Prior Statin vs In-Hospital Statin Usage in Severe COVID-19: Review and Meta-Analysis

Studies have shown that statins can decrease COVID-19 mortality in hospitalized patients. This paper evaluates these studies and reviews the possible mechanism of how statins modulate COVID-19 severity. Meta-analysis of 31 retrospective studies demonstrated a reduction in mortality rate among statin users (OR 0.69, 95% CI 0.56-0.86, P = 0.0008) (HR 0.83, 95% CI 0.72-0.95, P = 0.0078). Meta-analysis of 8 randomized control studies demonstrated a nonsignificant reduction in mortality (OR 0.90, 95% CI 0.69-1.18, P = 0.461), including 4 studies with medications other than statins, and 4 studies with only statins (OR 0.88, 95% CI 95% CI 0.64-1.21, P = 0.423). Prolonged statin usage decreases the extracellular localization of ACE2, along with statins' immunomodulating effects and reduction of oxidative stress, decreases COVID-19 mortality. Hospitalized patients with COVID-19 should continue statin treatment if previously prescribed, and patients should not be started on statins, as they do not seem to provide any mortality benefit.