Statin Use Associated with Lower COVID-19 Mortality, Spanish Study Shows

Lluis Masana, MD, PhD

Less than 2 weeks after an analysis detailed the apparent effects of statin use on mortality in patients with diabetes hospitalized with coronavirus disease 2019 (COVID-19), a new study is adding further credence to the idea that the anti-inflammatory effects of statins could play a role in reducing COVID-19 mortality.

Using data from more than 2000 patients presenting to more than a dozen medical centers across Spain, investigators concluded use of statins was associated with a 22-25% lower risk of mortality among patients hospitalized with COVID-19.

“Not only do these findings demonstrate that treatment with statins has no negative on the evolution of COVID-19, they also show that it significantly reduces patient mortality,” said lead investigator Lluis Masana, MD, of the Lipid and Arteriosclerosis Research Unit at the Universitat Rovira i Virgili (URV)’s Department of Medicine and Surgery, in a statement.

With recent studies and many clinicians suggesting the anti-inflammatory effects of statins could have on patients with COVID-19, Masana and a team of colleagues designed a study to create a more clear determination on the effects of statins using patients admitted to a group of 19 hospitals in Catalonia, Spain. From these hospitals, which were all members of the Lipids and Arteriosclerosis Units Net (XULA) of Catalonia, investigators obtained clinical data related to 2157 patients with COVID-19 diagnoses confirmed via reverse transcription-polymerase chain reaction (RT-PCR) tests.

Patients were considered eligible for inclusion in the study if they were at least 18 years of age or older and if they had a community-acquired infection. Statin therapy among these patients was categorized as high intensity or low-moderate intensity.

Of the 2157 patients, 1234 were men and the population had a median age of 67 (IQR, 54-78) years. From this group, 353 deaths were identified and 581 patients reported use of statin therapy. Of the 581 reporting use of statin therapy at admission, 30% were considered to be on high-intensity statin therapy. Among the 581 reporting statin use at admission, 245 had statin therapy withdrawn with the fiat 48 hours of admission while statin therapy was unchanged in the remaining 336 patients.

In univariate analyses after genetic matching, results indicated a significantly lower rate among patients receiving statin therapy when compared to those in a matched non-statin group (19.8% vs 25.4%, X2 with Yates continuity correction, P=.027). Further analysis, which also included genetic matching, indicated the mortality rate associated with statin use was even lower in patients who maintained statin therapy versus those who withdrew from statin therapy following admission (17.4%; P=.045).

Investigators pointed out determined applying Cox proportional hazards model to cause-specific hazard function (HR, 0.58; 95% CI, 0.39-0.89; P=.01) and the competing risks Fine and Gray model suggested use of statins was associated with reduced COVID-19-related mortality (HR, 0.60; 95% CI, 0.39-0.92; P=.02).

“In the case of statins, we have demonstrated that fear of the pandemic should never be used as an excuse to suspend treatment,” added Masana.

This study, “Effect of Statin Therapy on SARS-CoV-2 Infection-Related Mortality in Hospitalized Patients,” was published in the European Heart Journal - Cardiovascular Pharmacotherapy.