• Florêncio de MesquitaCynthiaCDepartment of Medicine, Federal University of Pernambuco, Recife, Brazil., André Rivera, Beatriz Araújo, Vitor Leão Durães, Ivo Queiroz, Vanessa Henriques Carvalho, Tahir Haque, and Taniela M Bes.
• Department of Medicine, Federal University of Pernambuco, Recife, Brazil.
• Am. J. Med. 2024 Oct 1; 137 (10): 966973.e11966-973.e11.

BackgroundThe efficacy and safety of adjunctive statin therapy in hospitalized patients with coronavirus disease 2019 (Covid-19) remains uncertain.MethodsWe systematically searched Medline, Embase, Cochrane, and ClinicalTrials.gov databases from inception to late April 2024 for randomized controlled trials (RCTs) comparing statin versus no statin use in patients hospitalized with Covid-19. We pooled risk ratios (RRs) and hazard ratios (HRs) with 95% confidence intervals (CIs) applying a random-effects model. R version 4.3.1 was used for statistical analyses.ResultsWe included 7 RCTs comprising 4,262 patients, of whom 2,645 (62%) were randomized to receive statin therapy. Compared with no statin, statin use significantly reduced case-fatality rate (RR 0.88; 95% CI 0.80-0.98; I2 = 0%). In a time-to-event analysis, we found similar results (HR 0.86; 95% CI 0.75-0.99; I2 = 0%). Statin use also significantly reduced World Health Organization (WHO) scale at 14 days (mean difference -0.27; 95% CI -0.54 to -0.01; I2 = 0%). There was no statistically significant difference between the two groups in length of hospital stay, elevation of liver enzymes, and C-reactive protein levels.ConclusionsIn patients hospitalized with Covid-19, statins significantly reduced case-fatality rate and WHO scale score.RegistrationA prospective register was recorded in International Prospective Register of Systematic Reviews (PROSPERO) with the number CRD42023479007.Copyright © 2024 Elsevier Inc. All rights reserved.

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