ICU admission Author Statin Sample Setting Study design Result Conclusion Reference User Nonuser Masana et al. 581 1576 Patients admitted to their hospitals because of SARS-CoV-2 infection Members of the Lipids and Arteriosclerosis Units Net (XULA) of Catalonia (Spain) Retrospective observational N/A N/A [30 ] 103 (17.7) 233 (14.8) Zhang et al. 1219 12762 Patients with COVID-19 Hubei Province, China Retrospective aHR: 0.69, CI: 0.56-0.85, Cox model analysis showed statin use associated with lower prevalence ICU admission [25 ] N/A N/A Song et al. 123 126 Patients with COVID-19 “Lifespan” healthcare system hospitals Retrospective cohort OR: 0.90, CI: 0.49-1.67, No significant associations between statin use and hospital death or ICU admission [31 ] N/A N/A Argenziano et al. 325 525 Patients with laboratory-confirmed COVID-19 infection New York-Presbyterian/Columbia University Irving Medical Center, a quaternary care academic medical center Retrospective case series N/A [32 ] 93 143 De Spiegeleer et al. 31 123 Residents at two elderly care homes with COVID-19 diagnosis One of two Belgian nursing homes Retrospective multicenter cohort OR: 0.75, CI: 0.24-1.87 Statin use showed nonsignificant benefits [33 ] 6 31 Yan et al. N/A N/A Confirmed COVID-19 diagnosis Hospitals in Zhejiang Province, China Case-control OR: 0.98, CI: 0.32-2.99, N/A [34 ] N/A N/A Dreher et al. 18 32 COVID-19 patients with and without acute respiratory distress syndrome (ARDS) Aachen University Hospital Retrospective cohort OR: 1.13, CI: 0.36-3.60 N/A [35 ] 9 15 Tan et al. 40 509 717 patients admitted Tertiary center in Singapore for COVID-19 infection Retrospective cohort ATET Coeff: − 0.12, CI: −0.23-0.01, Statin use independently associated with lower requirement for ICU admission [36 ] 1 N/A Daniels et al. 46 124 Patients hospitalized for treatment of COVID-19 University of California San Diego Health (UCSDH), ascertained by data capture within system-wide electronic health record (EHR) system (Epic Systems, Verona, WI, USA) Retrospective cohort Adjusted OR: 0.29, CI: 0.11-0.71, Inpatients hospitalized for COVID-19, use of statin medication prior to admission associated with reduced risk of severe disease [37 ] 20 70 Vahedian-Azimi et al. 326 525 Positive for SARS-CoV-2 Baqiyatallah University of Medical Sciences Prospective observational OR: 1.00, CI: 0.58-1.74, Statin use not associated with mortality [10 ] 39 243 Butt et al. 843 3999 Danish citizens had a primary or secondary diagnosis code for COVID-19 infection A Danish hospital, including inpatient, outpatient, and emergency department visits Observational cohort study HR 2.41 (95% CI 2.04 to 2.85) Statin exposure was associated with a significantly higher risk of severe COVID-19 infection compared with no statin exposure)severe COVID-19 infection, defined as a hospital diagnosis of “COVID-19 severe acute respiratory syndrome” (ICD-10 code: B972A) or admission to an intensive care unit( [38 ] 204 (24.2%) 419 (10.5%) Fan et al. 250 1897 Patients with COVID-19 Zhongnan Hospital of Wuhan University and Leishenshan Hospital in Wuhan, China Retrospective study Adjusted HR, 0.319; 95% CI, 0.270–0.945; The risk was lower for intensive care unit (ICU) care in the statin group vs. the nonstatin group [39 ] N/A N/A Hippisley-Cox et al. 5616 13870 Patients who had COVID-19 disease General practices in England contributing to the QResearch database from which current data were available, England Prospective cohort study For ICU admission, there was no significant associations with the statin [40 ] 487 (8.7%) 799 (5.8%) McCarthy et al. 107 140 Patients hospitalized with confirmed SARS-CoV-2 infection Three Partners Healthcare hospitals (Massachusetts General Hospital, Brigham and Women’s Hospital, and Newton-Wellesley Hospital) Retrospective cohort study Admitted to ICU or died N/A [41 ] 51 61 Mitacchione et al. 179 663 Patients