TY - JOUR
T1 - Effects of Pitavastatin on COVID-19 Incidence and Seriousness Among a Global Cohort of People With HIV
AU - Zanni, Markella V.
AU - Umbleja, Triin
AU - Fichtenbaum, Carl J.
AU - Fitch, Kathleen V.
AU - McCallum, Sara
AU - Aberg, Judith A.
AU - Overton, Edgar Turner
AU - Malvestutto, Carlos D.
AU - Bloomfield, Gerald S.
AU - Currier, Judith S.
AU - Schnittman, Samuel R.
AU - Erlandson, Kristine M.
AU - Diggs, Marissa R.
AU - Foldyna, Borek
AU - Martinez, Esteban
AU - Somboonwit, Charurut
AU - Wang, Gary P.
AU - Mushatt, David
AU - Connick, Elizabeth
AU - Lu, Michael T.
AU - Douglas, Pamela S.
AU - Ribaudo, Heather J.
AU - Grinspoon, Steven K.
N1 - Publisher Copyright:
© The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America.
PY - 2024/10/1
Y1 - 2024/10/1
N2 - Background. Among people with HIV (PWH), COVID-19 is common and potentially severe. We leveraged REPRIEVE (Randomized Trial to Prevent Vascular Events in HIV) to assess the effects of statin therapy for cardiovascular disease prevention on COVID-19 outcomes (incidence and serious cases) among a global cohort of PWH. Methods. COVID-19 data collection was implemented April 2020 to capture events from January 2020. COVID-19 was defined by positive test result or clinical diagnosis and serious COVID-19 according to the International Conference on Harmonisation definition. Among participants in follow-up on 1 January 2020, Cox proportional hazards modeling was used to estimate the hazard ratio (HR) of COVID-19 (pitavastatin/placebo), stratified by Global Burden of Disease region. Modification of statin effect following COVID-19 vaccination was evaluated via interaction with time-updated vaccination status. Results. Among 6905 PWH, 32% were natal female and 41% were Black or African American. The median age was 53 years and the 10-year atherosclerotic cardiovascular disease risk score 4.5%. Statin therapy did not reduce COVID-19 incidence (HR, 1.05; 95% CI, .95–1.15) but appeared to reduce incidence of serious COVID-19 (HR, 0.75; 95% CI, .52–1.09). Among 1701 PWH with COVID-19, the relative risk (pitavastatin/placebo) for serious COVID-19 was 0.73 (95% CI, .52–1.03). The treatment effect size for serious COVID-19 fell within the hypothesized range, but the 95% CI crossed 1 given fewer-than-anticipated cases (117 vs 200). Furthermore, 83% reported COVID-19 vaccination by end of study, with a strong protective effect on serious COVID-19 (HR, 0.27; 95% CI, .14–.53; P < .0001). A protective statin effect was observed prior to vaccination. Conclusions. Among PWH, statin therapy had no effect on COVID-19 incidence but showed potential to reduce risk of serious COVID-19 prior to COVID-19 vaccination.
AB - Background. Among people with HIV (PWH), COVID-19 is common and potentially severe. We leveraged REPRIEVE (Randomized Trial to Prevent Vascular Events in HIV) to assess the effects of statin therapy for cardiovascular disease prevention on COVID-19 outcomes (incidence and serious cases) among a global cohort of PWH. Methods. COVID-19 data collection was implemented April 2020 to capture events from January 2020. COVID-19 was defined by positive test result or clinical diagnosis and serious COVID-19 according to the International Conference on Harmonisation definition. Among participants in follow-up on 1 January 2020, Cox proportional hazards modeling was used to estimate the hazard ratio (HR) of COVID-19 (pitavastatin/placebo), stratified by Global Burden of Disease region. Modification of statin effect following COVID-19 vaccination was evaluated via interaction with time-updated vaccination status. Results. Among 6905 PWH, 32% were natal female and 41% were Black or African American. The median age was 53 years and the 10-year atherosclerotic cardiovascular disease risk score 4.5%. Statin therapy did not reduce COVID-19 incidence (HR, 1.05; 95% CI, .95–1.15) but appeared to reduce incidence of serious COVID-19 (HR, 0.75; 95% CI, .52–1.09). Among 1701 PWH with COVID-19, the relative risk (pitavastatin/placebo) for serious COVID-19 was 0.73 (95% CI, .52–1.03). The treatment effect size for serious COVID-19 fell within the hypothesized range, but the 95% CI crossed 1 given fewer-than-anticipated cases (117 vs 200). Furthermore, 83% reported COVID-19 vaccination by end of study, with a strong protective effect on serious COVID-19 (HR, 0.27; 95% CI, .14–.53; P < .0001). A protective statin effect was observed prior to vaccination. Conclusions. Among PWH, statin therapy had no effect on COVID-19 incidence but showed potential to reduce risk of serious COVID-19 prior to COVID-19 vaccination.
KW - COVID-19
KW - HIV
KW - PWH
KW - REPRIEVE
KW - statin
UR - https://www.scopus.com/pages/publications/85208130519
UR - https://www.scopus.com/pages/publications/85208130519#tab=citedBy
U2 - 10.1093/ofid/ofae574
DO - 10.1093/ofid/ofae574
M3 - Article
AN - SCOPUS:85208130519
SN - 2328-8957
VL - 11
JO - Open Forum Infectious Diseases
JF - Open Forum Infectious Diseases
IS - 10
M1 - ofae574
ER -