The severe respiratory illness due to SARS-CoV-2, the virus responsible for
coronavirus disease 2019 (COVID-19), is triggered by an intense pro-inflammatory host response.
Statins, prescribed primarily for
lipid reduction, are known to have anti-inflammatory and immunomodulatory properties and have been associated with a reduced mortality rate among
COVID-19 patients taking
statins as reported in two recent retrospective studies. However, a meta-analysis that included nine studies showed that
statin use did not improve in-hospital outcomes of those with
COVID-19. In addition, concerns regarding the use of
statins and an increase in
COVID-19 infections have been raised, as
statins may increase the expression of
angiotensin-converting enzyme 2 (ACE2), the primary receptor for the SARS-CoV-2 virus. Our goal was to investigate the effect of
statins in
COVID-19 patients in a large, diverse patient population across the United States containing nearly 120,000 patients diagnosed with
COVID-19. We used propensity score matching of demographics, comorbidities, and medication indication to compare
statin-treated patients (N = 2,297) with matched controls (N = 4,594). We observed a small, but statistically significant, decrease in mortality among patients prescribed
statins (16.1%) when compared with matched COVID-19-positive controls (18.0 to 20.6%). These results support previous evidence that
statins do not increase COVID-19-related mortality and may, in fact, have a mitigating effect on severity of the disease reflected in a slight reduction in mortality. Mixed findings on effects of
statins in
COVID-19 patients reported in the literature should prompt prospective randomized controlled trials in order to define better who might be advantaged with respect to clinical outcomes.