Statin use was associated with reduced in-hospital mortality in COVID-19 patients with diabetes, based on data published in the Journal of the American Heart Association. According to investigators, the anti-inflammatory effects of statins may attenuate the severity of COVID-19.
Investigators conducted an observational study of all consecutive adult patients with COVID-19 admitted to a single-center facility from March to May. Of the 4252 admitted patients, 1355 patients (32%) received a statin. More patients receiving statin therapy were older (P <.01), had history of hypertension (91% vs 84%; P <.01), had atherosclerotic heart disease (46% vs 28%; P <.01), and had a higher Charlson comorbidity index (6 vs 4; P <.01). Compared to patients not receiving a statin, patients receiving statin therapy had lower inflammatory markers, including C-reaction protein (P <.01).
Despite a higher co-morbidity burden, patients receiving statin therapy had lower cumulative in-hospital mortality compared to patients who did not receive statin therapy (23% vs 27%; P <.01). Further stratification revealed the effect was modified by diabetes. Among the 2266 diabetic patients, 983 (43%) received a statin and 1283 (57%) did not. Patients with diabetes and on a statin had lower cumulative in-hospital mortality compared to patients with diabetes who did not receive a statin (24% vs 39%; P <.01); no difference in in-hospital mortality was seen between non-diabetic patients with and without statin use (20% vs 21%; P =.82).
Propensity score matching (hazards ratio [HR], 0.88; 95% CI, 0.83-0.94; P <.01) and inverse probability treatment weighing (HR, 0.88; 95% CI 0.84-0.92; P <.01) revealed that statin users had a 12% lower risk of death during hospitalization compared to statin non-users.
Study limitations included difficulty differentiating statin users into sub-categories, not measuring clinical parameters that lead to discontinuation of statin therapy, lack of generalizability of results from a single-center study, and concern about the accuracy and level of documentation in electronic records. Investigators highlight that this study did not assess efficacy of statins as a therapeutic agent for COVID-19 in patients with diabetes.
Investigators observed that statin administration to patients with COVID-19 and diabetes was associated with a reduced risk of in-hospital mortality. “These findings, if validated, may further reemphasize administration of statins to patients with diabetes during the COVID-19 era,” investigators concluded.
Saeed O, Castagna F, Agalliu I, et al. Statin use and in-hospital mortality in diabetics with COVID-19. J Am Heart Assoc. Published online October 23, 2020. doi: 10.1161/JAHA.120.018475.