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Statins and Risk of Thrombosis in Critically ill Patients with COVID-19: A Multicenter Cohort Study

Shmeylan Al Harbi1,2,3, Raed Kensara1,3, Ohoud Aljuhani4

  • 1Pharmaceutical Care Department, 48168King Abdulaziz Medical City, Riyadh, Saudi Arabia.

Clinical and Applied Thrombosis/Hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis
|June 6, 2022
PubMed

Insights

Statins did not reduce thrombosis risk in critically ill COVID-19 patients. However, statin use was linked to improved survival rates in intensive care unit (ICU) patients.

Area of Science:

  • Critical care medicine
  • Infectious diseases
  • Pharmacology

Background:

  • Severe COVID-19 is associated with significant coagulation abnormalities, including venous thromboembolism (VTE).
  • Hypercoagulability and hyperfibrinogenemia in COVID-19 can lead to major thrombotic events.
  • Statins possess pleiotropic effects, suggesting potential as an adjuvant therapy for COVID-19.

Purpose of the Study:

  • To investigate the efficacy of statin therapy in mitigating thrombosis risk among hospitalized, critically ill COVID-19 patients.
  • To evaluate the impact of statins on venous thromboembolism (VTE) and overall thrombosis in this patient population.

Main Methods:

  • A multicenter, retrospective cohort study included critically ill adult COVID-19 patients admitted to ICUs.
  • Patients were stratified based on statin use during their ICU stay and matched using propensity scores.
  • The primary outcome assessed was the occurrence of all thrombosis cases, with VTE events as a key secondary outcome.

Main Results:

  • Propensity score matching included 396 patients (198 per group).
  • No significant difference in the odds of overall thrombosis (OR 0.84; P=0.62) or VTE (OR 1.13; P=0.81) was observed between statin and non-statin groups.
  • Statin therapy was associated with reduced 30-day mortality (HR 0.72; P=0.03) and in-hospital mortality (HR 0.67; P=0.007).

Conclusions:

  • Statin therapy in the ICU setting did not demonstrate a reduction in thrombosis risk for critically ill COVID-19 patients.
  • Statin use was associated with significant survival benefits, including lower 30-day and in-hospital mortality.
  • Further research may explore the specific mechanisms behind the survival benefits of statins in severe COVID-19.
Abstract

Keywords:
COVID-19SARS-CoV-2critical illnesshydroxymethylglutaryl-CoA reductase inhibitorsinflammationmortalitystatinthrombosisvenous thromboembolism

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