hospitalized for COVID-19 Hospitals include Luigi Sacco Hospital, Milan; Policlinico Umberto I Hospital, Rome; Spedali Civili Hospital, Brescia; Humanitas Gavazzeni Hospital; Bergamo, Italia Observational multicenter study Our results did not confirm the supposed favorable effects of statin therapy on COVID-19 intensive care unit admission [42 ] 6 (3%) 40 (6%) Ahlström et al. N/A N/A ICU COVID-19 patients Sweden Retrospective cohort study We did not find a protective effect on ICU admission in statin-treated patients [43 ] 518 1466 Izzi-Engbeaya et al. N/A N/A Patients hospitalized with swab-positive COVID-19 ICHNT, which includes three hospitals admitting patients with COVID-19 (Charing Cross Hospital, Hammersmith Hospital, and St. Mary’s Hospital), London Retrospective cohort study Primary outcome of death/ICU admission N/A [44 ] N/A N/A Tracheal intubation Author Statin Sample Setting Study design Result Conclusion User Nonuser Zhang et al. 1219 12762 Patients with COVID-19 Hubei Province, China Retrospective aHR: 0.37, CI: 0.26-0.53, Cox model analysis showed statin use associated with a lower prevalence of using mechanical ventilation [25 ] N/A N/A Song et al. 123 126 Patients with COVID-19 “Lifespan” healthcare system hospitals Retrospective cohort Statin use significantly associated with decreased risk for IMV OR: 0.45, CI: 0.20-0.99, Data support continued use of statins in patients hospitalized with COVID-19 due to decreased risk for IMV [31 ] N/A N/A Gupta et al. 648 648 Positive for SARS-CoV-2 Columbia University Irving Medical Center (CUIMC) and Allen Hospital sites of the New York-Presbyterian Hospital (NYPH) Retrospective No significant difference in invasive mechanical ventilation N/A [45 ] 130 (20.1%) 158 (24.4%) Masana et al. 581 1576 Patients admitted to hospitals due to SARS-CoV-2 infection Members of the Lipids and Arteriosclerosis Units Net (XULA) of Catalonia (Spain) Retrospective observational N/A N/A [30 ] 84 (14.46) 191 (12.12) Cariou et al. 1192 1257 Patients with diabetes admitted with COVID-19 68 French hospitals Nationwide observational OR: 1.13, CI: 0.83-1.53 Routine statin use not significantly associated with increased risk of tracheal intubation/mechanical ventilation [46 ] 19.2% 19.7% Tan et al. 40 509 Patients admitted for COVID-19 Tertiary center in Singapore for COVID-19 infection Retrospective cohort ATET Coeff: −0.08, CI: −0.19-0.02, No significant differences in intubation [36 ] 1 N/A Peymani et al. 75 75 Hospitalized COVID-19 patients Single tertiary hospital in Shiraz, Iran Retrospective OR: 0.96, CI: 0.61-2.99, Nonsignificant association between statin use and reduction in mortality in COVID-19 patients [47 ] N/A N/A Fan et al. 250 1897 Patients with COVID-19 Zhongnan Hospital of Wuhan University and Leishenshan Hospital in Wuhan, China Retrospective study N/A N/A [39 ] 26 (10.4%) 180 (9.4%) Mitacchione et al. 179 663 Patients hospitalized for COVID-19 Hospitals include Luigi Sacco Hospital, Milan; Policlinico Umberto I Hospital, Rome; Spedali Civili Hospital, Brescia; Humanitas Gavazzeni Hospital; Bergamo, Italia Observational multicenter study Our results did not confirm the supposed favorable effects of statin therapy on COVID-19 mechanical ventilation [42 ] 6 (3%) 36 (5%) Nicholson et al. 511 531 Adult patients with laboratory-confirmed COVID-19 infection Five hospitals in the Mass General Brigham healthcare system (Massachusetts General Hospital (MGH), Brigham and Women’s Hospital (BWH), Newton Wellesley Hospital (NWH), Brigham and Women’s Faulkner Hospital (BWFH), and North Shore Medical Center, NSMC) in Boston, USA Retrospective cohort N/A [48 ] 180 224 Mortality Author Statin Sample Setting Study design Result Conclusion Statin time User Nonuser Gupta et al. 648 648 Positive for SARS-CoV-2 Columbia University Irving Medical Center (CUIMC) and Allen Hospital sites of the New York-Presbyterian