Submitted:
29 October 2024
Posted:
30 October 2024
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Abstract
To date, SARS Cov-2 virus has caused more than 775 million cases worldwide and led to 7 million deaths. The virus enters cells with the aid of the ACE2 receptor located in the airway epithelium, but also in endothelial cells lining the inner walls of vessels. Endothelial damage results in impaired blood flow and gas exchange. Statins have been shown to have a pleiotropic effects on the vascular epithelium. Aim of the study: Assessment of the efficacy and safety of statin therapy in patients with COVID-19. Methods: Two hundred and one COVID-19 patients hospitalized at the Jerzy Gromkowski Regional Specialist Hospital between March 2020 and December 2021 (i.e. during the period dominated by Alpha, Beta, Gamma and Delta variants). Patients were divided into three groups: (I) patients treated with statins prior to the admission to the hospital; (II) patients started on statins after admission due to Covid-19; (III) control patients with Covid-19, not treated with statins either prior to or during hospitalization. Met Statistica 13.1 calculations were used in the paper. Shapiro-Wilk, Kruskal-Wallis and ANOVA tests were also performed. Results: Out of the 201 patients total, group I comprised 66 patients with a mean age of 66.2 years; group II comprised 33 patients with a mean age of 75.3 years; and the control group comprised 97 patients with a mean age of 61.1 years. The groups characteristics did not show significant differences in terms of gender, place of hospitalization, percentage of Covid-19 vaccinations, number of convalescents. Death was observed in: 12% of patients in group I, 6% of patients in group II, and 6% of patients in group III. Body Mass Index (BMI) in group I was 31.3: a value significantly higher than the control group’s 28.3, (p<0.05). The severity of Covid-19 assessed on admission in group I – 4.09 – was statistically higher than in the control group 3.52 (p<0.05). The number of pulmonary embolism incidents did not differ between groups. Conclusions: During the period dominated by Alpha, Beta, Gamma and then Delta variants, we found no statistically significant positive or negative effects of statin therapy on the duration of hospitalization, number of complications or percentage of deaths between the two studied groups of patients: those who received statins prior to hospitalization, and those who received statins during hospitalization.
Keywords:
1. Introduction
Objectives
2. Materials and Methods
Statistical Analysis
3. Results
| Group | x̅ | Me | Min | Max | Q1 | Q3 | SD | P-value* (main result) | P-value (multiple comparison) | |
| CRP | Group I (n=68) | 114.0 | 93.7 | 3.0 | 447.9 | 54.2 | 144.8 | 84.0 | 0.06 | - |
| Group II (n=31) | 74.9 | 79.9 | 0.9 | 194.4 | 20.9 | 109.8 | 54.9 | |||
| Control group III (n=94) | 103.7 | 63.1 | 0.5 | 565.6 | 25.2 | 150.2 | 107.4 | |||
