Association Of Statin Therapy On Clinical Outcomes In Covid-19 Patients: An Updated Systematic Review And Meta-Analysis On All Related Evidences

statin therapy in COVID-19 patients


Background: Statins is a class of lipid-lowering drugs and our previous investigations showed that statins have antiviral effects and have a wound healing effect in the lung. This systematic review and meta-analysis aimed to evaluate the effects of statin therapy on mortality and clinical outcomes in COVID-19 patients.

Methods: A comprehensive search was conducted in international databases, including MEDLINE, Scopus, Web of Science, and Embase from December 1, 2019 until January 26, 2022 without any restriction in language. The random-effects model was used to estimate the pooled odds ratio (OR).

Results: The statin therapy overally was associated with decrease in odds of ventilation [pooled OR (95% CI): 0.85 (0.70 to 0.99)] and mortality [pooled OR (95% CI): 0.73 (0.66 to 0.81)] but had no effects on the  ICU admission [pooled OR (95% CI):  0.93 (0.77 to 1.12)], oxygen therapy [pooled OR (95% CI): 0.85 (0.70 to 0.99)], recovery [pooled OR (95% CI): 1.85 (0.35 to 9.92)], kidney failure [pooled OR (95% CI): 1.01 (0.73 to 1.40)], hospitalization [pooled OR (95% CI): 1.45 (0.88 to 2.36)], asymptomatic disease [pooled OR (95% CI): 1.33 (0.24 to 7.44)], and ARDS [pooled OR (95% CI): 1.15 (0.88 to 1.49)].

Conclusions: The present meta-analysis showed that statin therapy was associated with a reduced risk of mortality and ventilation in patients with COVID-19 but had no effects on other clinical outcomes.

1. Malekifar P, Pakzad R, Shahbahrami R, Zandi M, Jafarpour A, Rezayat SA, et al. Viral Coinfection among COVID-19 Patient Groups: An Update Systematic Review and Meta-Analysis. Biomed Res Int. 2021; 2021: 5313832.
2. Soltani S, Faramarzi S, Zandi M, Shahbahrami R, Jafarpour A, Akhavan Rezayat S, et al. Bacterial coinfection among coronavirus disease 2019 patient groups: an updated systematic review and meta-analysis. New Microbes New Infect. 2021; 43: 100910.
3. Pakzad R, Malekifar P, Shateri Z, Zandi M, Akhavan Rezayat S, Soleymani M, et al. Worldwide prevalence of microbial agents' coinfection among COVID-19 patients: A comprehensive updated systematic review and meta-analysis. J Clin Lab Anal. 2022; 36 (1): e24151.
4. Soltani S, Zandi M, Faramarzi S, Shahbahrami R, Vali M, Rezayat SA, et al. Worldwide prevalence of fungal coinfections among COVID-19 patients: a comprehensive systematic review and meta-analysis. Osong Public Health Res Perspect. 2022; 13 (1): 15-23.
5. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The Lancet. 2020; 395 (10223): 497-506.
6. Holshue ML, DeBolt C, Lindquist S, Lofy KH, Wiesman J, Bruce H, et al. First case of 2019 novel coronavirus in the United States. N Engl J Med. 2020.
7. Ruan Q, Yang K, Wang W, Jiang L, Song J. Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China. Intensive Care Med. 2020; 46 (5): 846-8.
8. Zheng Z, