In-hospital Use of Statins is Associated with a Reduced Risk of Mortality among Individuals with COVID-19

Zhang, Xiao-Jing; Qin, Juan-Juan; Cheng, Xu; Shen, Lijun; Zhao, Yan-Ci; Yuan, Yufeng; Lei, Fang; Chen, Ming-Ming; Yang, Huilin; Bai, Liangjie; Song, Xiaohui; Lin, Lijin; Xia, Meng; Zhou, Feng; Zhou, Jianghua; She, Zhi-Gang; Zhu, Lihua; Ma, Xinliang; Xu, Qingbo; Ye, Ping; Chen, Guohua; Liu, Liming; Mao, Weiming; Yan, Youqin; Xiao, Bing; Lu, Zhigang; Peng, Gang; Liu, Minyu; Yang, Jun; Yang, Luyu; Zhang, Changjiang; Lu, Haofeng; Xia, Xigang; Wang, Daihong; Liao, Xiaofeng; Wei, Xiang; Zhang, Bing-Hong; Zhang, Xin; Yang, Juan; Zhao, Guang-Nian; Zhang, Peng; Liu, Peter P.; Rohit, Loomba; Ji, Yan-Xiao; Xia, Jiahong; Wang, Yibin; Cai, Jingjing; Guo, Jiao; Li, Hongliang

Summary 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 Cox model with time-varying exposure, as well as 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 a hazard ratio 0.58. These results imply the potential benefits of statin therapy in hospitalized subjects with COVID-19. Further, they give support for the completion of on-going 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.