| HGB [g/dL] | Group I (n=68) | 14.3 | 14.4 | 10.3 | 18.8 | 13.5 | 15.3 | 1.7 | 0.001 | Group I vs Group II: p<0.001; Group I vs. Control group III: p=0.10; Group II vs. Control group III: p=0.06 |
| Group II (n=33) | 12.9 | 13.2 | 8.9 | 15.4 | 11.9 | 14.2 | 1.6 | |||
| Control group III (n=98) | 13.7 | 14.0 | 6.5 | 17.2 | 12.7 | 15.0 | 1.9 | |||
| WBC | Group I (n=68) | 7.0 | 6.6 | 2.6 | 16.1 | 4.8 | 8.6 | 3.0 | 0.43 | - |
| Group II (n=33) | 7.8 | 7.1 | 3.0 | 16.0 | 5.4 | 9.2 | 3.1 | |||
| Control group III (n=98) | 7.7 | 6.7 | 0.0 | 45.6 | 4.8 | 8.9 | 5.3 | |||
| Total billirubin [mg%] | Group I (n=60) | 0.67 | 0.60 | 0.20 | 1.40 | 0.50 | 0.80 | 0.27 | 0.64 | - |
| Group II (n=31) | 0.67 | 0.50 | 0.30 | 1.90 | 0.40 | 0.90 | 0.38 | |||
| Control group III (n=86) | 0.74 | 0.60 | 0.10 | 4.80 | 0.40 | 0.80 | 0.61 | |||
| ALT [IU/ml] | Group I (n=68) | 58.2 | 44.5 | 11.0 | 657.0 | 26.5 | 57.0 | 85.0 | 0.044 | Group I vs Group II: p=0.33; Group I vs. Control group III: p=0.98; Group II vs. Control group III: p=0.37 |
| Group II (n=32) | 35.0 | 28.6 | 7.0 | 122.0 | 15.7 | 46.0 | 24.7 | |||
| Control group III (n=96) | 55.9 | 37.5 | 8.0 | 752.0 | 23.0 | 64.0 | 80.9 | |||
| INR | Group I (n=68) | 1.04 | 1.040 | 0.880 | 1.4 | 0.975 | 1.08 | 0.09 | 0.40 | - |
| Group II (n=32) | 1.09 | 1.045 | 0.910 | 1.6 | 0.970 | 1.12 | 0.16 | |||
| Control group III (n=96) | 1.10 | 1.040 | 0.890 | 4.15 | 0.990 | 1.11 | 0.34 | |||
| D-dimers | Group I (n=67) | 1840.1 | 954.0 | 309.0 | 14831.0 | 679.0 | 1826.0 | 2669.5 | 0.56 | - |
| Group II (n=32) | 2674.6 | 848.0 | 400.0 | 53670.0 | 588.5 | 1197.5 | 9328.0 | |||
| Control group III (n=95) | 1342.9 | 957.0 | 227.0 | 5799.0 | 561.0 | 1702.0 | 1146.4 | |||
| Creatinine | Group I (n=68) | 1.00 | 0.840 | 0.550 | 5.6 | 0.765 | 1.03 | 0.63 | 0.14 | - |
| Group II (n=33) | 1.14 | 0.970 | 0.590 | 2.9 | 0.840 | 1.26 | 0.50 | |||
| Control group III (n=97) | 1.16 | 0.890 | 0.570 | 9.07 | 0.730 | 1.11 | 1.08 | |||
| Cholesterol | Group I (n=26) | 143.5 | 142.4 | 80.4 | 190.1 | 128.0 | 160.2 | 27.7 | 0.56 | - |
| Group II (n=14) | 164.5 | 135.6 | 90.9 | 551.0 | 113.6 | 162.3 | 115.2 | |||
| Control group III (n=35) | 154.8 | 148.0 | 78.0 | 238.6 | 122.7 | 187.2 | 42.5 | |||
| TGL | Group I (n=24) | 183.7 | 169.2 | 70.2 | 455.0 | 127.4 | 219.8 | 87.7 | 0.07 | - |
| Group II (n=9) | 119.5 | 102.5 | 68.6 | 189.0 | 96.1 | 142.3 | 39.5 | |||
| Control group III (n=30) | 154.2 | 150.1 | 47.3 | 334.4 | 104.2 | 179.4 | 67.8 | |||
| LDH | Group I (n=64) | 545.4 | 452.5 | 238.0 | 1950.0 | 349.0 | 607.0 | 305.8 | 0.005 | Group I vs Group II: p=0.007; Group I vs. Control group III: p=0.25; Group II vs. Control group III: p=0.12 |
| Group II (n=29) | 367.2 | 319.0 | 231.0 | 732.0 | 278.0 | 429.0 | 132.8 | |||
| Control group III (n=91) | 477.4 | 410.0 | 175.0 | 1499.0 | 290.0 | 618.0 | 257.4 |
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
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| Group | P-value* | |||||||
| Group I (n=68) | Group II (n=33) | Control group III | ||||||
| (n=98) | ||||||||
| n | % | n | % | n | % | |||
| Gender | Female | 24 | 35.3 | 18 | 54.5 | 37 | 38.1 | 0.16 |
