Abstract
Abstract only Background: Morbidity and mortality from COVID-19 largely stem from a severe systemic inflammatory response. As such, medications with anti-inflammatory properties such as statins may have protective effects in COVID-19 patients. The purpose of our study was to determine whether in-hospital statin use was associated with lower morbidity or mortality in patients hospitalized with COVID-19. Methods: We conducted a two-center retrospective study of 692 adult patients hospitalized from March 2020 to October 2021 with COVID-19 confirmed by RT-PCR. Groups were stratified based on in-hospital statin use. Baseline characteristics, biomarkers, and in-hospital outcomes were described. A multivariate regression model was used to estimate the association of the primary outcome of interest with in-hospital statin use. Statin use was defined as any dose of atorvastatin, rosuvastatin, simvastatin, pravastatin, or fluvastatin. Statistical analyses were performed using SPSS 28. Results: Statin use was present in 45.7% (315/692) of patients. These patients were older (68 vs. 62 years old, p<0.001) and had higher rates of hyperlipidemia (31.9% vs. 16.3%, p<0.001), hypertension (78.7% vs. 54.9%, p<0.001), type 2 diabetes (50.2% vs. 31.5%, p<0.001), coronary artery disease (21.9% vs. 6.4%, p<0.001), heart failure (19.4% vs. 7.5%, p<0.001), and chronic kidney disease (16.8% vs. 5.1%, p<0.001). There was no difference in levels of low-density lipoprotein or inflammatory markers (D-dimer, CRP, and ferritin) between groups. However, patients with in-hospital statin use were less often treated with remdesivir (53.8% vs 61.3%, p=0.03), corticosteroids (71.8% vs 77.9%, p=0.04), or tocilizumab (10.4% vs 18.9%, p=0.001). Patients with in-hospital statin use had shorter length of stay (18 vs. 21 days, p<0.001) and lower adjusted odds of intubation (0.65 [0.46-0.92], p=0.01). There was no difference in all-cause mortality. Conclusion: COVID-19 patients treated with in-hospital statin therapy had more cardiovascular risk factors and received less treatment for COVID-19, yet they had shorter length of stay and lower odds of intubation. In-hospital statin use was not associated with lower risk of mortality.