Hospital (NYPH) Retrospective Univariate OR: 0.69, CI: 0.56-0.85. Multivariate adjusted OR: 0.49, CI: 0.38-0.63 Antecedent statin use associated with significantly lower rates of in-hospital mortality within 30 days [45 ] 112 (17.2%) 201 (31.0%) Masana et al. 581 581 Patients admitted to hospitals due to SARS-CoV-2 infection Members of the Lipids and Arteriosclerosis Units Net (XULA) of Catalonia (Spain) Retrospective observational Significant difference in mortality rate between groups A lower SARS-CoV-2 infection-related mortality observed in patients treated with statin therapy prior to hospitalization [30 ] 115 (19.79) 148 (25.40) Zhang et al. 1219 12762 Patients with COVID-19 Hubei Province, China Retrospective Individuals with statin therapy had a lower crude 28-day mortality (incidence rate ratios (IRR): 0.78, CI: 0.61–1.00, Statin use in hospitalized COVID-19 patients associated with lower risk of all-cause mortality and favorable recovery profile [25 ] 0.21% 0.27% Rossi et al. 42 29 Patients with preexisting chronic cardiovascular disease, with COVID-19 N/A Observational Mortality rates of patients taking statins were 21.4% (9/42) and 34.5% (10/29) in those not taking statins ( Statin use significantly reduced risk of mortality in COVID-19 patients [19 ] 9 (21.4%) 10 (34.5%) Cariou et al. 1192 1257 Patients with diabetes admitted with COVID-19 68 French hospitals Nationwide observational Mortality rates significantly higher in statin users in 28 days (23.9% vs. 18.2%, Routine statin treatment significantly associated with increased mortality in T2DM patients hospitalized for COVID-19 [46 ] 23.9% 18.2% Saeed et al. 983 1283 Patients with diabetes mellitus hospitalized with COVID-19 Montefiore Medical Center, Bronx, New York Observational retrospective Patient with diabetes on statins had lower cumulative in-hospital mortality (24% vs. 39%, Statin use associated with reduced in-hospital mortality from COVID-19 in patients with diabetes [21 ] 24% 39% Saeed et al. 372 1614 Patients without diabetes mellitus hospitalized with COVID-19 Montefiore Medical Center in Bronx, New York Observational retrospective No difference noted in patients without diabetes (20% vs. 21%, Statin use associated with reduced in-hospital mortality from COVID-19 inpatients with diabetes [21 ] 20% 21% Song et al. 123 126 Patients with COVID-19 “Lifespan” healthcare system hospitals Retrospective cohort No significant associations between statin use and in-hospital death No significant associations between statin use and hospital death [31 ] N/A N/A De Spiegeleer et al. 31 123 Residents at two elderly care homes with COVID-19 diagnosis One of two Belgian nursing homes Retrospective multicenter cohort Considering death as serious outcome, the effect sizes, OR: 0.61, CI: 0.15-1.71, Statins not statistically significantly associated with death from COVID-19 in elderly adults in nursing homes [33 ] N/A N/A Rodriguez-Nava et al. 47 40 Laboratory-confirmed COVID-19 Community hospital intensive care unit (ICU) located in Evanston, IL Retrospective cohort Multivariable Cox PH regression model showed atorvastatin nonusers had 73% chance of faster progression to death compared with users. HR: 0.38, CI: 0.18-0.77, Slower progression to death associated with atorvastatin use in patients with COVID-19 admitted to ICU [26 ] 23 (49%) 25 (63%) Zenga et al. 38 993 COVID-19 inpatients Tongji Hospital, Tongji Medical College of HUST (Wuhan, China) Retrospective cohort N/A [49 ] 5 160 Nguyen et al. 90 266 African American population with COVID-19 University of Chicago Medical Center (UCMC), serving south metropolitan Chicago Retrospective observational N/A [50 ] 10 35 Wang et al. 24 12 Multiple myeloma patients with COVID-19 Mount Sinai Hospital Retrospective cohort Statin use significantly associated with mortality. OR: 6.21, CI: 1.37-39.77, N/A [49 ] 11 3 Grasselli et al. N/A N/A Patients