Statin therapy has been associated with a number of pleiotropic effects. During the COVID-19 pandemic, the impact of statin therapy on mortality from COVID-19 has come to the forefront as we consider whether the pleiotropic effects extend further. In this population-based cohort study of residents in Stockholm using the Swedish health register, the investigators explored the relationship between statin treatment and mortality from COVID-19 (1).
A total of 963,876 individuals were included for analysis and 17.6% had a recorded prescription of statins within the last year prior to the pandemic. Deaths from COVID-19 were statistically greater in the statin-treated group, mainly driven by older age, ischaemic heart disease and hypertension. When adjusted for confounders however statin therapy was associated with a modestly lower risk of COVID-19 mortality (HR 0.88; 95% CI, 0.79 to 0.97).
This study reinforces our understanding that the presence of cardiovascular risk factors and multimorbid patients are most at risk of death from COVID-19. It also sheds some light on the association between treatment for cardiovascular disease and modestly reduced risk of mortality. There are however, significant limitations including (importantly) the fact that statin prescription does not equate to compliance with therapy. We already know that compliance with statin therapy is poor and perhaps if this was greater, resulting in improved control of cardiovascular risk factors, the impact of therapy on mortality would have been greater.
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