• Hikmat Permana, Ian Huang, Aga Purwiga, Nuraini Yasmin Kusumawardhani, Teddy Arnold Sihite, Erwan Martanto, Rudi Wisaksana, and Nanny Natalia M Soetedjo.
• Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Hasan Sadikin General Hospital, Universitas Padjadjaran, Bandung, Indonesia. hikmat.permana@unpad.ac.id.
• Pharmacol Rep. 2021 Jun 1; 73 (3): 769-780.

Background And AimsThe idea of treating COVID-19 with statins is biologically plausible, although it is still controversial. The systematic review and meta-analysis aimed to address the association between the use of statins and risk of mortality in patients with COVID-19.MethodsSeveral electronic databases, including PubMed, SCOPUS, EuropePMC, and the Cochrane Central Register of Controlled Trials, with relevant keywords up to 11 November 2020, were used to perform a systematic literature search. This study included research papers containing samples of adult COVID-19 patients who had data on statin use and recorded mortality as their outcome of interest. Risk estimates of mortality in statin users versus non-statin users were pooled across studies using inverse-variance weighted DerSimonian-Laird random-effect models.ResultsThirteen studies with a total of 52,122 patients were included in the final qualitative and quantitative analysis. Eight studies reported in-hospital use of statins; meanwhile, the remaining studies reported pre-admission use of statins. In-hospital use of statin was associated with a reduced risk of mortality (RR 0.54, 95% CI 0.50-0.58, p < 0.00001; I2: 0%, p = 0.87), while pre-admission use of statin was not associated with mortality (RR 1.18, 95% CI 0.79-1.77, p = 0.415; I2: 68.6%, p = 0.013). The funnel plot for the association between the use of statins and mortality were asymmetrical.ConclusionThis meta-analysis showed that in-hospital use of statins was associated with a reduced risk of mortality in patients with COVID-19.

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