Statin Use Tied to Lower Mortality Among Diabetics Hospitalized with COVID-19

This study originally appeared on Practical Cardiology's sister site, EndocrinologyNetwork.com.

Data from a study of more than 4000 patients admitted to a New York City medical center with coronavirus disease 2019 (COVID-19) suggests statin use could reduce the risk of death by 12% in patients with diabetes.​

Performed by investigators at the Albert Einstein College of Medicine, results of the study give credence to the idea the anti-inflammatory effect of statin therapy could reduce the severity of COVID-19.

“In this analysis involving a large cohort of hospitalized patients with COVID-19, statin use was associated with reduced in-hospital mortality in patients with diabetes,” wrote investigators. “This observation was made despite older age, higher prevalence of hypertension and atherosclerotic heart disease in diabetic statin users.”

With the anti-inflammatory effects of statin therapy described in multiple studies, a team led by Omar Saeed, MD, sought to determine whether use would impact outcomes in patients with COVID-19. With this in mind, they designed an analysis to assess data collected from within the Montefiore Medical Center in the Bronx, New York.

Using March 1, 2020 to May 2, 2020 as the study period, investigators conducted a retrospective analysis of consecutive patients admitted with COVID-19. Overall, 4252 patients were admitted during the study period. The mean age of this cohort was 65±16 years and 53% were male. Among the most prevalent comorbidities were atherosclerotic cardiovascular disease (23%), diabetes (53%), and hypertension (72%).

Among the 4252-patient cohort, 1355 received a statin. Those who received a statin were generally older and had a higher Charlson comorbidity index (5; IQR, 3-8 vs 3; IQR, 1-5; P <.01). Initial analysis indicated patients reviving a statin had a lower cumulative rate of in-hospital mortality compared to those not receiving a statin (23% vs 27%; P <.01), but investigators found the presence of diabetes modified this apparent effect.

Of the 4252 patients included in the study, 2266 were considered diabetic. Of these 2266, 983 received and 1283 did not receive a statin. When stratifying by diabetes status, patients with diabetes receiving a statin had a low cumulative in-hospital mortality than those not receiving a statin (24% vs 39%; P <.01), but no difference was observed among patients without diabetes (20% vs 21%; P=.82).

In a multivariable regression model, investigators determined statin use among patients with diabetes was associated with a 49% reduction for in-hospital mortality(HR, 0.51; 95% CI, 0.43-0.61). In propensity score-matched analyses using caliper matching (HR, 0.88; 95% CI, 0.83-0.94; P <.01) or inverse probably treatment waiting (HR, 0.88; 95% CI, 0.84-0.92; P <.01), statin use was associated with a 12% lower risk of death during hospitalization for statin users compared to non-users.

“In this observational analysis, statin administration to patients with diabetes was associated with a reduced risk of in-hospital mortality during COVID-19. Further study to validate our findings and investigate underlying mechanisms is needed,” wrote investigators.

This study, “Statin Use and In-Hospital Mortality in Diabetics with COVID-19,” was published in the Journal of the American Heart Association.