Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2021 Jun 24;16(6):e0253576.
doi: 10.1371/journal.pone.0253576. eCollection 2021.

The protective association between statins use and adverse outcomes among COVID-19 patients: A systematic review and meta-analysis

Ronald Chow  1   2   3 , James Im  4 , Nicholas Chiu  5 , Leonard Chiu  6 , Rahul Aggarwal  5 , Jihui Lee  7 , Young-Geun Choi  8 , Elizabeth Horn Prsic  2 , Hyun Joon Shin  3   9   10
Affiliations
Meta-Analysis

The protective association between statins use and adverse outcomes among COVID-19 patients: A systematic review and meta-analysis

Ronald Chow et al. PLoS One. .

Abstract

Introduction: Statins may reduce a cytokine storm, which has been hypothesized as a possible mechanism of severe COVID-19 pneumonia. The aim of this study was to conduct a systematic review and meta-analysis to report on adverse outcomes among COVID-19 patients by statin usage.

Methods: Literatures were searched from January 2019 to December 2020 to identify studies that reported the association between statin usage and adverse outcomes, including mortality, ICU admissions, and mechanical ventilation. Studies were meta-analyzed for mortality by the subgroups of ICU status and statin usage before and after COVID-19 hospitalization. Studies reporting an odds ratio (OR) and hazard ratio (HR) were analyzed separately.

Results: Thirteen cohorts, reporting on 110,078 patients, were included in this meta-analysis. Individuals who used statins before their COVID-19 hospitalization showed a similar risk of mortality, compared to those who did not use statins (HR 0.80, 95% CI: 0.50, 1.28; OR 0.62, 95% CI: 0.38, 1.03). Patients who were administered statins after their COVID-19 diagnosis were at a lower risk of mortality (HR 0.53, 95% CI: 0.46, 0.61; OR 0.57, 95% CI: 0.43, 0.75). The use of statins did not reduce the mortality of COVID-19 patients admitted to the ICU (OR 0.65; 95% CI: 0.26, 1.64). Among non-ICU patients, statin users were at a lower risk of mortality relative to non-statin users (HR 0.53, 95% CI: 0.46, 0.62; OR 0.64, 95% CI: 0.46, 0.88).

Conclusion: Patients administered statins after COVID-19 diagnosis or non-ICU admitted patients were at lower risk of mortality relative to non-statin users.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. COVID-19 patients who used statins vs did not use statins—Mortality analysis.
a By Statin Usage, b By ICU/Non-ICU Patients.
Fig 2
Fig 2. Statin use before hospitalization.
a By Age (β = 0.02; p = 0.38) b By Percentage Male (β = 0.01; p = 0.16).
Fig 3
Fig 3. Statin use, after hospitalization.
a By Age (β = -0.01; p = 0.45) b By Percentage Male (β = -0.01; p = 0.41).
Fig 4
Fig 4. Potential patient scenarios.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Chow R, Simone CB II, Lock M. Hydroxycloroquine for the treatment of COVID-19: the importance of scrutiny of positive trials. Annals of Palliative Medicine 2020; 9(6): 3716–20. doi: 10.21037/apm-20-1538 - DOI - PubMed
    1. Chow R, Elsayed S, Lock M. How robust are the results of one of the first positive trials of hydroxycloroquine for treatment of COVID-19? medRxiv 2020
    1. Jose RJ, Manuel A. COVID-19 cytokine storm: the interplay between inflammation and coagulation. Lancet Respiratory Medicine 2020. doi: 10.1016/S2213-2600(20)30216-2 - DOI - PMC - PubMed
    1. Fedson DS, Opal SM, Rordam OM. Hiding in Plain Sight: an Approach to Treating Patients with Severe COVID-19 Infection. mBio 2020. doi: 10.1128/mBio.00398-20 - DOI - PMC - PubMed
    1. Scicali R, Di Pino A, Piro S, Rabuazzo AM, Purrello F. May statins and PCSK9 inhibitors be protective from COVID-19 in familial hypercholesterolemia subjects? Nutr Metab Cardiovasc Dis 2020; 30(7): 1068–9. doi: 10.1016/j.numecd.2020.05.003 - DOI - PMC - PubMed

MeSH terms

Substances