tetano
Editor, Senior Moderator
Thromb Res
. 2025 Sep 20:255:109484.
doi: 10.1016/j.thromres.2025.109484. Online ahead of print. Safety and effectiveness of statins in hospitalized patients with COVID-19: Systematic review and collaborative meta-analysis of randomized controlled trials
Luis Ortega-Paz[SUP] 1 [/SUP], Azita H Talasaz[SUP] 2 [/SUP], Parham Sadeghipour[SUP] 3 [/SUP], Sina Rashedi[SUP] 4 [/SUP], Jean M Connors[SUP] 5 [/SUP], Dominick J Angiolillo[SUP] 1 [/SUP], Larisa H Cavallari[SUP] 6 [/SUP], David Jimenez[SUP] 7 [/SUP], Gabriela Bastidas[SUP] 8 [/SUP], Elizabeth Lorenzi[SUP] 9 [/SUP], Lindsay R Berry[SUP] 9 [/SUP], Thomas Hills[SUP] 10 [/SUP], Daniel Francis McAuley[SUP] 11 [/SUP], Tayyab Shah[SUP] 12 [/SUP], Alexandra J Lansky[SUP] 12 [/SUP], Siddharthan Deepti[SUP] 13 [/SUP], Hernando Guillermo Gaitán-Duarte[SUP] 14 [/SUP], Tatjana S Potpara[SUP] 15 [/SUP], Mattia Galli[SUP] 16 [/SUP], Dave L Dixon[SUP] 17 [/SUP], Gregory Piazza[SUP] 4 [/SUP], Gregory Y H Lip[SUP] 18 [/SUP], Roxana Mehran[SUP] 19 [/SUP], Peter Libby[SUP] 20 [/SUP], Harlan M Krumholz[SUP] 21 [/SUP], Behnood Bikdeli[SUP] 22 [/SUP]
Affiliations
Aims: Statins may impact COVID-19 outcomes through lipid-mediated and lipid-independent pathways. However, the clinical impact of statin therapy among hospitalized patients with COVID-19 remains unclear due to the limited power of existing randomized controlled trials (RCTs).
Methods: A systematic search of PubMed, Embase, and clinicaltrials.gov was conducted through July 17th, 2024. RCTs were included if they compared statin therapy to control (placebo or standard care) in hospitalized COVID-19 patients and enrolled at least 250 randomized participants. Studies with co-treatment were considered in sensitivity analyses. The primary effectiveness outcome was 30-day all-cause death. The main safety outcomes were myopathy and rise in liver enzymes.
Results: Three RCTs were included in the main analysis (3882 statin-naive patients, 33.7 % female, average follow-up duration 37 days). Compared with control, statin therapy was associated with reduced all-cause death (20.9 % vs. 23.8 %; odds ratio [OR]: 0.82, 95 % confidence interval [CI] 0.70-0.96; P = 0.01), with a small but significant increase in myopathy (0.6 % vs. 0 %; risk difference: 0.00, 95 % CI -0.00; 0.01), and no significant difference in liver enzyme abnormalities (1.0 % vs. 1.4 %; OR 1.00, 95 % CI: 0.25-3.99). A sensitivity analysis including two additional RCTs that included randomized co-treatments yielded similar findings. There were no significant interactions for effectiveness by disease severity (critically vs. non-critically ill, P = 0.38) or sex (males vs. females, P = 0.83).
Conclusion: Among hospitalized patients with COVID-19, statin therapy was associated with a significant reduction in 30-day all-cause death compared with control and exhibited an excellent safety profile.
Study registration: This study is registered in PROSPERO (CRD42023478764).
Keywords: Coronavirus disease 2019; Death; Lipid; Statin; Venous thromboembolism.
. 2025 Sep 20:255:109484.
doi: 10.1016/j.thromres.2025.109484. Online ahead of print. Safety and effectiveness of statins in hospitalized patients with COVID-19: Systematic review and collaborative meta-analysis of randomized controlled trials
Luis Ortega-Paz[SUP] 1 [/SUP], Azita H Talasaz[SUP] 2 [/SUP], Parham Sadeghipour[SUP] 3 [/SUP], Sina Rashedi[SUP] 4 [/SUP], Jean M Connors[SUP] 5 [/SUP], Dominick J Angiolillo[SUP] 1 [/SUP], Larisa H Cavallari[SUP] 6 [/SUP], David Jimenez[SUP] 7 [/SUP], Gabriela Bastidas[SUP] 8 [/SUP], Elizabeth Lorenzi[SUP] 9 [/SUP], Lindsay R Berry[SUP] 9 [/SUP], Thomas Hills[SUP] 10 [/SUP], Daniel Francis McAuley[SUP] 11 [/SUP], Tayyab Shah[SUP] 12 [/SUP], Alexandra J Lansky[SUP] 12 [/SUP], Siddharthan Deepti[SUP] 13 [/SUP], Hernando Guillermo Gaitán-Duarte[SUP] 14 [/SUP], Tatjana S Potpara[SUP] 15 [/SUP], Mattia Galli[SUP] 16 [/SUP], Dave L Dixon[SUP] 17 [/SUP], Gregory Piazza[SUP] 4 [/SUP], Gregory Y H Lip[SUP] 18 [/SUP], Roxana Mehran[SUP] 19 [/SUP], Peter Libby[SUP] 20 [/SUP], Harlan M Krumholz[SUP] 21 [/SUP], Behnood Bikdeli[SUP] 22 [/SUP]
Affiliations
- PMID: 40992230
- DOI: 10.1016/j.thromres.2025.109484
Aims: Statins may impact COVID-19 outcomes through lipid-mediated and lipid-independent pathways. However, the clinical impact of statin therapy among hospitalized patients with COVID-19 remains unclear due to the limited power of existing randomized controlled trials (RCTs).
Methods: A systematic search of PubMed, Embase, and clinicaltrials.gov was conducted through July 17th, 2024. RCTs were included if they compared statin therapy to control (placebo or standard care) in hospitalized COVID-19 patients and enrolled at least 250 randomized participants. Studies with co-treatment were considered in sensitivity analyses. The primary effectiveness outcome was 30-day all-cause death. The main safety outcomes were myopathy and rise in liver enzymes.
Results: Three RCTs were included in the main analysis (3882 statin-naive patients, 33.7 % female, average follow-up duration 37 days). Compared with control, statin therapy was associated with reduced all-cause death (20.9 % vs. 23.8 %; odds ratio [OR]: 0.82, 95 % confidence interval [CI] 0.70-0.96; P = 0.01), with a small but significant increase in myopathy (0.6 % vs. 0 %; risk difference: 0.00, 95 % CI -0.00; 0.01), and no significant difference in liver enzyme abnormalities (1.0 % vs. 1.4 %; OR 1.00, 95 % CI: 0.25-3.99). A sensitivity analysis including two additional RCTs that included randomized co-treatments yielded similar findings. There were no significant interactions for effectiveness by disease severity (critically vs. non-critically ill, P = 0.38) or sex (males vs. females, P = 0.83).
Conclusion: Among hospitalized patients with COVID-19, statin therapy was associated with a significant reduction in 30-day all-cause death compared with control and exhibited an excellent safety profile.
Study registration: This study is registered in PROSPERO (CRD42023478764).
Keywords: Coronavirus disease 2019; Death; Lipid; Statin; Venous thromboembolism.