Purpose

Previously, we have reported potential clinical benefits with the use of statins in patients with coronavirus disease 2019 (COVID-19) in a meta-analysis, where there was a significantly reduced hazard for a fatal or severe course of illness with the use of statins, but the meta-analysis was limited by the small number of studies included, with small heterogeneity among studies, due to the unavailability of more studies at the point of literature search. We aimed to perform an updated systematic review and meta-analysis to summarize the existing evidence on the effect of statins on the clinical outcomes of patients with COVID-19.

Methods

Electronic databases, including PubMed, Google Scholar, and Scopus, and preprint servers were searched (last updated June 3, 2021) to identify studies investigating the association between the use of statins in patients with COVID-19 and the development of severe disease and/or mortality. Random-effects model meta-analyses were performed to estimate the pooled odds ratio (OR) or hazard ratio (HR) with 95% confidence intervals (CIs). The outcomes of interest were (1) all-cause mortality and (2) a composite endpoint of severe illness of COVID-19.

Results

Upon systematic literature search, we identified 35 studies, of which 32 studies reported the outcome of all-cause mortality and 15 studies reported the composite endpoint of severe COVID-19 illness between statin users versus non-statin users with COVID-19. Our meta-analysis revealed that the use of statins was associated with a significantly lower risks of all-cause mortality (HR = 0.70, 95% CI 0.58–0.84, n = 21,127, and OR = 0.63, 95% CI 0.51–0.79, n = 115,097) and the composite endpoint of severe illness (OR = 0.80, 95% CI 0.73–0.88, n = 10,081) in patients with COVID-19, compared to non-use of statins, at the current sample size.

Conclusion

Statin use is associated with a better prognosis in patients with COVID-19. Our findings provide a rationale to investigate the use of statins among patients with COVID-19 in large scale clinical trials.

中文翻译：

---

他汀类药物的使用与 COVID-19 患者临床结果之间的关联：系统评价和荟萃分析

目的

此前，我们在一项荟萃分析中报告了在 2019 年冠状病毒病 (COVID-19) 患者中使用他汀类药物的潜在临床益处，其中使用他汀类药物可显着降低致命或严重疾病过程的风险，但荟萃分析受限于纳入的研究数量较少，研究之间的异质性很小，因为在文献检索时无法获得更多研究。我们旨在进行更新的系统评价和荟萃分析，以总结关于他汀类药物对 COVID-19 患者临床结果影响的现有证据。

方法

搜索了包括 PubMed、Google Scholar 和 Scopus 在内的电子数据库和预印本服务器（最后更新于 2021 年 6 月 3 日），以确定调查 COVID-19 患者使用他汀类药物与严重疾病和/或死亡。进行随机效应模型荟萃分析以估计具有 95% 置信区间 (CI) 的汇总优势比 (OR) 或风险比 (HR)。感兴趣的结果是（1）全因死亡率和（2）COVID-19重症的复合终点。

结果

通过系统文献检索，我们确定了 35 项研究，其中 32 项研究报告了全因死亡率的结果，15 项研究报告了他汀类药物使用者与 COVID-19 非他汀类药物使用者之间严重 COVID-19 疾病的复合终点。我们的荟萃分析显示，使用他汀类药物与显着降低全因死亡率风险相关（HR = 0.70, 95% CI 0.58–0.84, n = 21,127, 和 OR = 0.63, 95% CI 0.51–0.79,在当前样本量下，与未使用他汀类药物相比，COVID-19 患者的严重疾病复合终点（OR = 0.80, 95% CI 0.73–0.88, n = 10,081 ）。

结论

他汀类药物的使用与 COVID-19 患者的更好预后相关。我们的研究结果为在大规模临床试验中调查 COVID-19 患者中他汀类药物的使用提供了依据。