Statin use is associated with lower disease severity in COVID-19 infection

Sci Rep. 2020 Oct 15;10(1):17458. doi: 10.1038/s41598-020-74492-0.

Abstract

We aim to study the association of hyperlipidemia and statin use with COVID-19 severity. We analysed a retrospective cohort of 717 patients admitted to a tertiary centre in Singapore for COVID-19 infection. Clinical outcomes of interest were oxygen saturation ≤ 94% requiring supplemental oxygen, intensive-care unit (ICU) admission, invasive mechanical-ventilation and death. Patients on long term dyslipidaemia medications (statins, fibrates or ezetimibe) were considered to have dyslipidaemia. Logistic regression models were used to study the association between dyslipidaemia and clinical outcomes adjusted for age, gender and ethnicity. Statin treatment effect was determined, in a nested case-control design, through logistic treatment models with 1:3 propensity matching for age, gender and ethnicity. All statistical tests were two-sided, and statistical significance was taken as p < 0.05. One hundred fifty-six (21.8%) patients had dyslipidaemia and 97% of these were on statins. Logistic treatment models showed a lower chance of ICU admission for statin users when compared to non-statin users (ATET: Coeff (risk difference): - 0.12 (- 0.23, - 0.01); p = 0.028). There were no other significant differences in other outcomes. Statin use was independently associated with lower ICU admission. This supports current practice to continue prescription of statins in COVID-19 patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Betacoronavirus / isolation & purification
  • COVID-19
  • Case-Control Studies
  • Coronavirus Infections / complications
  • Coronavirus Infections / pathology*
  • Coronavirus Infections / virology
  • Dyslipidemias / complications
  • Dyslipidemias / drug therapy*
  • Dyslipidemias / pathology
  • Female
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
  • Immunity, Innate
  • Intensive Care Units
  • Leukocyte Count
  • Logistic Models
  • Male
  • Middle Aged
  • Pandemics
  • Pneumonia, Viral / complications
  • Pneumonia, Viral / pathology*
  • Pneumonia, Viral / virology
  • Retrospective Studies
  • SARS-CoV-2
  • Severity of Illness Index

Substances

  • Hydroxymethylglutaryl-CoA Reductase Inhibitors