BACKGROUND AND PURPOSE:

• Bergqvist et al. (PLoS Medicine, 2021) assessed the relationship between statin use and COVID-19 mortality

METHODS:

• Cohort study
  • Registries
  • Routinely collected data
• Participants
  • All residents residing in Stockholm (March 1 2019 to February 29 2020)
  • ≥45 years
• Exposure
  • Statin treatment | Initiated prior to the COVID-19 pandemic to avoid bias due to altered healthcare related to the pandemic
• Study design
  • Hazard ratios (HRs) were calculated using multivariable Cox regression models
  • Subgroup analyses: Age groups | Sexes | Different statin indications | COVID-19 risk groups
  • Follow-up from March 2020 to November 2020
• Primary outcome
  • COVID-19 specific mortality (Swedish Cause of Death Registry)

RESULTS:

• 963,876 adults
  • 51.6% female
  • Statin users: 17.6%
• Statin users were
  • Older
    • Users: 71.0 years
    • Non-users: 58.0 years
  • More likely to be male
    • Users: 53.3%
    • Non-users: 46.7%
  • More often diagnosed with comorbidities (e.g., ischemic heart disease)
  • More frequently on anticoagulant and antihypertensive treatments
  • Less likely to have a university-level education
    • Users: 34.5%
    • Non-users: 45.4%
  • More likely to have a low disposable income
    • Users: 20.6%
    • Non-users: 25.2%
  • Less likely to reside in crowded housing
    • Users: 6.1%
    • Non-users: 10.3%
• COVID-19 specific mortality
  • Deaths during follow up: 2545 individuals
    • Deaths of statin users: 0.5%
    • Deaths of non-users: 0.2%
• Statin treatment was associated with a lowered COVID-19 mortality
  • Adjusted HR 0.88 (95% CI, 0.79 to 0.97); P=0.01
• This association did not vary appreciably across age groups, sexes, or COVID-19 risk groups

CONCLUSION:

• There was a moderately lower risk of COVID-19 mortality among statin users
• In keeping with previous studies | Current study has the benefit of including not just hospitalized patients, but the total population of Stockholm County
• The authors state

In the absence of results from randomized clinical trials, our study can provide some guidance

Specifically, it gives further support for continuing statin treatment for conditions such as cardiovascular disease and hyperlipidemia, in line with current recommendations, during the COVID-19 pandemic

Learn More – Primary Sources:

HMG-CoA reductase inhibitors and COVID-19 mortality in Stockholm, Sweden: A registry-based cohort study

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