Statin use linked to reduced risk of severe COVID-19 outcomes

Patients who are on long-term statin therapy may have a reduced risk of severe COVID-19–related outcomes including mortality, intensive care unit (ICU) admission, and requirement for mechanical ventilation, according to a study presented at Anesthesiology 2022.

This observational, retrospective study was carried out using electronic medical data of 38,875 patients hospitalized for COVID-19 between January and September 2020 at 185 hospitals in the US. Thirty percent of the population were chronic statin users (mean age 70.82 years, 47.1 percent female) who were compared with nonusers of statins (mean age 58.44 years, 48.5 percent female).

The risk of all-cause mortality was 31 percent lower among chronic statin users vs nonusers (odds ratio [OR], 0.69, 95 percent confidence interval [CI], 0.64–0.75; p=0.001). [Anesthesiology 2022, abstract A406]

The risk of COVID-19 mortality was also significantly reduced among chronic statin users vs nonusers (OR, 0.63, 95 percent CI, 0.58–0.69), as was the risk of admission to the ICU (OR, 0.69, 95 percent CI, 0.66–0.74) or requirement for mechanical ventilation (OR, 0.60, 95 percent CI, 0.56–0.65; p=0.001 for all).

Patients who were chronic statin users also had a reduced risk of critical (OR, 0.57, 95 percent CI, 0.52–0.61) or severe acute respiratory distress syndrome with COVID-19 (OR, 0.72, 95 percent CI, 0.66–0.79), severe sepsis with septic shock (OR, 0.66, 95 percent CI, 0.57–0.76), or thrombosis (OR, 0.46, 95 percent CI, 0.30–0.72; p=0.001 for all) compared with nonusers. Chronic statin users were also less likely to be discharged to hospice than nonusers (OR, 0.79, 95 percent CI, 0.68–0.88; p=0.001) and had a shorter duration of hospitalization or mechanical ventilation (p=0.001 for both).

The potential association between statin use and reduced risk of COVID-19 outcomes was previously explored in other studies. For instance, one study from France showed a reduced risk of hospitalization for COVID-19 and in-hospital mortality among patients who did vs did not use statins. [J Am Heart Assoc 2022;11:e023357] However, another study, this time conducted at Johns Hopkins Medical Institutions in the US, showed a different result, with no effect of statin use on mortality as well as a potentially increased risk of severe COVID-19 infection. [PLoS One 2021;16:e0256899]

“Results of our study clearly showed regular statin use is associated with reduced risk of death and improved outcomes in hospitalized COVID-19 patients,” said lead author of the present study, Professor Ettore Crimi from the University of Central Florida, Orlando, Florida, US.

“While there is no ‘magic bullet’ to help patients who are very ill with COVID-19, statins decrease inflammation, which may help reduce the severity of the disease,” he continued.

“This research illustrates the importance of evaluating medications that could be repurposed to help patients in ways other than their intended use. Our results suggest statins could be an additional cost-effective solution against COVID-19 disease severity and should be studied further,” Crimi concluded. This further research should evaluate if the relationship between statin use and reduced severe COVID-19 outcomes is a causal one as well as explore drug-disease pharmacokinetics, said Crimi and co-authors.