Prior Treatment with Statins is Associated with Improved Outcomes of Patients with COVID-19: Data from the SEMI-COVID-19 Registry

Torres-Peña, José David; Pérez-Belmonte, Luis M.; Fuentes-Jiménez, Francisco; López Carmona, Mª Dolores; Pérez-Martinez, Pablo; López-Miranda, José; Carrasco Sánchez, Francisco Javier; Vargas Núñez, Juan Antonio; del Corral Beamonte, Esther; Magallanes Gamboa, Jeffrey Oskar; González García, Andrés; González Moraleja, Julio; Cortés Troncoso, Andrés; Taboada Martínez, María Luisa; del Fidalgo Montero, María del Pilar; Seguí Ripol, José Miguel; Gil Sánchez, Ricardo; Alegre González, Diana; Boixeda, Ramon; Cortés Rodríguez, Begoña; Ena, Javier; García García, Gema María; Ventura Esteve, Ana; Ramos Rincón, José Manuel; Gómez-Huelgas, Ricardo

BACKGROUND: The impact of statins on COVID-19 outcomes is important given the high prevalence of their use among individuals at risk for severe COVID-19. Our aim is to assess whether patients receiving chronic statin treatment who are hospitalized with COVID-19 have reduced in-hospital mortality if statin therapy is maintained during hospitalization. METHODS: This work is a cross-sectional, observational, retrospective multicenter study that analyzed 2921 patients who required hospital admission at 150 Spanish centers included in the nationwide SEMI-COVID-19 Network. We compared the clinical characteristics and COVID-19 disease outcomes between patients receiving chronic statin therapy who maintained this therapy during hospitalization versus those who did not. Propensity score matching was used to match each statin user whose therapy was maintained during hospitalization to a statin user whose therapy was withdrawn during hospitalization. RESULTS: After propensity score matching, continuation of statin therapy was associated with lower all-cause mortality (OR 0.67, 0.54–0.83, p < 0.001); lower incidence of acute kidney injury (AKI) (OR 0.76,0.6–0.97, p = 0.025), acute respiratory distress syndrome (ARDS) (OR 0.78, 0.69- 0.89, p < 0.001), and sepsis (4.82% vs 9.85%, p = 0.008); and less need for invasive mechanical ventilation (IMV) (5.35% vs 8.57, p < 0.001) compared to patients whose statin therapy was withdrawn during hospitalization. CONCLUSIONS: Patients previously treated with statins who are hospitalized for COVID-19 and maintain statin therapy during hospitalization have a lower mortality rate than those in whom therapy is withdrawn. In addition, statin therapy was associated with a decreased probability that patients with COVID-19 will develop AKI, ARDS, or sepsis and decreases the need for IMV.