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Statins in patients with COVID-19: a retrospective cohort study in Iranian COVID-19 patients
Payam Peymani1,2,3, Tania Dehesh4, Farnaz Aligolighasemabadi5
1Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran.
Insights
Statins may offer benefits for COVID-19 patients, potentially reducing mortality and morbidity. Further research is needed to confirm these promising findings for coronavirus disease 2019 (COVID-19) treatment.
Area of Science:
- Cardiology
- Infectious Diseases
- Pharmacology
Background:
- The COVID-19 pandemic, caused by SARS-CoV-2, lacks approved treatments, necessitating rapid therapeutic strategies.
- Repurposing existing drugs like statins, known for safety and pleiotropic effects, is an efficient approach.
- Prior research indicated statins possess antiviral properties and aid lung healing.
Purpose of the Study:
- To investigate the association between statin use and mortality rates in patients diagnosed with COVID-19.
- To evaluate the potential of statins in mitigating severe outcomes of SARS-CoV-2 infection.
Main Methods:
- A retrospective study involving 150 COVID-19 patients (75 on statins) from Shiraz, Iran.
- Cox proportional-hazards regression models and propensity score matching were employed.
- Analysis focused on mortality, morbidity, mechanical ventilation, and CT scan results.
Main Results:
- Statin use showed a trend towards lower risk of morbidity (HR=0.85) and death (HR=0.76), but not statistically significant.
- No significant association was found between statin use and reduced mortality (P=0.735).
- Statin use was linked to reduced need for mechanical ventilation and more normal CT scan results, though not statistically significant.
Conclusions:
- While not statistically significant, results suggest statins may have clinical relevance in managing COVID-19.
- Further prospective randomized controlled trials are warranted to validate statins' benefits.
- Extensive retrospective studies are recommended to confirm effects on COVID-19 clinical symptoms and mortality.
Background:
The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has profoundly affected the lives of millions of people. To date, there is no approved vaccine or specific drug to prevent or treat COVID-19, while the infection is globally spreading at an alarming rate. Because the development of effective vaccines or novel drugs could take several months (if not years), repurposing existing drugs is considered a more efficient strategy that could save lives now. Statins constitute a class of lipid-lowering drugs with proven safety profiles and various known beneficial pleiotropic effects. Our previous investigations showed that statins have antiviral effects and are involved in the process of wound healing in the lung. This triggered us to evaluate if statin use reduces mortality in COVID-19 patients.
Results:
After initial recruitment of 459 patients with COVID-19 (Shiraz province, Iran) and careful consideration of the exclusion criteria, a total of 150 patients, of which 75 received statins, were included in our retrospective study. Cox proportional-hazards regression models were used to estimate the association between statin use and rate of death. After propensity score matching, we found that statin use appeared to be associated with a lower risk of morbidity [HR = 0.85, 95% CI = (0.02, 3.93), P = 0.762] and lower risk of death [(HR = 0.76; 95% CI = (0.16, 3.72), P = 0.735)]; however, these associations did not reach statistical significance. Furthermore, statin use reduced the chance of being subjected to mechanical ventilation [OR = 0.96, 95% CI = (0.61-2.99), P = 0.942] and patients on statins showed a more normal computed tomography (CT) scan result [OR = 0.41, 95% CI = (0.07-2.33), P = 0.312].
Conclusions:
Although we could not demonstrate a significant association between statin use and a reduction in mortality in patients with COVID19, we do feel that our results are promising and of clinical relevance and warrant the need for prospective randomized controlled trials and extensive retrospective studies to further evaluate and validate the potential beneficial effects of statin treatment on clinical symptoms and mortality rates associated with COVID-19.
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