| Male | 44 | 64.7 | 15 | 45.5 | 60 | 61.9 | ||
| SARS-Cov-2 vaccination | No | 55 | 80.9 | 26 | 81.3 | 89 | 90.8 | 0.14 |
| Yes | 13 | 19.1 | 6 | 18.8 | 9 | 9.2 | ||
| Death/Discharge | Death | 8 | 11.8 | 2 | 6.1 | 6 | 6.1 | 0.38 |
| Discharge | 60 | 88.2 | 31 | 93.9 | 92 | 93.9 | ||
| Group | x̅ | Me | Min | Max | Q1 | Q3 | SD | P-value* (main result) | P-value (multiple comparison) | |
| Age [years] | Group I (n=68) | 66.2 | 69.0 | 38.0 | 89.0 | 60.5 | 73.0 | 11.7 | <0.001* | Group I vs Group II: p=0.007***; Group I vs. Control group III: p=0.06**** Group II vs. Control group III: p<0.001*** |
| Group II (n=33) | 75.3 | 76.0 | 46.0 | 92.0 | 70.0 | 82.0 | 10.7 | |||
| Control group III (n=98) | 61.1 | 63.0 | 23.0 | 99.0 | 48.0 | 72.0 | 16.6 | |||
| BMI | Group I (n=38) | 31.3 | 31.3 | 23.4 | 45.7 | 26.3 | 35.4 | 5.5 | 0.026** | Group I vs Group II: p=0.29****; Group I vs. Control group III: p=0.017****; Group II vs. Control group III: p=0.89**** |
| Group II (n=18) | 29.0 | 27.0 | 21.4 | 45.5 | 25.0 | 31.8 | 6.0 | |||
| Control group III (n=69) | 28.3 | 28.4 | 17.3 | 41.7 | 25.1 | 31.9 | 5.3 | |||
| Length of hospitalization [days] | Group I (n=68) | 11.5 | 9.5 | 1.0 | 43.0 | 6.0 | 14.5 | 7.3 | 0.85* | - |
| Group II (n=33) | 10.7 | 9.0 | 1.0 | 41.0 | 7.0 | 12.0 | 7.2 | |||
| Control group III (n=98) | 11.5 | 9.0 | 1.0 | 34.0 | 6.0 | 16.0 | 7.8 |
| Group | x̅ | Me | Min | Max | Q1 | Q3 | SD | P-value* (main result) | P-value (multiple comparison) | |
| WHO grade – upon admission | Group I (n=67) | 4.09 | 4.00 | 2.00 | 7.00 | 3.00 | 5.00 | 1.08 | 0.005 | Group I vs Group II: p=0.08;Group I vs. Control group III: p=0.003; Group II vs. Control group III: p=0.96 |
| Group II (n=33) | 3.58 | 3.00 | 2.00 | 6.00 | 3.00 | 4.00 | 1.23 | |||
| Control group III (n=97) | 3.52 | 3.00 | 2.00 | 6.00 | 3.00 | 4.00 | 1.09 | |||
| WHO grade – upon discharge | Group I (n=59) | 2.29 | 2.00 | 2.00 | 6.00 | 2.00 | 2.00 | 0.81 | 0.62 | - |
| Group II (n=30) | 2.17 | 2.00 | 1.00 | 5.00 | 2.00 | 2.00 | 0.65 | |||
| Control group III (n=89) | 2.17 | 2.00 | 1.00 | 6.00 | 2.00 | 2.00 | 0.80 |
| Group | P-value* | |||||||
| Group I (n=68) | Group II (n=33) | Control group III (n=98) | ||||||
| n | % | n | % | n | % | |||
| GSK (dexamethason 8mg daily) | No | 3 | 4.4 | 6 | 18.2 | 16 | 16.3 | 0.042 |
| Yes | 65 | 95.6 | 27 | 81.8 | 82 | 83.7 | ||
| Heparin | No | 1 | 1.5 | 1 | 3.0 | 5 | 5.1 | 0.45 |
| Yes | 67 | 98.5 | 32 | 97.0 | 93 | 94.9 | ||
| Antivirals, anti-SARS-Cov-2 (remdesivir. malnupirawir) | No | 56 | 82.4 | 22 | 66.7 | 62 | 63.9 | 0.032 |
| Yes | 12 | 17.6 | 11 | 33.3 | 35 | 36.1 | ||
|
Immunomodulators (tocilizumab) |
No | 67 | 98.5 | 31 | 96.9 | 97 | 100.0 | 0.28 |
| Yes | 1 | 1.5 | 1 | 3.1 | 0 | 0.0 | ||
| Group | P-value* | |||||||
| Group I (n=68) | Group II (n=33) | Control group III (n=98) | ||||||
| n | % | n | % | n | % | |||
| Pulmonary embolism | No | 64 | 94.1 | 31 | 96.9 | 90 | 91.8 | 0.58 |
| Yes | 4 | 5.9 | 1 | 3.1 | 8 | 8.2 | ||
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