Influencia del tratamiento con estatinas en una cohorte de pacientes ingresados por COVID-19

Rey, Juan R; Luis Merino, José; Iniesta, Ángel M; Rosillo, Sandra O; Castrejón-Castrejón, Sergio; Arbas-Redondo, Emilio; Poveda-Pinedo, Isabel Dolores; Tebar-Márquez, Daniel; Severo-Sánchez, Andrea; Rivero-Santana, Borja; Juárez-Olmos, Victor; Martínez-Cossiani, Marcel; Buño-Soto, Antonio; Gonzalez-Valle, Luis; Herrero-Ambrosio, Alicia; de-Sá, Esteban López; Caro-Codón, Juan

Aims and objectives: Statins have been proposed as potentially useful agents for modulating the host response in COVID-19. However, solid evidence-based recommendations are still lacking. Our aim was to study the association between statin use and clinical outcomes in a large cohort of hospitalized patients with SARS-CoV-2 infection, as well as the specific consequences of chronic treatment withdrawal during hospital admission. Material and methods: Retrospective observational study including 2191 hospitalized patients with confirmed SARS-CoV-2 infection. Results: Mean age was 68,0 ± 17,8 years and 597 (27,3%) patients died during follow-up. A total of 827 patients (37,7% of the whole sample), received chronic treatment with statins. Even though they underwent more frequent admissions in critical care units, chronic treatment with statins was not independently associated with all-cause mortality [HR 0,95 (0,72-1,25)]. During the whole hospital admission, 371 patients (16,9%) received at least one dose of statin. Although these patients had a significantly worse clinical profile, both treatment with statins during admission [HR 1,03 (0,78-1,35)] and withdrawal of chronic statin treatment [HR 1,01 (0,78-1,30)] showed a neutral effect in mortality. However, patients treated with statins presented more frequently hepatic cytolysis, rhabdomyolysis and thrombotic / hemorrhagic events. Conclusions: In this large cohort of hospitalized COVID-19 patients, statins were not independently associated with all-cause mortality during follow-up. Clinically relevant statin-associated adverse effects should be carefully monitored during hospital admission.