Effects of Statins on Outcomes in Hispanic Patients with COVID-19

Abstract

The Hispanic population is regarded among those who are at greater risk of adverse prognoses due to higher rates of diabetes and obesity in the USA during the COVID-19 pandemic. Statin medications are speculated to help treat the infection by decreasing inflammation caused by COVID-19. In this retrospective, observational study, outcomes of statin use were assessed among Hispanic patients with COVID-19 by screening all patients hospitalized between March, 2020 and March, 2021 at a tertiary care hospital in El Paso, Texas, resulting in a total of 1039 patients. The patients were categorized into a group of either being on statins or not. The considered outcomes were mechanical ventilation, intensive care unit (ICU) hospitalization, oxygen supplementation at discharge, hospital length of stay, and mortality. Patients receiving statins were observed to be older with more comorbidities. In the propensity-scores adjusted analysis, no association was found between statin use and: mortality (adjusted risk ratio (aRR)=0.96, p=0.754), mechanical ventilation (aRR=0.91, p=0.503), ICU transfer (aRR=0.96, p=0.395), and O2 supplementation at discharge (aRR=1.03, p=0.729). These outcomes were also evaluated in patients who had myocardial infarction and stroke with COVID-19. Among these patients, association was found between statin use and: a reduced risk of mortality (aRR=0.61, p=0.005), mechanical ventilation (aRR=0.53, p=0.012) and ICU transfers (aRR=0.81, p=0.005). These results may not give us a reason to start patients on statins for the specific treatment of COVID-19, but it may be sufficient evidence to suggest statins should not be discontinued during hospitalization due to COVID-19.

Effectiveness of HMG-CoA reductase inhibitors on inflammation and metabolic markers in the US-Mexico border Hispanic population

“…22,37,38 Moreover, the disparities in the use of statins for the prevention of CVD have been reported among Hispanics of diverse backgrounds. 21 Although several studies reported the effects of statins among Hispanics, [39][40][41] none of the studies reported a direct effect of statins on inflammatory and metabolic markers in Hispanics, particularly those living on the US-Mexico border. Although the true benefits and harms of statins for cardiovascular risk prevention are debatable, 42 our study clearly demonstrates a strong association between statin use and lowering metabolic abnormalities, inflammation, and liver enzymes among the predominantly Hispanic population.…”

Statin Therapy to Improve Outcome of COVID-19 Patients: Useful or Not Useful?

“…In less numerous studies, no benefit was found with previous statin use, including on mortality rate [ 34 , 35 ]. The association of statin use with lower adverse 30-day outcomes was weaker in COVID-19 patients than in non-COVID-19 patients, suggesting that statins did not exert anti-SARS-CoV-2 effects [ 36 ].…”

“…It is not clear why discrepancies exist between studies and whether studies demonstrating no effects were lacking power or included patients whose vulnerabilities differed. In a Spanish cohort study, while no significant reduction in any risk was found, significant association was established between statins and reduced mortality (adjusted RR, 0.61; 95% IC, 0.43–0.86; p = 0.005), mechanical ventilation (adjusted RR, 0.53; 95% IC, 0.32–0.87; p = 0.01), and ICU transfer (adjusted RR, 0.81; 95% IC, 0.69–0.94; p = 0.005) in the subgroup of patients with a history of myocardial infarction or stroke [ 34 ]. In a nationwide South Korean cohort study, a protective role of previous statin use was found only in patients with past hypertension (OR, 0.40; 95% CI, 0.23–0.69; p = 0.009) [ 21 ].…”