admitted to ICUs in Lombardy with suspected SARS-CoV-2 infection One of the network ICUs, Milan Retrospective, observational study Statins associated with higher mortality in univariate analysis. HR: 0.98, CI: 0.81-1.2, Long-term treatment with statins, before ICU admission associated with higher mortality unadjusted analysis only. Multivariate analysis did not confirm association between any home therapies and increased mortality [51 ] N/A N/A Ayed et al. 10 93 Intensive care unit- (ICU-) admitted COVID-19 patients Jaber Al-Ahmad Al Sabah Hospital, Kuwait Retrospective cohort OR: 0.49, CI: 0.11-2.08 N/A [52 ] 4 43 Tan et al. 40 509 717 patients admitted Tertiary center in Singapore for COVID-19 infection Retrospective cohort ATET Coeff: −0.04, CI: −0.16-0.08, No significant differences in mortality [36 ] 2 Peymani et al. 75 75 Hospitalized COVID-19 patients Single tertiary hospital, Shiraz, Iran Retrospective HR: 0.76, CI: 0.16-3.72, Nonsignificant association between statin use and reduction in mortality in patients with COVID-19 [47 ] N/A N/A Nicholson et al. 511 531 1042 people with COVID-19 symptoms admitted Mass General Brigham Hospitals Retrospective cohort OR: 0.50, CI: 0.27-0.93, Chronic statin use associated with reduced in-hospital mortality [53 ] N/A N/A Lala et al. 984 1752 Hospitalized COVID-19-positive patients 1 of 5 Mount Sinai Health System hospitals in New York City Multihospital retrospective cohort HR: 0.57, CI: 0.47-0.69, Statin use associated with improved survival [54 ] N/A N/A Krishnan et al. 81 71 Consecutive patients requiring mechanical ventilation from March 10 to April 15 St. Joseph Mercy Oakland Hospital Retrospective observational OR: 2.44, CI: 1.23-4.76, Statin use associated with increased mortality [55 ] N/A N/A Vahedian-Azimi et al. 326 525 Positive for SARS-CoV-2 Baqiyatallah University of Medical Sciences Prospective observational OR: 0.18, CI: 0.06–0.49 Statin use associated with decreased mortality [10 ] 8 282 Butt et al. 843 3999 Danish citizens had a primary or secondary diagnosis code for COVID-19 infection A Danish hospital, including inpatient, outpatient, and emergency department visits Observational cohort study HR 2.87 (95% CI 2.39 to 3.46) Statin exposure was associated with a significantly higher risk of mortality compared with no statin exposure [38 ] 177 (21.0%) 311 (7.8%) Fan et al. 250 1897 Patients with COVID-19 Zhongnan Hospital of Wuhan University and Leishenshan Hospital in Wuhan, China Retrospective study Adjusted HR, 0.428; 95% CI, 0.169–0.907; Statin use was associated with lower mortality [39 ] 6 (2.4%) 70 (3.7%) Israel et al. N/A N/A Hospitalized COVID-19 patients were assigned to two distinct case-control cohorts. Control patients were taken from the general population Clalit Health Services (CHS) data warehouse Retrospective cohort Rosuvastatin has protective effects in this large population analysis [56 ] N/A N/A Israel et al. N/A N/A Hospitalized COVID-19 patients were assigned to two distinct case-control cohorts. Case patients were nonhospitalized SARS-CoV-2-positive patients Clalit Health Services (CHS) data warehouse Case-control matched cohort OR (95% CI) 0.530 (0.360, 0.766) Rosuvastatin has protective effects in this large population analysis [56 ] N/A N/A Mughal et al.—abstract 44 76 Adult patients who were hospitalized with RT-PCR-confirmed SARS-CoV-2 infection N/A Retrospective cohort N/A N/A [57 ] 14 (31.8%) 7 (9.2%) Mallow et al. 5313 16363 COVID-19 patient Database of inpatient and hospital-based outpatient detailed claims across more than 300 acute care hospitals in the US Retrospective cohort OR 0.54, 95% CI, 0.49–0.60; Our findings suggest that patients administered statins in the hospital had a 46% lower risk of death than those not receiving statins [28 ] N/A N/A McCarthy et al. 107 140 Patients hospitalized with confirmed SARS-CoV-2 infection Three Partners