Statins in Patients with COVID-19: A Retrospective Cohort Study in Iranian COVID-19 Patients

Abstract

Background: The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has profoundly affected the lives of millions of people. To date, there is no approved vaccine or specific drug to prevent or treat COVID-19, while the infection is spreading at an alarming rate globally. Because the development of effective vaccines or novel drugs could take several months (if not years), repurposing existing drugs is considered a more efficient strategy that could save lives now. Statins constitute a class of lipid-lowering drugs with proven safety profiles and many known beneficial pleiotropic effects. Our previous investigations showed that statins have antiviral effects and are involved in the process of wound healing in the lung. This triggered us to evaluate if statin use reduces mortality in COVID-19 patients. Results: After initial recruitment of 459 patients with COVID-19 (Shiraz province, Iran) and careful consideration of the exclusion criteria, a total of 150 patients, of which 75 received statins, were included in our retrospective study. Cox proportional-hazards regression models were used to estimate the association between statin use and rate of death. After propensity score matching, we found that statin use appeared to be associated with a lower risk of morbidity [HR=0.85, 95% CI=(0.02, 3.93), P=0.762] and lower risk of death [(HR= 0.76; 95% CI=(0.16, 3.72), P=0.735)]; however, these associations did not reach statistical significance. Furthermore, statin use reduced the chance of being subjected to mechanical ventilation [OR=0.96, 95% CI=(0.61–2.99), P=0.942] and patients on statins had a more normal computed tomography (CT) scan result [OR=0.41, 95% CI= (0.07–2.33), P=0.312]. Conclusions: Although we could not demonstrate a significant association between statin use and a reduction in mortality in patients with COVID19 , we do feel that our results are promising and of clinical relevance and warrant the need for prospective randomized controlled trials and extensive retrospective studies to validate the potential beneficial effects of statin treatment on clinical symptoms and mortality rates associated with COVID-19.

Atorvastatin therapy in COVID-19 adult inpatients: A double-blind, randomized controlled trial

“…Patients consuming statins had more normal computed tomography (CT) scan results than others (OR = 0.41, 95% CI = (0.07–2.33), P = 0.312). However, none of these variables were statistically significant [20] . A single-center survey in California found that using statins significantly reduced the risk of severe COVID-19 (adjusted OR 0.29, 95 %CI 0.11 to 0.71, p < 0.01) and recovered faster in hospitalized patients without the severe form of the disease (adjusted HR for recovery 2.69, 95 %CI 1.36 to 5.33, p < 0.01) [21] .…”

Statin Use Is Associated with a Decreased Risk of Mortality among Patients with COVID-19

“…We further examined 26 full-text articles and searched the references of relevant articles, retrieving 2 additional publications. Finally, 22 studies met all inclusion criteria [ 1 , 9 , 10 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 ]. The flow diagram of the systematic articles search is presented in Figure 1 .…”

Altered immunoemotional regulatory system in COVID-19: From the origins to opportunities

“…Armed with the capacity to utilize the suggested methods, we can aim for a robust immune system and fight this battle ( Mohamed and Rezaei, 2020 ), which has persisted for a year now ( Jabbari and Rezaei, 2020 ). Pro-sensing biomaterials are of emerging interest that can accelerate the early immune responses ( Saghazadeh and Rezaei, 2021 ), while testing the clinical efficacy of a variety of ancient and modern therapies that selectively modulate inflammation remains under investigation ( Pezeshki and Rezaei, 2021 ; Zarandi et al, 2021 ; Palit et al, 2020 ; Peymani et al, 2021 ).…”