AUTHOR=Al Sulaiman Khalid , Aljuhani Ohoud , Korayem Ghazwa B. , Altebainawi Ali F. , Al Harbi Shmeylan , Al Shaya Abdulrahman , Badreldin Hisham A. , Kensara Raed , Alharthi Abdullah F. , Alghamdi Jahad , Alawad Ahad , Alotaibi Rand , Kharbosh Abdullah , Al Muqati Hessa , Alhuwahmel Abdulmohsen , Almusallam Mohammed , Albarrak Ghada , Al Sulaihim Ibrahim , Alanazi Bader , Al-Dosari Bodoor S. , Vishwakarma Ramesh , Alsaeedi Alawi S. , Al Ghamdi Ghassan , Alkofide Hadeel , Al-Dorzi Hasan M. 

TITLE=The impact of HMG-CoA reductase inhibitors use on the clinical outcomes in critically ill patients with COVID-19: A multicenter, cohort study

JOURNAL=Frontiers in Public Health

VOLUME=Volume 10 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2022.877944

DOI=10.3389/fpubh.2022.877944

ISSN=2296-2565

ABSTRACT=Background    
The cardiovascular complications of Severe Coronavirus Disease 2019 (COVID-19) may be attributed to the hyperinflammatory state leading to increased mortality in patients with COVID-19. Statins are known to have pleiotropic and anti-inflammatory effects and may influence viral transmission along with their cholesterol-lowering activity. Thus, statin therapy is potentially a potent adjuvant therapy in COVID-19 infection. This study investigated the association of statin use on the outcome of critically ill patients with COVID-19.
Methods
A multicenter, retrospective cohort study of all adults critically ill patients with confirmed COVID-19 admitted to Intensive Care Units (ICUs) between March 1, 2020, and March 31, 2021. Eligible patients were classified into two groups based on statin use during ICU stay and were matched with a propensity score based on patient’s age and admission APACHE II and SOFA scores. The primary endpoint was in-hospital mortality, while 30 days Ventilator-free days (VFDs) and ICU complications were secondary endpoints.    
Results
A total of 1049 patients were eligible; 502 patients were included after propensity score matching (1:1 ratio). The 30-day (hazard ratio 0.75 (95% CI 0.58, 0.98), P=0.03) and in-hospital mortality (hazard ratio 0.69 (95% CI 0.54, 0.89), P=0.004) were significantly lower in patients who received statin therapy on multivariable cox proportional hazards regression analysis. Moreover, patients who received statin had a lower odd of hospital-acquired pneumonia (OR 0.48(95% CI 0.32, 0.69), P=<0.001), lower levels of markers of inflammation on follow up and no increased risk of liver injury. 
Conclusion
The use of statin during ICU stay in COVID-19 critically ill patients may have a beneficial role and survival benefits with a good safety profile.