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

• DOI: 10.1016/j.cmet.2020.06.015
• Publication Date: 2020-06-24T08:07:37Z
• Authors: Xiao-Jing Zhang; Juan-Juan Qin; Xu Cheng; Lijun Shen; Yan-Ci Zhao; Yufeng Yuan; Fang Lei; Ming-Ming Chen; Huilin Yang; Liangjie Bai; Xiaohui Song; Lijin Lin; Meng Xia; Feng Zhou; Jianghua Zhou; Zhi-Gang She; Lihua Zhu; Xinliang Ma; Qingbo Xu; Ping Ye; Guohua Chen; Liming Liu; Weiming Mao; Youqin Yan; Bing Xiao; Zhigang Lu; Gang Peng; Mingyu Liu; Jun Yang; Luyu Yang; Changjiang Zhang; Haofeng Lu; Xigang Xia; Daihong Wang; Xiaofeng Liao; Xiang Wei; Bing-Hong Zhang; Xin Zhang; Juan Yang; Guang-Nian Zhao; Peng Zhang; Peter P. Liu; Rohit Loomba; Yan-Xiao Ji; Jiahong Xia; Yibin Wang; Jingjing Cai; Jiao Guo; Hongliang Li
• Keywords: Male; Physiology; Pneumonia, Viral; Angiotensin-Converting Enzyme Inhibitors; SARS-COV-2; Comorbidity; Medical Biochemistry and Metabolomics; Peptidyl-Dipeptidase A; Article; Endocrinology & Metabolism; Betacoronavirus; Drug Therapy; Clinical Research; Humans; Viral; Molecular Biology; Pandemics; Antihypertensive Agents; Retrospective Studies; Aged; SARS-CoV-2; Prevention; statin; Drug Repositioning; Evaluation of treatments and therapeutic interventions; COVID-19; Cell Biology; Pneumonia; ACEi/ARB; Middle Aged; mortality; 3. Good health; Infectious Diseases; Good Health and Well Being; 6.1 Pharmaceuticals; Combination; Hypertension; Drug Therapy, Combination; Female; Patient Safety; Biochemistry and Cell Biology; Angiotensin-Converting Enzyme 2; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Coronavirus Infections; Cytokine Release Syndrome

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.