Table I.

Extracted data of studies. All studies were conducted in 2020

Author	Statin		Sample	Setting	Study design	Result	Conclusion
	User	Non-user
ICU admission:
Masana et al. [55]	581	1576	Patients admitted to their hospitals because of SARS-CoV-2 infection	Members of the Lipids and Arteriosclerosis Units Net (XULA) of Catalonia (Spain)	Retrospective observational	N/A	N/A
	103 (17.7%)	233 (14.8%)
Zhang et al. [52]	1219	12762	Patients with COVID-19	Hubei Province, China	Retrospective	aHR = 0.69, CI: 0.56–0.85, p = 0.001	Cox model analysis showed statin use associated with lower prevalence ICU admission
	N/A	N/A
Song et al. [56]	123	126	Patients with COVID-19	“Lifespan” healthcare system hospitals	Retrospective cohort	OR = 0.90, CI: 0.49–1.67, p = 0.756	No significant associations between statin use and hospital death or ICU admission
	N/A	N/A
Argenziano et al. [57]	325	525	Patients with laboratory confirmed covid-19 infection	New York-Presbyterian/Columbia University Irving Medical Center, a quaternary care academic medical center	Retrospective case series	OR = 1.07, CI: 0.79–1.46	N/A
	93 (28.6%)	143 (27.2%)
De Spiegeleer et al. [58]	31	123	Residents at two elderly care homes with COVID-19 diagnosis	One of two Belgian nursing homes	Retrospective multi-centre cohort	OR = 0.75, CI: 0.24–1.87	Statin use showed non-significant benefits
	6 (19.3%)	31 (25.2%)
Yan et al. [47]	N/A	N/A	Confirmed Covid-19 diagnosis	Hospitals in Zhejiang province, China	Case-control	OR = 0.98, CI: 0.32–2.99, p = 0.973	N/A
	N/A	NA
Dreher et al. [59]	18	32	COVID-19 patients with and without acute respiratory distress syndrome [ARDS)	Aachen University Hospital	Retrospective cohort	OR = 1.13, CI: 0.36–3.60	N/A
	9 (50.0%)	15 (46.8%)
Tan et al. [60]	40	509	717 patients admitted	Tertiary centre in Singapore for COVID-19 infection	Retrospective cohort	ATET Coeff: –0.12, CI: –0.23–0.01, p = 0.028	Statin use independently associated with lower requirement for ICU admission
	1 (2.5%)	N/A
ICU admission:
Daniels et al. [61]	46	124	Patients hospitalised for treatment of COVID-19	University of California San Diego Health (UCSDH), ascertained by data capture within system-wide electronic health record (EHR) system (Epic Systems, Verona, WI, USA)	Retrospective cohort	Statin use prior to admission associated with reduced risk of severe COVID-19 (adjusted OR = 0.29, CI: 0.11–0.71, p < 0.01)	In patients hospitalised for COVID-19, use of statin medication prior to admission associated with reduced risk of severe disease
	20 (43.4%)	70 (56.4%)
Vahedian-Azimi et al. [54]	326	525	Positive for SARS-CoV-2	Baqiyatallah University of Medical Sciences	Prospective observational	OR = 1.00, CI: 0.58–1.74, p = 0.736	Statin use not associated with mortality
	39 (11.9%)	243 (46.2%)
Tracheal intubation:
Zhang et al. [52]	1219	12762	Patients with COVID-19	Hubei Province, China	Retrospective	aHR = 0.37, CI: 0.26–0.53, p < 0.001	Cox model analysis showed statin use associated with a lower prevalence of using mechanical ventilation
	N/A	N/A
Song et al. [56]	123	126	Patients with COVID-19	“Lifespan” healthcare system hospitals	Retrospective cohort	Statin use significantly associated with decreased risk for IMVOR: 0.45, CI: 0.20–0.99, p = 0.048	Data support continued use of statins in patients hospitalised with COVID-19 due to decreased risk for IMV
	N/A	N/A
Gupta et al. [62]	648	648	Positive for SARS-CoV-2	Columbia University Irving Medical Center (CUIMC) and Allen Hospital sites of the New York-Presbyterian Hospital (NYPH)	Retrospective	No significant difference in invasive mechanical ventilation	N/A
	130 (20.1%)	158 (24.4%)
Masana et al. [55]	581	1576	Patients admitted to hospitals due to SARS-CoV-2 infection	Members of the Lipids and Arteriosclerosis Units Net (XULA) of Catalonia (Spain)	Retrospective observational	N/A	N/A
