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Meta-Analysis
. 2021 Jun 7;31(6):1662-1670.
doi: 10.1016/j.numecd.2021.02.020. Epub 2021 Feb 27.

Statin and outcomes of coronavirus disease 2019 (COVID-19): A systematic review, meta-analysis, and meta-regression

Timotius I Hariyanto  1 , Andree Kurniawan  2
Affiliations
Meta-Analysis

Statin and outcomes of coronavirus disease 2019 (COVID-19): A systematic review, meta-analysis, and meta-regression

Timotius I Hariyanto et al. Nutr Metab Cardiovasc Dis. .

Abstract

Aims: One of the comorbidities associated with severe outcome and mortality of COVID-19 is dyslipidemia. Statin is one of the drugs which is most commonly used for the treatment of dyslipidemic patients. This study aims to analyze the association between statin use and composite poor outcomes of COVID-19.

Data synthesis: We systematically searched the PubMed and Europe PMC database using specific keywords related to our aims until November 25th, 2020. All articles published on COVID-19 and statin were retrieved. Statistical analysis was done using Review Manager 5.4 and Comprehensive Meta-Analysis 3 software.

Results: A total of 35 studies with a total of 11, 930, 583 patients were included in our analysis. Our meta-analysis showed that statin use did not improve the composite poor outcomes of COVID-19 [OR 1.08 (95% CI 0.86-1.35), p = 0.50, I2 = 98%, random-effect modelling]. Meta-regression showed that the association with composite poor outcomes of COVID-19 was influenced by age (p = 0.010), gender (p = 0.045), and cardiovascular disease (p = 0.012). Subgroup analysis showed that the association was weaker in studies with median age ≥60 years-old (OR 0.94) compared to <60 years-old (OR 1.43), and in the prevalence of cardiovascular disease ≥25% (RR 0.94) compared to <25% (RR 1.24).

Conclusion: Statin use did not improve the composite poor outcomes of COVID-19. Patients with dyslipidemia should continue taking statin drugs despite COVID-19 infection status, given its beneficial effects on cardiovascular outcomes.

Keywords: COVID-19; Coronavirus disease 2019; Dyslipidemia; Statin; Treatment.

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Conflict of interest statement

Declaration of competing interest The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
PRISMA flowchart.
Figure 2
Figure 2
Forest plot that demonstrates the association of statin with composite poor outcome and its subgroup which comprises of risk of COVID-19, severe COVID-19, and mortality.
Figure 3
Figure 3
Bubble-plot for Meta-regression. Meta-regression analysis showed that the association between statin and composite poor outcome was affected by age [A], gender [B], and cardiovascular disease [C].
Figure 4
Figure 4
Funnel plot analysis for the association of statin with composite poor outcome of COVID-19.
See this image and copyright information in PMC

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