J Infect Dis. 2021 Oct 19:jiab539. doi: 10.1093/infdis/jiab539. Online ahead of print.
BACKGROUND: Statins may be protective in SARS-CoV-2 infection. The aim of this study was to evaluate the effect of in-hospital statin use on 28-day mortality and ICU admission among patients with SARS-CoV-2 stratified into 4 groups: those who used statins prior to hospitalization (continued, discontinued) and those who did not (newly initiated, never).
METHODS: In a cohort study of 1179 patients with SARS-CoV-2, chart review was used to assess demographics, laboratory measurements, comorbidities, and time from admission to death, ICU admission, or discharge. Using marginal structural Cox models, we estimated hazard ratios for mortality and ICU admission.
RESULTS: Among 1179 patients, 676 (57 %) were male, 443 (37 %) were at least 65 years old, and 493 (46%) had a BMI ≥30. Inpatient statin use reduced the hazard of death (HR 0.566, P = 0.008). This association held among patients who did and did not use statins prior to hospitalization (HR 0.270, P=0.003; HR 0.493, P=0.038). Statin use was associated with improved time-to-death for patients >65 years, but not patients ≤65 years.
CONCLUSION: Statin use during hospitalization for SARS-CoV-2 infection was associated with reduced 28-day mortality. Well-designed randomized control trials are needed to better define this relationship.