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Meta-Analysis
. 2021 Jun;73(3):769-780.
doi: 10.1007/s43440-021-00233-3. Epub 2021 Feb 20.

In-hospital use of statins is associated with a reduced risk of mortality in coronavirus-2019 (COVID-19): systematic review and meta-analysis

Hikmat Permana  1 , Ian Huang  2 , Aga Purwiga  2 , Nuraini Yasmin Kusumawardhani  3 , Teddy Arnold Sihite  3 , Erwan Martanto  3 , Rudi Wisaksana  4 , Nanny Natalia M Soetedjo  5
Affiliations
Meta-Analysis

In-hospital use of statins is associated with a reduced risk of mortality in coronavirus-2019 (COVID-19): systematic review and meta-analysis

Hikmat Permana et al. Pharmacol Rep. 2021 Jun.

Abstract

Background and aims: The idea of treating COVID-19 with statins is biologically plausible, although it is still controversial. The systematic review and meta-analysis aimed to address the association between the use of statins and risk of mortality in patients with COVID-19.

Methods: Several electronic databases, including PubMed, SCOPUS, EuropePMC, and the Cochrane Central Register of Controlled Trials, with relevant keywords up to 11 November 2020, were used to perform a systematic literature search. This study included research papers containing samples of adult COVID-19 patients who had data on statin use and recorded mortality as their outcome of interest. Risk estimates of mortality in statin users versus non-statin users were pooled across studies using inverse-variance weighted DerSimonian-Laird random-effect models.

Results: Thirteen studies with a total of 52,122 patients were included in the final qualitative and quantitative analysis. Eight studies reported in-hospital use of statins; meanwhile, the remaining studies reported pre-admission use of statins. In-hospital use of statin was associated with a reduced risk of mortality (RR 0.54, 95% CI 0.50-0.58, p < 0.00001; I2: 0%, p = 0.87), while pre-admission use of statin was not associated with mortality (RR 1.18, 95% CI 0.79-1.77, p = 0.415; I2: 68.6%, p = 0.013). The funnel plot for the association between the use of statins and mortality were asymmetrical.

Conclusion: This meta-analysis showed that in-hospital use of statins was associated with a reduced risk of mortality in patients with COVID-19.

Keywords: COVID-19; In-hospital; Mortality; Pre-admission; SARS-CoV-2; Statins.

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Conflict of interest statement

The authors declare that there is no conflict of interest.

Figures

Fig. 1
Fig. 1
Study flow diagram
Fig. 2
Fig. 2
Forest plot showing overall effect estimates of in-hospital use of statins and mortality in patients with COVID-19. RR Relative Risk, CI Confidence Interval
Fig. 3
Fig. 3
Forest plot showing overall effect estimates of pre-admission use of statins and mortality in patients with COVID-19. RR Relative Risk, CI Confidence Interval
Fig. 4
Fig. 4
Funnel-plot analysis. a In-hospital and b Pre-admission use of statins and mortality in patients with COVID-19. CI Confidence Interval
See this image and copyright information in PMC

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