In-Hospital Use of Statins Is Associated with a Reduced Risk of Mortality among Individuals with COVID-19

Cell Metab. 2020 Aug 4;32(2):176-187.e4. doi: 10.1016/j.cmet.2020.06.015. Epub 2020 Jun 24.

Abstract

Statins are lipid-lowering therapeutics with favorable anti-inflammatory profiles and have been proposed as an adjunct therapy for COVID-19. However, statins may increase the risk of SARS-CoV-2 viral entry by inducing ACE2 expression. Here, we performed a retrospective study on 13,981 patients with COVID-19 in Hubei Province, China, among which 1,219 received statins. Based on a mixed-effect Cox model after propensity score-matching, we found that the risk for 28-day all-cause mortality was 5.2% and 9.4% in the matched statin and non-statin groups, respectively, with an adjusted hazard ratio of 0.58. The statin use-associated lower risk of mortality was also observed in the Cox time-varying model and marginal structural model analysis. These results give support for the completion of ongoing prospective studies and randomized controlled trials involving statin treatment for COVID-19, which are needed to further validate the utility of this class of drugs to combat the mortality of this pandemic.

Keywords: ACEi/ARB; COVID-19; SARS-COV-2; mortality; statin.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Angiotensin-Converting Enzyme 2
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use*
  • Antihypertensive Agents / therapeutic use*
  • Betacoronavirus / drug effects
  • COVID-19
  • Comorbidity
  • Coronavirus Infections / drug therapy*
  • Coronavirus Infections / mortality
  • Cytokine Release Syndrome / drug therapy
  • Drug Repositioning / methods*
  • Drug Therapy, Combination
  • Female
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
  • Hypertension / drug therapy
  • Male
  • Middle Aged
  • Pandemics
  • Peptidyl-Dipeptidase A / drug effects
  • Pneumonia, Viral / drug therapy*
  • Pneumonia, Viral / mortality
  • Retrospective Studies
  • SARS-CoV-2

Substances

  • Angiotensin-Converting Enzyme Inhibitors
  • Antihypertensive Agents
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Peptidyl-Dipeptidase A
  • ACE2 protein, human
  • Angiotensin-Converting Enzyme 2