The use of statins appears to benefit patients hospitalized with coronavirus disease 2019 (COVID-19), according to the findings of a retrospective study conducted in Hubei Province, China.
The study included 13,981 COVID-19 patients in 21 hospitals in Hubei Province, China. Of these patients, 1219 used statins, 319 used statins plus angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs), and 603 used statins plus other antihypertensive medications.
Mortality rates were analyzed as well as several secondary outcomes, including the incidence of mechanical ventilation, intensive care unit (ICU) admission, acute respiratory distress syndrome (ARDS), and injury to the liver, kidney, or heart. Subset analyses were also performed since the majority of patients taking statins were older and had a higher incidence of lung lesions and chronic diseases. The follow-up period of the study was 28 days.
Findings revealed that statin use was associated with a lower mortality rate compared with non-statin use (5.5% vs 6.8%, respectively; 19% decrease). Similarly, when the patients were matched for baseline characteristics (age, disease severity, and pre-existing conditions), a lower mortality rate was also observed in patients who received statins compared with those who did not (9.4% vs 5.2%, respectively; 45% decrease). Additionally, statin use was found to be associated with lower levels of inflammatory biomarkers, as well as lower rates of ARDS and ICU admission in the matched cohort.
Results also showed that, in the matched cohort, combination therapy of a statin plus an ACE inhibitor or ARB was not only associated with a lower mortality rate compared with the combination of a statin plus another antihypertensive agent (3.4% vs 9.8%, respectively; 65% decrease), but also lower rates of heart injury and ARDS. These differences were not observed in the unmatched sample.
“Due to the nature of such retrospective studies, these results should be interpreted with caution; however, these data provide supportive evidence for the safety of statin or combination of a statin with ACEi/ARB for treatment in patients with COVID-19,” the study authors concluded. They added, “Further [randomized controlled trials] to prospectively explore the efficacy of statins on COVID-19 outcomes are urgently needed.”
Zhang XJ, Qin JJ, Cheng X, et al. In-Hospital use of statins is associated with a reduced risk of mortality among Individuals with COVID-19 [published online June 24, 2020]. Cell Metabolism. doi: 10.1016/j.cmet.2020.06.015.