Association between antecedent statin use and decreased mortality in hospitalized patients with COVID-19

The coronavirus disease 2019 (COVID-19) can result in a hyperinflammatory state, leading to acute respiratory distress syndrome (ARDS), myocardial injury, and thrombotic complications, among other sequelae. Statins, which are known to have anti-inflammatory and antithrombotic properties, have been studied in the setting of other viral infections, but their benefit has not been assessed in COVID-19.

2021-02-26

Gupta, Aakriti, Mahesh V. Madhavan, Timothy J. Poterucha, Ersilia M. DeFilippis, Jessica A. Hennessey, Bjorn Redfors, Christina Eckhardt, Behnood Bikdeli, Jonathan Platt, Ani Nalbandian, Pierre Elias, Matthew J. Cummings, Shayan N. Nouri, Matthew Lawlor, Lauren S. Ranard, Jianhua Li, Claudia Boyle, Raymond Givens, Daniel Brodie, Harlan M. Krumholz, Gregg W. Stone, Sanjum S. Sethi, Daniel Burkhoff, Nir Uriel, Allan Schwartz, Martin B. Leon, Ajay J. Kirtane, Elaine Y. Wan, and Sahil A. Parikh. 2021. "Association between antecedent statin use and decreased mortality in hospitalized patients with COVID-19." Nature Communications 12 (1):1325.

The coronavirus disease 2019 (COVID-19) can result in a hyperinflammatory state, leading to acute respiratory distress syndrome (ARDS), myocardial injury, and thrombotic complications, among other sequelae. Statins, which are known to have anti-inflammatory and antithrombotic properties, have been studied in the setting of other viral infections, but their benefit has not been assessed in COVID-19. This is a retrospective analysis of patients admitted with COVID-19 from February 1^st through May 12^th, 2020 with study period ending on June 11^th, 2020. Antecedent statin use was assessed using medication information available in the electronic medical record. We constructed a multivariable logistic regression model to predict the propensity of receiving statins, adjusting for baseline sociodemographic and clinical characteristics, and outpatient medications. The primary endpoint includes in-hospital mortality within 30 days. A total of 2626 patients were admitted during the study period, of whom 951 (36.2%) were antecedent statin users. Among 1296 patients (648 statin users, 648 non-statin users) identified with 1:1 propensity-score matching, statin use is significantly associated with lower odds of the primary endpoint in the propensity-matched cohort (OR 0.47, 95% CI 0.36–0.62, p < 0.001). We conclude that antecedent statin use in patients hospitalized with COVID-19 is associated with lower inpatient mortality.

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