Statins Use in COVID-19 Patients; a scoping review

Abstract

Abstract Background: WHO announced COVID-19 as a global epidemic in March 2020, and starting from this date, many drugs and treatment protocols had been investigated for their role in COVID-19 infection, however none of these drugs was find to be curative for all cases. Patients with multiple comorbidities are more prone to severe COVID-19 infection, especially those with cardiovascular diseases, because COVID-19 severe form is related to cytokine storm, and damage of the endothelium which leads to increased blood coagulability. Statins are group of anti-hyperlipidemic drugs; however, they also possess multiple beneficial pleiotropic actions on blood vessels and endothelium. In some observational studies statins was observed to have a positive impact on mortality and hospitalization rates in COVID-19 patients, however other studies stated that statins are not beneficial in COVID-19 patients. In this setting of conflicting evidence, we sought to scoop available data about the effect of statins in COVID-19 patients to answer whether they could be beneficial or not. Methods: Database search on Medline and EMBASE via OVID platform databases for the chronic or de-novo use of medium or high intensity statins on COVID-19 patients regarding all-cause mortality, hospitalization rates and ICU admission. Results: Database search revealed 416 articles. Only 8 of them matched the current review inclusion criteria. Involved articles were of observational nature, since the ongoing clinical trials on the use of Statins in COVID-19 patients have not published results yet. Six of the included studies concluded beneficial use of statins, however 2 articles concluded non beneficial use of starting statins in COVID-19 patients, although continuing on them during the infection for those who are already taking statins are is not harmful. Conclusion: Observational studies for older individuals using statins chronically showed the theoretical advantages of statin usage in COVID-19 infections on all-cause mortality, hospitalization rates and ICU admission. However, more research into the use of statins for the first time during a COVID-19 infection is needed. Furthermore, randomized-controlled experiments are required to explore the aforementioned results.