Should statins be considered for treatment of COVID-19 patients?

ABSTRACT

INTRODUCTION: The novel coronavirus disease (COVID-19), is an infectious disease caused by the newly discovered virus (SARS-CoV-2). Statin therapy might be considered for patients with COVID-19 based on following rationales. First, one of the greatest risk factors for severe COVID-19 disease is underlying cardiovascular disease. Several cardiovascular complications of COVID-19 infection have been described and statins might be beneficial in preventing some of these. Secondly, there is a hypothesis that statins may protect innate immune responses to viral respiratory infections (including to SARS-CoV) through inhibiting the MYD88 pathway. Thirdly, statins are generally considered 'safe'. Some COVID-19 patients have severe disease that is life-threatening and requires ICU admission. The objective of this study was to compare outcomes of patients admitted to the ICU with COVID-19 who were on chronic statins (S Group) vs those who never were on statins (NS group). METHODS: All data ware retrospectively collected from electronic health records of COVID-19 patients admitted to our ICU between March 1st and May 30th, 2020. Data was used to calculate APACHE IV (Acute Physiology and Chronic Health Evaluation), MEWS (Modified Early Warning Score), and mSOFA (Modified Sequential Organ Failure Assessment) on day 1 of ICU admission for each patient's baseline characteristics. Student t test was used to compare means. Outcomes included ICU length of stay in days (ICU LOS), hospital length of stay in days (hospital LOS), ICU mortality, and hospital mortality. RESULTS: A total of 74 patients with COVID-19 were included, with 35 in the S group and 39 in the NS group. Compared to NS group, S group had similar APACHE IV scores (61 ± 28 vs 62 ± 35, p = 0.9), similar MEWS (2.6 ± 1.7 vs 3.3 ± 2.3, p = 0.2), and similar mSOFA (3.6 ± 2.3 vs 3.7 ± 3.7, p = 0.9). There were no statistically significant differences in ICU LOS (13 +/- 15 vs 10 +/- 11, p = 0.4), hospital LOS (19 +/- 16 vs 16 +/- 16, p = 0.4), ICU mortality (37% vs 31 %, p = 0.6), or hospital mortality (40% vs 36 %, p = 0.7). CONCLUSIONS: In a single center study, statins were not associated with protective effect against COVID-19 patients that required ICU admission. Statins for COVID-19 should be investigated in prospective studies.