	84 (14.5%)	191 (12.1%)
Cariou et al. [63]	112	1257	Patients with diabetes admitted with COVID-19	68 French hospitals	Nation-wide observational	OR = 1.13, CI: 0.83–1.53	Routine statin use not significantly associated with increased risk of tracheal intubation/mechanical ventilation
	229 (19.2%)	248 (19.7%)
Tan et al. [60]	40	509	Patients admitted for COVID-19	Tertiary centre in Singapore for COVID-19 infection	Retrospective cohort	ATET Coeff: –0.08, CI: –0.19–0.02, p = 0.114	No significant differences in intubation
	1 (2.5%)	N/A
Peymani et al. [64]	75	75	Hospitalised COVID-19 patients	Single tertiary hospital in Shiraz, Iran	Retrospective	OR = 0.96, CI: 0.61–2.99, p = 0.942	Non-significant association between statin use and reduction in mortality in COVID-19 patients
	N/A	N/A
Mortality
Gupta et al. [62]	648	648	Positive for SARS-CoV-2	Columbia University Irving Medical Center (CUIMC) and Allen Hospital sites of the New York-Presbyterian Hospital (NYPH)	Retrospective	Univariate – OR = 0.69, CI: 0.56–0.85 Multivariate adjusted – OR = 0.49, CI: 0.38–0.63	Antecedent statin use associated with significantly lower rates of in-hospital mortality within 30 days
	112 (17.2%)	201 (31.0%)
Masana et al. [55]	581	581	Patients admitted to hospitals due to SARS-CoV-2 infection	Members of the Lipids and Arteriosclerosis Units Net (XULA) of Catalonia (Spain)	Retrospective observational	Significant difference in mortality rate between groups – HR = 0.58, CI: 0.39–0.89, p = 0.01	A lower SARS-CoV-2 infection-related mortality observed in patients treated with statin therapy prior to hospitalization
	115 (19.8%)	148 (25.4%)
Zhang et al. [52]	1219	12762	Patients with COVID-19	Hubei Province, China	Retrospective	Individuals with statin therapy had a lower crude 28-day mortality (Incidence rate ratios (IRR): 0.78, CI: 0.61–1.00, p = 0.046)	Statin use in hospitalized COVID-19 patients associated with lower risk of all-cause mortality and favorable recovery profile
	0.21%*	0.27%*
Rossi et al. [65]	42	29	Patients with pre-existing chronic cardiovascular disease, with COVID-19	N/A	Observational	Mortality rates of patients taking statins was 21.4% (9/42), and 34.5% (10/29) in those not taking statins (p < 0.05)	Statin use significantly reduced risk of mortality in COVID-19 patients
	9 (21.4%)	10 (34.5%)
Cariou et al. [63]	1192	1257	Patients with diabetes admitted with COVID-19	68 French hospitals	Nation-wide observational	Mortality rates significantly higher in statin users in 28 days (23.9% vs. 18.2%, p < 0.001), OR = 1.46, CI: 1.08–1.95	Routine statin treatment significantly associated with increased mortality in T2DM patients hospitalized for COVID-19
	285 (23.9%)	229 (18.2%)
Saeed et al. [50]	983	1283	Patients with diabetes mellitus hospitalized with COVID-19	Montefiore Medical Center, Bronx, New York	Observational retrospective	Patient with diabetes on statins had lower cumulative in-hospital mortality (24% vs. 39%, p < 0.01). HR = 0.51, CI: 0.43–0.61, p < 0.001	Statin use associated with reduced in-hospital mortality from COVID-19 in patients with diabetes
	236 (24.0%)	500 (39.0%)
Saeed et al. [50]	372	1614	Patients without diabetes mellitus hospitalized with COVID-19	Montefiore Medical Center in Bronx, New York	Observational retrospective	No difference noted in patients without diabetes (20% vs. 21%, p = 0.82)	Statin use associated with reduced in-hospital mortality from COVID-19 in patients with diabetes
	74 (20.0%)	339 (21.0%)
Song et al. [56]	123	126	Patients with COVID-19	“Lifespan” healthcare system hospitals	Retrospective cohort	No significant associations between statin use and in hospital death OR = 0.88, CI: 0.37–2.08, p = 0.781	No significant associations between statin use and hospital death
