Background: Basic studies suggest that statins as add-on therapy may benefit patients with COVID-19; however, real-world evidence of such a beneficial association is lacking. Objective: We investigated differences in SARS-CoV-2 test positivity and clinical outcomes of COVID-19 (composite endpoint: admission to intensive care unit, invasive ventilation, or death) between statin users and nonusers. Methods: Two independent population-based cohorts were analyzed, and we investigated the differences in SARS-CoV-2 test positivity and severe clinical outcomes of COVID-19, such as admission to the intensive care unit, invasive ventilation, or death, between statin users and nonusers. One group comprised an unmatched cohort of 214,207 patients who underwent SARS-CoV-2 testing from the Global Research Collaboration Project (GRCP)-COVID cohort, and the other group comprised an unmatched cohort of 74,866 patients who underwent SARS-CoV-2 testing from the National Health Insurance Service (NHIS)-COVID cohort. Results: The GRCP-COVID cohort with propensity score matching had 29,701 statin users and 29,701 matched nonusers. The SARS-CoV-2 test positivity rate was not associated with statin use (statin users, 2.82% [837/29,701]; nonusers, 2.65% [787/29,701]; adjusted relative risk [aRR] 0.97; 95% CI 0.88-1.07). Among patients with confirmed COVID-19 in the GRCP-COVID cohort, 804 were statin users and 1573 were matched nonusers. Statin users were associated with a decreased likelihood of severe clinical outcomes (statin users, 3.98% [32/804]; nonusers, 5.40% [85/1573]; aRR 0.62; 95% CI 0.41-0.91) and length of hospital stay (statin users, 23.8 days; nonusers, 26.3 days; adjusted mean difference –2.87; 95% CI –5.68 to –0.93) than nonusers. The results of the NHIS-COVID cohort were similar to the primary results of the GRCP-COVID cohort. Conclusions: Our findings indicate that prior statin use is related to a decreased risk of worsening clinical outcomes of COVID-19 and length of hospital stay but not to that of SARS-CoV-2 infection.
Bibliographical noteFunding Information:
The authors appreciate health care professionals dedicated to treating patients with COVID-19 in Korea, the Ministry of Health and Welfare, the Health Insurance Review & Assessment Service of Korea, and the National Health Insurance Service of Korea for sharing invaluable national cohorts in a prompt manner. This work was supported by an Institute of Information and Communications Technology Planning & Evaluation (IITP) grant funded by the Korean Government (Ministry of Science and ICT [MSIT]; No. 2020-0-01969; Development of HW/SW platform for interactive self-monitoring in real-time addressing the mental health problems based on brain-cognitive behavioral data). The funders had no role in study design, data collection, data analysis, data interpretation, or writing of the report.
© Seung Won Lee, So Young Kim, Sung Yong Moon, In Kyung Yoo, Eun-Gyong Yoo, Gwang Hyeon Eom, Jae-Min Kim, Jae Il Shin, Myung Ho Jeong, Jee Myung Yang, Dong Keon Yon.
All Science Journal Classification (ASJC) codes
- Public Health, Environmental and Occupational Health
- Health Informatics