                Frontiers Media S.A.
                1663-9812
                05 July 2022
                2022
                05 July 2022
                : 13
                : 742273
                Affiliations
                [1] 1 Department of Para-clinical sciences , Faculty of Medical Sciences , The University of the West Indies, St Augustine , Trinidad, Trinidad and Tobago
                [2] 2 Project Lead and Research Programmee Committee Member , International Research Association Unit , India
                [3] 3 Director and Consultant in Emergency Medicine , Department of Medicine , RRN Multispeciality Hospital , India
                [4] 4 Consultant Pulmonologist , Department of Medicine , Holy Cross Hospital , Nagercoil, India
                [5] 5 National Regional Collaboration for Medical Research Foundation , India
                [6] 6 Department of Biostatistics, Epidemiology, and Informatics , Piramal Research Centre , Gujarat, India
                [7] 7 Medical Residents , Swaminathan Multispecialty Hospital , Chennai, India
                Author notes

                Edited by: Hendrik W. Van Veen, University of Cambridge, United Kingdom

                Reviewed by: Boghuma Titanji, Emory University, United States

                Juan Moisés De La Serna, Universidad Internacional De La Rioja, Spain

                *Correspondence: Srikanth Umakanthan, Srikanth.Umakanthan@ 123456sta.uwi.edu

                This article was submitted to Pharmacology of Infectious Diseases, a section of the journal Frontiers in Pharmacology

                Article
                742273
                10.3389/fphar.2022.742273
                9294274
                35865966
                7aad0a63-9a89-4fa5-8178-bde14a9aa405
                Copyright © 2022 Umakanthan, Senthil, John, Madhavan, Das, Patil, Rameshwaram, Cintham, Subramaniam, Yogi, Bansal, Achutham, Shekar, Murthy and Selvaraj.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 15 July 2021
                : 14 June 2022
                Categories
                Pharmacology
                Original Research

                Pharmacology & Pharmaceutical medicine
                covid-19,statins,cohort,mortality,propensity
                Pharmacology & Pharmaceutical medicine
                covid-19, statins, cohort, mortality, propensity

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