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Statins reduce mortality in patients with COVID-19: an updated meta-analysis of 147 824 patients
Carlos Diaz-Arocutipa1, Beatriz Melgar-Talavera2, Ángel Alvarado-Yarasca3
1Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru; Programa de Atencion Domiciliaria - EsSalud, Lima, Peru; Asociación para el Desarrollo de la Investigación Estudiantil en Ciencias de la Salud (ADIECS), Lima, Peru.
Insights
Statin use in COVID-19 patients showed reduced mortality in adjusted analyses. Chronic statin use was particularly effective, but further randomized trials are needed for confirmation.
Area of Science:
- Cardiology
- Infectious Diseases
- Epidemiology
Background:
- Conflicting evidence exists regarding statin efficacy in COVID-19 patients.
- Statins are commonly prescribed for cardiovascular disease prevention.
- Understanding statin's role in COVID-19 outcomes is crucial.
Purpose of the Study:
- To systematically review and meta-analyze the effect of statin use on mortality in COVID-19 patients.
- To clarify the association between statin therapy and clinical outcomes in COVID-19.
Main Methods:
- Systematic review and meta-analysis of 25 cohort studies.
- Inclusion of data from 147,824 COVID-19 patients.
- Pooled unadjusted and adjusted effect estimates using random-effects models.
Main Results:
- Unadjusted analyses showed no association between statin use and mortality.
- Adjusted analyses (OR, HR) revealed a significant reduction in mortality with statin use.
- Chronic statin use demonstrated a significant mortality reduction in adjusted models.
Conclusions:
- Adjusted data suggest statins are associated with lower mortality in COVID-19 patients.
- Chronic statin use appears particularly beneficial.
- Randomized controlled trials are necessary to validate these findings.
Objectives:
There is conflicting evidence about the efficacy of statin use in regard to clinical outcomes in patients with coronavirus disease 2019 (COVID-19). A systematic review and meta-analysis was performed to examine the effect of statin use on mortality in COVID-19 patients.
Methods:
The electronic databases were searched, from inception to March 3, 2021. Unadjusted and adjusted effect estimates with their 95% confidence intervals (95% CI) were pooled using random-effects models.
Results:
Twenty-five cohort studies involving 147 824 patients were included. The mean age of the patients ranged from 44.9 to 70.9 years; 57% of patients were male and 43% were female. The use of statins was not associated with mortality when applying the unadjusted risk ratio (uRR 1.16, 95% CI 0.86-1.57; 19 studies). In contrast, meta-analyses of the adjusted odds ratio (aOR 0.67, 95% CI 0.52-0.86; 11 studies) and adjusted hazard ratio (aHR 0.73, 95% CI 0.58-0.91; 10 studies) showed that statins were independently associated with a significant reduction in mortality. Subgroup analyses showed that only chronic use of statins significantly reduced mortality according to the adjusted models.
Conclusions:
The use of statins was found to be associated with a lower risk of mortality in COVID-19 patients based on adjusted effects of cohort studies. However, randomized controlled trials are still needed to confirm these findings.
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