Association Between Statin Use, Cytokine Storm, and Clinical Outcomes in COVID-19 Patients with Diabetes

Objective: To examine patterns of inflammatory markers, kidney function, and clinical outcomes in patients with type 2 diabetes (T2D) hospitalized for COVID-19, with particular focus on the impact of therapy with hydroxymethylglutaryl-CoA reductase inhibitors (statins). Methods: We conducted a retrospective analysis of 440 T2D patients, divided into those who were on statin therapy prior to hospitalization and those who were not. Clinical characteristics, laboratory markers of inflammation, kidney function, and the requirement for invasive ventilation were compared between the groups. Results: Patients were predominantly older adults with a high burden of comorbidities, most commonly arterial hypertension and chronic kidney disease, and presented with elevated inflammatory markers and hyperglycemia at admission. Statin users more frequently had cardiovascular comorbidities and showed lower unadjusted interleukin-6 (IL-6) and ferritin levels, although these differences were not significant after multivariable adjustment. Importantly, statin therapy was independently associated with lower odds of mechanical ventilation in multivariable analysis. Conclusions: Despite a higher prevalence of cardiovascular comorbidities, diabetic patients receiving statins had lower odds of mechanical ventilation. No independent association with inflammatory markers was confirmed, and the observed relationship with respiratory outcomes should be interpreted cautiously given the observational design.