	N/A	N/A
De Spiegeleer et al. [58]	31	123	Residents at 2 elderly care homes with COVID-19 diagnosis	1 of 2 Belgian nursing homes	Retrospective multi-centre cohort	Considering death as serious outcome, the effects sizes, OR = 0.61, CI: 0.15–1.71, p = 0.380	Statins not statistically significant associated with death from COVID-19 in elderly adults in nursing homes
	N/A	N/A
Rodriguez-Nava et al. [53]	47	40	Laboratory-confirmed COVID-19	Community hospital intensive care unit (ICU) located in Evanston, IL	Retrospective cohort	Multivariable Cox PH regression model showed atorvastatin non-users had 73% chance of faster progression to death compared with users. HR = 0.38, CI: 0.18–0.77, p = 0.008	Slower progression to death associated with atorvastatin use in patients with COVID-19 admitted to ICU
	23 (49.0%)	25 (63.0%)
Zenga et al. [66]	38	993	COVID-19 inpatients	Tongji Hospital, Tongji Medical College of HUST (Wuhan, China)	Retrospective cohort	OR = 0.79, CI = 0.3–2.05	N/A
	5 (13.1%)	160 (16.1%)
Nguyen et al. [67]	90	266	African American Population with COVID-19	University of Chicago Medical Center (UCMC), serving south metropolitan Chicago	Retrospective observational	OR = 0.81, CI: 0.39–1.72	N/A
	10 (11.1%)	35 (13.1%)
Wang et al. [34]	24	12	multiple myeloma patients with COVID-19	Mount Sinai Hospital	Retrospective	Statin use significantly associated with mortality. OR = 6.21, CI: 1.37–39.77, p = 0.012	N/A
	11 (45.8%)	3 (25.0%)
Grasselli et al. [46]	N/A	N/A	Patients admitted to ICUs in Lombardy with suspected SARS-CoV-2 infection	One of the Network ICUs, Milan	Retrospective, observational study	Statins associated with higher mortality in univariate analysis. HR = 0.98, CI: 0.81–1.2, p = 0.87	Long-term treatment with statins, before ICU admission associated with higher mortality un-adjusted analysis only. Multivariate analysis did not confirm association between any home therapies and increased mortality
	N/A	N/A
Ayed et al. [68]	10	93	Intensive care unit intensive care unit (ICU)-admitted COVID-19 patients	Jaber Al-Ahmad Al Sabah Hospital, Kuwait	Retrospective cohort	OR = 0.49, CI: 0.11–2.08	N/A
	4 (40.0%)	43 (46.2%)
Tan et al. [60]	40	509	717 patients admitted	Tertiary centre in Singapore for COVID-19 infection	Retrospective cohort	ATET Coeff: –0.04, CI: –0.16–0.08, p = 0.488	No significant differences in mortality
	2 (5.0%)	N/A
Peymani et al. [64]	75	75	Hospitalised COVID-19 patients	Single tertiary hospital, Shiraz, Iran	Retrospective	HR = 0.76, CI: 0.16–3.72, p = 0.735	Non-significant association between statin use and reduction in mortality in patients with COVID19
	N/A	N/A
Nicholson et al. [69]	511	531	1042 people with COVID-19 symptoms admitted	Mass General Brigham Hospitals	Retrospective cohort	OR = 0.50, CI: 0.27–0.93, p = 0.027	Chronic statin use associated with reduced in-hospital mortality
	N/A	N/A
Lala et al. [70]	984	1752	Hospitalized COVID-19 positive patients	1 of 5 Mount Sinai Health System hospitals in New York City	Multihospital retrospective cohort	HR = 0.57, CI: 0.47–0.69, p < 0.001	Statin use associated with improved survival
	N/A	N/A
Krishnan et al. [35]	81	71	Consecutive patients requiring mechanical ventilation from March 10 to April 15	St. Joseph Mercy Oakland Hospital	Retrospective observational	OR = 2.44, CI: 1.23–4.76, p = 0.0080	Statin use associated with increased mortality
	N/A	N/A
Vahedian-Azimi et al. [54]	326	525	Positive for SARS-CoV-2	Baqiyatallah University of Medical Sciences	Prospective observational	OR = 0.18, CI: 0.06–0.49, p = 0.0001	Statin use associated with decreased mortality
	8 (2.5%)	282 (53.7%)

N/A – not available.

^*Values represent the incidence rate of death during a 28-day follow-up per 100 person-days.