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Table 2 Summary of the results of meta-analysis of studies assessing the effect of statins on the course and prognosis of COVID-19. ICU – intensive care unit

From: COVID-19 and lipids. The role of lipid disorders and statin use in the prognosis of patients with SARS-CoV-2 infection

Author/ year Analyzed period Number of included studies Sample size Results Conclusions
Kow and Hasan [46] to July 27, 2020 4 8990 Severity and mortality: risk ↓30% (HR = 0.70; 95% CI: 0.53–0.94) The use of statins improves the prognosis in patients with COVID-19
Scheen [47] Dec 2019 to Dec 2020 13 42,722 Mortality: no statistically riskreduction (OR = 0.97; 95% CI: 0.92–1.03)Severity: no statistically risk reduction (OR = 1.09; 95% CI: 0.99–1.22) Adjusted for confounders, a 27% reduction in the risk of severe disease and mortality in COVID-19 was demonstrated (adjusted OR = 0.73 ± 0.31 versus unadjusted OR = 1.44 ± 0.84; p = 0.0028). Statin therapy in patients with COVID-19 may improve their prognosis
Onorato et al. [48] 2019 toSep 28, 2020 7 2398 Severity and mortality: risk ↓ by 41 (OR = 0.59; 95% CI: 0.35–0.99). The analysis of the results of studies in which statins were used before admission to the hospital showed even greater benefits of their use (OR = 0.51; 95% CI: 0.41–0.64). The use of statins improves the prognosis in patients with COVID-19
Pal et al. [49] to Dec 18, 2020 14 19,988 Severity and mortality: no statistically risk reduction (OR = 1.02; 95% CI: 0.69–1.50). After adjustment reduce the risk of adverse outcomes by 49% (OR = 0.51; 95% CI: 0.41–0.63). Statin therapy in patients with COVID-19 may improve their prognosis
Chow et al. [50] Jan 2019 to Dec 2020 13 110,078 The use of statins before hospitalization: no significantly affect the risk of death (OR = 0.62; 95% CI: 0.38–1.03). The use of statins since the diagnosis of COVID-19: reduced the risk of death (OR = 0.57; 95% CI: 0.43–0.75). The use of statins did not reduce the mortality of COVID-19 patients admitted to the ICU (OR = 0.65; 95% CI: 0.26–1.64). Among patients in non-ICU, statin users were at lower risk of death (OR = 0.64; 95% CI: 0.46–0.88). The use of statins did not reduce the risk of admission to an ICU Patients administered statins after COVID-19 diagnosis or non-ICU admitted patients were at lower risk of mortality
Vahedian-Azimi et al. [32] to Nov 2, 2020 24 32,715 Significant reductions risk of ICU admission (OR = 0.78; 95% CI: 0.58–1.06). No significant effect on risk of tracheal intubation (OR = 0.79; 95% CI: 0.57–1.11). Significant reductions of death (OR = 0.70; 95% CI: 0.55–0.88). Was demonstrated that decrease mortality by in-hospital application of statins (OR = 0.40; 95% CI: 0.22–0.73), compared with pre-hospital use (OR = 0.77; 95% CI: 0.60–0.98) Statins potentially reduction of ICU admission and total mortality reduction in COVID-19 patients
Wu et al [51]. to Nov 10, 2020 28 63,537 Statin use was associated with a reduction in the risk of mortality (OR = 0.71, 95% CI: 0.55–0.92) and the need for artificial ventilation (OR = 0.81, 95% CI: 0.69–0.95). Statin use was not found to reduce the risk of treatment in ICU (OR = 0.91; 95% CI: 0.55–1.51). Statins can improve the prognosis of COVID-19 patients, so it does not seem necessary to stop taking them when the patient is admitted to the hospital.
Permana et al [52]. Dec 1, 2019 to Nov 11, 2020 13 52,122 In-hospital use of statin was associated with a decreased risk of mortality by 56% (RR = 0.54; 95% CI: 0.50–0.58).Pre-admission use of statin was not associated with risk of mortality (RR = 1.18; 95% CI: 0.79–1.77). In-hospital use of statins was associated with a decreased risk of death in patients with COVID-19
Yetmar et al. [53] to Dec, 2020 16 395,513 The use of statins before contracting COVID-19 reduced the risk of mortality (adjusted RR = 0.65; 95% CI: 0.56–0.77) and the risk of severe disease (aRR = 0.73; 95% CI: 0.57–0.94). The use of statins is associated with a lower risk of death or serious illness in patients with COVID-19. The important role of the continued use of statins in patients indicated for lipid-lowering therapy during the COVID-19 pandemic is indicated.
Hariyanto and Kurniawan [54] to Nov 25, 2020 35 11,930,583 Statin use has not significant effect on reducing the risk of COVID-19 (OR = 1.09; 95% CI: 0.58–2.03). Statin use has not significant effect on reducing the risk severity course of COVID-19 (OR = 1.07; 95% CI: 0.86–1.33). Statin use did not improve the outcomes of patients with COVID-19.
Zein et al. [55] to March 1, 2021 8 14,446 The use of statins reduced the risk of mortality (RR = 0.72; 95% CI: 0.55–0.95). In the subgroup of patients who used statins during hospitalization, an even lower risk of mortality was observed (RR = 0.71; 95% CI: 0.54–0.94). The observed effects were not influenced by such factors as: age, male gender, diabetes and arterial hypertension. Statins reduce the risk of mortality in COVID-19 patients.
Diaz-Arocutipa et al. [56] to March 3, 2021 25 147,824 In-hospital use of statins did not affect the risk of mortality (adjusted HR = 0.74; 95% CI: 0.49–1.10). Chronic statin use significantly reduced the risk of mortality (aHR = 0.71; 95% CI: 0.56–0.91). Statins, especially when used chronically, reduce the risk of death in patients with COVID-19
Kollias et al. [57] to March 5, 2021 22 114,688 Using statins versus not using statins reduced the risk of mortality (HR = 0.65; 95% CI: 0.53–0.81 and OR = 0.65; 95% CI: 0.55–0.78). Statin treatment was associated with an approximately 35% reduction in adjusted risk of death in hospitalized COVID-19 patients.
Kow and Hasan [58] to Jun 3, 2021 35 138,402 Statin use reduced the risk of mortality from any cause (OR = 0.63, 95% CI: 0.51–0.79), and the risk of severe COVID-19 (OR = 0.80, 95% CI: 0.73–0.88). The use of statins is associated with a better prognosis in COVID-19 patients.