Background:
Statins have multiple protective effects on
inflammation, immunity and coagulation, and may help alleviate
pneumonia. However, there was no report focusing on the association of
statin use with in-hospital outcomes of patients with
coronavirus disease 2019 (COVID-19). We investigated the association between the use of
statins and in-hospital outcomes of patients with
COVID-19. Methods: In this retrospective case series, consecutive
COVID-19 patients admitted at 2 hospitals in Wuhan, China, from March 12, 2020 to April 14, 2020 were analyzed. A 1:1 matched cohort was created by propensity score-matched analysis. Demographic data, laboratory findings, comorbidities, treatments and in-hospital outcomes were collected and compared between
COVID-19 patients taking and not taking
statins. Result: A total of 2,147 patients with
COVID-19 were enrolled in this study. Of which, 250 patients were on
statin therapy. The mortality was 2.4% (6/250) for patients taking
statins while 3.7% (70/1,897) for those not taking
statins. In the multivariate Cox model, after adjusting for age, gender, admitted hospital, comorbidities, in-hospital medications and blood
lipids, the risk was lower for mortality (adjusted HR, 0.428; 95% CI, 0.169-0.907; P = 0.029),
acute respiratory distress syndrome (ARDS) (adjusted HR, 0.371; 95% CI, 0.180-0.772; P = 0.008) or intensive care unit (ICU) care (adjusted HR, 0.319; 95% CI, 0.270-0.945; P = 0.032) in the
statin group vs. the non-
statin group. After propensity score-matched analysis based on 18 potential confounders, a 1:1 matched cohort (206:206) was created. In the matched cohort, the Kaplan-Meier survival curves showed that the use of
statins was associated with better survival (P = 0.025). In a Cox regression model, the use of
statins was associated with lower risk of mortality (unadjusted HR, 0.254; 95% CI, 0.070-0.926; P = 0.038), development of ARDS (unadjusted HR, 0.240; 95% CI, 0.087-0.657; P = 0.006), and admission of ICU (unadjusted HR, 0.349; 95% CI, 0.150-0.813; P = 0.015). The results remained consistent when being adjusted for age, gender, total
cholesterol,
triglyceride,
low density lipoprotein cholesterol,
procalcitonin, and
brain natriuretic peptide. The favorable outcomes in
statin users remained statistically significant in the first sensitivity analysis with comorbid diabetes being excluded in matching and in the second sensitivity analysis with
chronic obstructive pulmonary disease being added in matching. Conclusion: In this retrospective analysis, the use of
statins in
COVID-19 patients was associated with better clinical outcomes and is recommended to be continued in patients with
COVID-19.