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

• Published in: Cell metabolism Vol. 32; no. 2; pp. 176 - 187.e4
• Main Authors: Zhang, Xiao-Jing, Qin, Juan-Juan, Cheng, Xu, Shen, Lijun, Zhao, Yan-Ci, Yuan, Yufeng, Lei, Fang, Chen, Ming-Ming, Yang, Huilin, Bai, Liangjie, Song, Xiaohui, Lin, Lijin, Xia, Meng, Zhou, Feng, Zhou, Jianghua, She, Zhi-Gang, Zhu, Lihua, Ma, Xinliang, Xu, Qingbo, Ye, Ping, Chen, Guohua, Liu, Liming, Mao, Weiming, Yan, Youqin, Xiao, Bing, Lu, Zhigang, Peng, Gang, Liu, Mingyu, Yang, Jun, Yang, Luyu, Zhang, Changjiang, Lu, Haofeng, Xia, Xigang, Wang, Daihong, Liao, Xiaofeng, Wei, Xiang, Zhang, Bing-Hong, Zhang, Xin, Yang, Juan, Zhao, Guang-Nian, Zhang, Peng, Liu, Peter P., Loomba, Rohit, Ji, Yan-Xiao, Xia, Jiahong, Wang, Yibin, Cai, Jingjing, Guo, Jiao, Li, Hongliang
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 04.08.2020
• Subjects: ACEi/ARB; Aged; Angiotensin-Converting Enzyme 2; Angiotensin-Converting Enzyme Inhibitors - therapeutic use; Antihypertensive Agents - therapeutic use; Betacoronavirus - drug effects; Comorbidity; Coronavirus Infections - drug therapy; Coronavirus Infections - mortality; COVID-19; 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; mortality; Pandemics; Peptidyl-Dipeptidase A - drug effects; Pneumonia, Viral - drug therapy; Pneumonia, Viral - mortality; Retrospective Studies; SARS-COV-2; statin; COVID-19; mortality; ACEi/ARB; statin; SARS-COV-2
• DOI: 10.1016/j.cmet.2020.06.015
• ISSN: 1550-4131; 1932-7420

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. [Display omitted] •Statin treatment among 13,981 patients with COVID-19 was retrospectively studied•Statin use in this cohort was associated with a lower risk of all-cause mortality•Adding an ACE inhibitor or an ARB did not affect statin-associated outcome in the cohort•The benefit of statins among this cohort may be due to immunomodulatory benefits Statins have anti-inflammatory benefits and were suggested as an adjunct therapy for COVID-19. But statins may increase the expression of ACE2, the receptor for SARS-CoV-2. Here, Zhang et al. retrospectively analyzed 13,981 COVID-19 cases and found that in-hospital statin use is associated with a lower risk of all-cause mortality.