Statins reduce mortality in patients with COVID-19: an updated meta-analysis of 147,824 patients

Diaz-Arocutipa, Carlos; Melgar-Talavera, Beatriz; Alvarado-Yarasca, Ángel; Saravia-Bartra, María M.; Cazorla, Pedro; Belzusarri, Iván; Hernandez, Adrian V.

OBJECTIVES: There is conflicting evidence about the utility of statins use on clinical outcomes in patients with coronavirus disease 2019 (COVID-19). We performed a systematic review and meta-analysis to examine the effect of statins use on mortality in COVID-19 patients. METHODS: We searched electronic databases from inception to March 3, 2021. We pooled unadjusted and adjusted effect estimates with their 95% confidence intervals (95% CI) using random-effects models. RESULTS: Twenty-five cohort studies involving 147824 patients were included. The mean age ranged from 44.9 to 70.9 years and 57% of patients were men. The use of statins was not associated with mortality using unadjusted risk ratio (uRR, 1.16; 95% CI, 0.86-1.57, 19 studies). In contrast, meta-analyses of adjusted odds ratio (aOR, 0.67; 95% CI, 0.52-0.86, 11 studies) and adjusted hazard ratio (aHR, 0.73; 95% CI, 0.58-0.91, 10 studies) showed that statins were independently associated with a significant reduction of mortality. Subgroup analyses showed that only chronic use of statins significantly reduced mortality according to the adjusted models. CONCLUSIONS: The use of statins was associated with a lower risk of mortality in COVID-19 patients based on adjusted effects of cohort studies. However, randomized controlled trials are still needed to confirm these findings.