Preexisting Statin Use Linked to Lower COVID-19 Severity

Ettore Crimi, MD, MBA

A new study presented at the American Society of Anesthesiologists’ ANESTHESIOLOGY 2022 annual meeting suggests use of statin therapy might lower risk of increased disease severity and risk of death among people infected with COVID-19.

A retrospective analysis of electronic health record data from nearly 40,000 people hospitalized during 2020, results of the study suggest preexisting use of statin therapy was associated with a more than 35% reduction in risk of death from COVID-19 and more than 50% reduction in risk of thrombosis compared to nonusers.

“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,” said lead investigator Ettore Crimi, MD, MBA, professor of anesthesiology and critical care medicine, University of Central Florida, in a statement. “Results of our study clearly showed regular statin use is associated with reduced risk of death and improved outcomes in hospitalized COVID-19 patients.”

Few classes of medication have received as much attention for their effects, both proven and purported, as statins. Regarded among cardiology professionals as among the most impactful breakthroughs in history of cardiovascular care, perceived side effects and the “nocebo” effect have placed statins in the public focus in multiple occasions.

The current study, which was conducted by Crimi and a team of colleagues from the University of Central Florida, was created to further examine potential protective benefits of preexisting statin therapy in hospitalized COVID-19 patients observed in other studies. With this in mind, investigators designed their study as an observational, retrospective cohort study of patient data obtained from those hospitalized for COVID-19 at 185 hospitals in the United States from January 1-September 30, 2020.

From their search, investigators identified 43,950 individuals for potential inclusion in their analyses. Among this cohort, 38,875 met inclusion criteria and 23,066 were included in a propensity-matched cohort, which included 11,533 statin users and 27,342 individuals with no prior statin use. The primary outcome of interest for the study was all-cause mortality, but the study also featured a multitude of relevant secondary outcomes, including mortality from COVID-19, risk of acute respiratory distress syndrome (ARDS), and risk of thrombosis.

Results of the investigators’ analyses indicated those with preexisting statin use experienced lower rates of multiple of the study’s outcomes of interest, including all-cause mortality (OR, 0.69 [95% CI 0.64-0.75]; P <.001), mortality from COVID-19 (OR, 0.63 [95% CI 0.58-0.69]; P <.001), discharge to hospice (OR, 0.79 [95% CI 0.68-0.88]; P <.001), ICU admission (OR, 0.69 [95% CI 0.66-0.74]; P <.001), severe ARDS with COVID-19 (OR, 0.72 [95% CI, 0.66-0.79]; P <.001), critical ARDS with COVID-19 (OR, 0.57 [95% CI, 0.52-0.61]; P <.001), mechanical ventilation (OR, 0.6 [95% CI 0.56-0.65]; P <.001), severe sepsis with septic shock (OR, 0.66 [95% CI, 0.57-0.76]; P <.001), thrombosis (OR, 0.46 [95% CI 0.30-0.72]; P <.001), shorter hospital length of stay (P <.001) and shorter duration of mechanical ventilation (P <.001).

“This research illustrates the importance of evaluating medications that could be repurposed to help patients in ways other than their intended use,” Crimi added. “Our results suggest statins could be an additional cost-effective solution against COVID-19 disease severity and should be studied further.”

This study, “Preexisting Use of Statins Is Associated with Decreased Mortality and Morbidity Outcomes in Hospitalized Patients With COVID-19,” was presented at ANESTHESIOLOGY 2022.