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Multicenter Study
. 2022 Jan-Dec:28:10760296221103864.
doi: 10.1177/10760296221103864.

Statins and Risk of Thrombosis in Critically ill Patients with COVID-19: A Multicenter Cohort Study

Shmeylan Al Harbi  1   2   3 , Raed Kensara  1   3 , Ohoud Aljuhani  4 , Ghazwa B Korayem  5 , Ali F Altebainawi  6 , Abdullah Al Harthi  1   3 , Ramesh Vishwakarma  7 , Alaa M Alenazi  8 , Abdulmajed Almutairi  9 , Omar Alshaya  1   2   3 , Sultan Alraddadi  1   2   3 , Tareq Al Sulaiman  10 , Latifah Aldakkan  11 , Reem Mahboob  12 , Kholoud Alaamer  1   2   3 , Abdulrahman Alissa  13 , Awatif Hafiz  4 , Nada Aldhayyan  2 , Sara Althewaibi  2 , Farhan Alenezi  3   9 , Nadeen Y Alkhotani  4 , Sara A Alghamdi  4 , Abeer A Alenazi  14 , Khalid Al Sulaiman  1   2   3   15
Affiliations
Multicenter Study

Statins and Risk of Thrombosis in Critically ill Patients with COVID-19: A Multicenter Cohort Study

Shmeylan Al Harbi et al. Clin Appl Thromb Hemost. 2022 Jan-Dec.

Abstract

Purpose: Coagulation abnormalities are one of the most important complications of severe COVID-19, which might lead to venous thromboembolism (VTE). Hypercoagulability with hyperfibrinogenemia causes large vessel thrombosis and major thromboembolic sequelae. Statins are potentially a potent adjuvant therapy in COVID-19 infection due to their pleiotropic effect. This study aims to evaluate the effectiveness of statins in reducing the risk of thrombosis among hospitalized critically ill patients with COVID-19.

Methods: A multicenter, retrospective cohort study of all critically ill adult patients with confirmed COVID-19 admitted to Intensive Care Units (ICUs) between March 1, 2020, and March 31, 2021. Eligible patients were categorized based on their usage of statins throughout their ICU stay and were matched with a propensity score. The primary endpoint was the odds of all cases of thrombosis; other outcomes were considered secondary.

Results: A total of 1039 patients were eligible; following propensity score matching, 396 patients were included (1:1 ratio). The odds of all thrombosis cases and VTE events did not differ significantly between the two groups (OR 0.84 (95% CI 0.43, 1.66), P = 0.62 and OR 1.13 (95% CI 0.43, 2.98), P = 0.81, respectively. On multivariable Cox proportional hazards regression analysis, patients who received statin therapy had lower 30-day (HR 0.72 (95 % CI 0.54, 0.97), P = 0.03) and in-hospital mortality (HR 0.67 (95 % CI 0.51, 0.89), P = 0.007). Other secondary outcomes were not statistically significant between the two groups except for D-dimer levels (peak) during ICU stay.

Conclusion: The use of statin therapy during ICU stay was not associated with thrombosis reduction in critically ill patients with COVID-19; however, it has been associated with survival benefits.

Keywords: COVID-19; SARS-CoV-2; critical illness; hydroxymethylglutaryl-CoA reductase inhibitors; inflammation; mortality; statin; thrombosis; venous thromboembolism.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Critically ill patients with COVID-19 flowchart.
See this image and copyright information in PMC

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