학술논문
Simvastatin in Critically Ill Patients with Covid-19.
Document Type
article
Author
Hills, Thomas; Lorenzi, Elizabeth; Berry, Lindsay; Shyamsundar, Murali; Al-Beidh, Farah; Annane, Djillali; Arabi, Yaseen; Aryal, Diptesh; Au, Carly; Beane, Abigail; Bhimani, Zahra; Bonten, Marc; Bradbury, Charlotte; Brunkhorst, Frank; Burrell, Aidan; Buxton, Meredith; Calfee, Carolyn; Cecconi, Maurizio; Cheng, Allen; Cove, Matthew; Detry, Michelle; Estcourt, Lise; Fitzgerald, Mark; Goligher, Ewan; Goossens, Herman; Green, Cameron; Haniffa, Rashan; Harrison, David; Hashmi, Madiha; Higgins, Alisa; Huang, David; Ichihara, Nao; Jayakumar, Deva; Kruger, Peter; Lamontagne, François; Lampro, Lamprini; Lawler, Patrick; Marshall, John; Mason, Alexina; McGlothlin, Anna; McGuinness, Shay; McQuilten, Zoe; McVerry, Bryan; Mouncey, Paul; Murthy, Srinivas; Neal, Matthew; Nichol, Alistair; OKane, Cecilia; Parke, Rachael; Parker, Jane; Rabindrarajan, Ebenezer; Reyes, Luis; Rowan, Kathryn; Saito, Hiroki; Santos, Marlene; Saunders, Christina; Seymour, Christopher; Shankar-Hari, Manu; Sinha, Pratik; Thompson, B; Turgeon, Alexis; Turner, Anne; van de Veerdonk, Frank; Weis, Sebastian; Young, Ian; Zarychanski, Ryan; McArthur, Colin; Angus, Derek; Berry, Scott; Derde, Lennie; Webb, Steve; Gordon, Anthony; McAuley, Daniel; Lewis, Roger
Source
The New England Journal of Medicine. 389(25)
Subject
Language
Abstract
BACKGROUND: The efficacy of simvastatin in critically ill patients with coronavirus disease 2019 (Covid-19) is unclear. METHODS: In an ongoing international, multifactorial, adaptive platform, randomized, controlled trial, we evaluated simvastatin (80 mg daily) as compared with no statin (control) in critically ill patients with Covid-19 who were not receiving statins at baseline. The primary outcome was respiratory and cardiovascular organ support-free days, assessed on an ordinal scale combining in-hospital death (assigned a value of -1) and days free of organ support through day 21 in survivors; the analyis used a Bayesian hierarchical ordinal model. The adaptive design included prespecified statistical stopping criteria for superiority (>99% posterior probability that the odds ratio was >1) and futility (>95% posterior probability that the odds ratio was