Effects of Statins on Clinical Outcomes in Hospitalized Patients with COVID-19: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

Background: It has been suggested that statins can decrease the cytokine storm and the risk of serious clinical outcomes in patients with COVID-19 due to their pleiotropic effects.Aim: To summarize the current evidence from randomized clinical trials (RCTs) on the effects of statins on clinical outcomes in patients with COVID-19.Method: Searches were performed in PubMed, Web of Science, Embase, medRxiv, Google Scholar, and ClinicalTrials.gov from January 1, 2020 to April 19, 2022. The following elements were used to define eligibility criteria: (1) Population: hospitalized patients with COVID-19; (2) Intervention: statins (atorvastatin, simvastatin, lovastatin, pravastatin, or rosuvastatin); (3) Comparison: placebo or standard protocol; (4) Outcomes: length of stay, intensive care unit (ICU) admission, death, and any adverse events; (5) Study type: RCTs. Treatment effects were reported as relative risk (RR) for dichotomous variables and mean difference (MD) for continuous variables with 95% confidence intervals (CI). We used a random-effects model to pool the results.Results: Five RCTs were included in the meta-analysis. We found no difference in the length of stay between patients treated with statins and the control group (MD = 0.25; 95% CI -1.62 to 1.45). In addition, there was no increased risk for ICU admission (RR = 1.72; 95% CI 0.61 to 4.85) and death (RR = 0.90; 95% CI 0.73 to 1.11) among hospitalized patients with COVID-19 receiving statins.Conclusion: Available evidence based on the results of RCTs showed no clinical benefits of statins as a treatment for COVID-19.