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The use of statins was associated with reduced COVID-19 mortality: a systematic review and meta-analysis
Kuan-Sheng Wu1,2, Pei-Chin Lin3,4, Yao-Shen Chen2,5
1Department of Internal Medicine, Division of Infectious Diseases, Kaohsiung Veterans General Hospital, Kaohsiung City, ROC.
Insights
Statin use in COVID-19 patients was linked to lower mortality and reduced need for mechanical ventilation. Further research is recommended to confirm these benefits for severe COVID-19 outcomes.
Area of Science:
- Cardiology
- Infectious Diseases
- Pharmacology
Background:
- Statins are commonly prescribed for metabolic and cardiovascular conditions.
- The impact of statins on COVID-19 outcomes remains uncertain.
- This study aimed to clarify the association between statin use and COVID-19 severity.
Purpose of the Study:
- To investigate the relationship between statin use and COVID-19 outcomes.
- To identify specific patient groups who may benefit most from statins during COVID-19 infection.
- To analyze the effect of statins on mortality, ICU admission, and mechanical ventilation requirements.
Main Methods:
- A systematic review and meta-analysis of 28 observational studies.
- Included data from 63,537 individuals with COVID-19.
- Analyzed dichotomous outcomes including need for invasive mechanical ventilation (IMV), intensive care unit (ICU) admission, and death.
Main Results:
- Statin use was significantly associated with decreased COVID-19 mortality (OR=0.71).
- Statin use was linked to a reduced need for IMV (OR=0.81).
- No significant association was found between statin use and ICU care (OR=0.91).
Conclusions:
- Statin use is associated with reduced mortality and need for IMV in COVID-19 patients.
- Statins do not appear to increase the risk of adverse outcomes and may not need discontinuation upon COVID-19 diagnosis.
- Further randomized controlled trials are warranted to establish a causal link and confirm benefits.
Background:
Statins are widely used to treat people with metabolic and cardiovascular disorders. The effect of statins on coronavirus disease 2019 (COVID-19) is unclear. To investigate the association between statins and COVID-19 outcomes and, if possible, identify the subgroup population that benefits most from statin use.
Materials And Methods:
A systematic review and meta-analysis of published studies that included statin users and described COVID-19 outcomes through 10 November 2020. This study used the generic inverse variance method to perform meta-analyses with random-effects modelling. The main outcomes were evaluation of the need for invasive mechanical ventilator (IMV) support, the need for intensive care unit (ICU) care and death. All outcomes were measured as dichotomous variables.
Results:
A total of 28 observational studies, covering data from 63,537 individuals with COVID-19, were included. The use of statins was significantly associated with decreased mortality (odds ratio [OR] = 0.71, 95% confidence interval [CI]: 0.55-0.92, I2=72%) and the need for IMV (OR = 0.81, 95% CI: 0.69-0.95, I2=0%) but was not linked to the need for ICU care (OR = 0.91, 95% CI: 0.55-1.51, I2=66%). Subgroup analysis further identified five types of studies in which statin users had even lower odds of death.
Conclusions:
The use of statins was significantly associated with a reduced need for IMV and decreased mortality among individuals with COVID-19. Statins may not need to be discontinued because of concern for COVID-19 on admission. Further randomized controlled trial (RCTs) are needed to clarify the causal effect between statin use and severe COVID-19 outcomes.Key messagesParticipants in five types of studies were shown to have even lower odds of death when taking statins.The use of statins was significantly associated with a reduced need for invasive mechanical ventilation and decreased all-cause mortality among individuals with COVID-19. However, statin use did not prevent participants from needing care in the intensive care unit.The results justify performing randomized controlled trials (RCTs) to validate the benefits of statins on COVID-19 outcomes.
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