Healthcare hospitals (Massachusetts General Hospital, Brigham and Women’s Hospital, and Newton-Wellesley Hospital) Retrospective cohort study Admitted to ICU or died N/A [41 ] 51 61 Alamdari et al. 117 342 COVID-19 patients Patients who were admitted to Shahid Modarres Hospital, which is a 279-bed tertiary referral center in Tehran, Iran Retrospective cohort OR: 0.27 (0.11–0.64) Statin use history decreased the incidence of mortality dramatically [58 ] 6 (9.5%) 57 (16.7%) Soleimani et al. 66 188 Patients with COVID-19 Sina Hospital in Tehran, Iran Retrospective observational study OR: 0.93 (0.49–1.76) N/A [59 ] 17 (25%) 51 (27%) Ayeh et al. 594 3853 Patients with a diagnosis of SARS-CoV-2 infection Johns Hopkins Hospital and affiliated hospitals, Johns Hopkins Bayview Medical Center, Howard County General Hospital, Sibley Memorial Hospital, and Suburban Hospital, USA Retrospective study The average treatment effect of statin use on COVID-19-related mortality in the matched groups was not statistically significant [60 ] N/A N/A Ahlström et al. N/A N/A ICU COVID-19 patients Sweden Retrospective cohort study Statins were protective of ICU death [43 ] 110 N/A An et al. 1074 9160 Patients diagnosed with COVID-19 South Korea Nationwide cohort OR: 4.11 (3.07-5.51) N/A [61 ] 69 (6.4%) 159 (1.7%) Holman et al. 118995 142710 COVID-19 people with type 1 diabetes The National Diabetes Audit (NDA), UK Population-based cohort study Association of prescription of statins with mortality in type 1 diabetes was not significant [62 ] 338 120 Holman et al. 2099505 752245 COVID-19 people with type 2 diabetes The National Diabetes Audit (NDA), UK Population-based cohort study In people with type 2 diabetes, prescription for statins was associated with reduced mortality [62 ] 7355 3086 Inciardi et al. 25 74 Patients hospitalized for COVID-19 pneumonia Civil Hospitals of Brescia, Lombardy, Italy Retrospective cohort N/A [63 ] 9 (36%) 17 (23%) Luo et al. 55 228 Patients with confirmed COVID-19 Tongji Hospital in Wuhan, China Retrospective study N/A [27 ] N/A N/A Ullah et al. 108 104 Confirmed COVID-19 patients Primary, secondary, and tertiary electronic healthcare records (EHRs) of HPB patients in East London Retrospective single-center cohort study N/A [64 ] 36 18 Ramachandran et al. 114 181 Patients admitted with a principal diagnosis of COVID-19 Tertiary care academic medical center in Brooklyn, New York Retrospective cohort study N/A [65 ] N/A N/A Izzi-Engbeaya et al. N/A N/A Patients hospitalized with swab-positive COVID-19 ICHNT, which includes three hospitals admitting patients with COVID-19 (Charing Cross Hospital, Hammersmith Hospital, and St. Mary’s Hospital), London Retrospective cohort study Primary outcome of death/ICU admission N/A [44 ] N/A N/A Bifulco et al. 117 424 COVID-19 patients Patients admitted to Humanitas Clinical and Research Hospital (Rozzano, Milan, Italy) Retrospective cohort Adjusted odds ratio (aOR): 0.75; 95% confidence interval (CI): 0.26–2.17; Deaths were lower, although not significantly, in statin users with respect to nonstatin users [66 ] N/A N/A Oh et al. N/A N/A Patients with COVID-19 NHIS-COVID-19 cohort database, South Korean Retrospective cohort study OR (95% CI) 0.74, (0.52, 1.05), We found that it did not affect the hospital mortality of patients who were diagnosed with COVID-19 [29 ] N/A N/A Maric et al. 2297 4594 COVID-19 patients Cerner’s large COVID-19 EHR database, USA Retrospective cohort study 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%) [67 ] 369 (16.1%) 845 (18.39%) Mitacchione et al. 179 663 Patients hospitalized for COVID-19 Hospitals include Luigi Sacco Hospital, Milan; Policlinico Umberto I Hospital, Rome; Spedali Civili Hospital, Brescia; and Humanitas Gavazzeni Hospital, Bergamo, Italia Observational multicenter study Statin users appeared to show higher mortality rates [42 ] 52 (%29) 130 (%20)
