Severe coronavirus disease (COVID-19) is characterized by a pro-inflammatory state with high mortality. Statins have anti-inflammatory effects and may attenuate the severity of COVID-19.
Methods and Results
An observational study of all consecutive adult patients with COVID-19 from March 1, 2020 to May 2, 2020 admitted to a single-center located in Bronx, New York. Patients were grouped as those that did and did not receive a statin and in-hospital mortality was compared by competing events regression. In addition, propensity score matching and inverse probability treatment weighting (IPTW) were used in survival models to examine the association between statin use and death during hospitalization. A total of 4,252 patients were admitted with COVID-19. Diabetes modified the association between statin use and in-hospital mortality. Patient with diabetes on a statin (n=983) were older (69±11 vs. 67±14 years, p<0.01), had lower inflammatory markers (C-reactive protein: 10.2, IQR: 4.5-18.4 vs. 12.9, IQR: 5.9-21.4 mg/dl, p<0.01) and reduced cumulative in-hospital mortality (24% vs. 39%, p<0.01) than those not on a statin (n=1,283). No difference in hospital mortality was noted in patients without diabetes on or off statin (20% vs. 21%, p=0.82). Propensity score matching (HR=0.88, 95% CI 0.83-0.94, p<0.01) and IPTW (HR=0.88, 95% CI 0.84-0.92, p<0.01) showed a 12% lower risk of death during hospitalization for statin users than non-users.
Statin use was associated with reduced in-hospital mortality from COVID-19 in patients with diabetes. These findings, if validated, may further reemphasize administration of statins to patients with diabetes during the COVID-19 era.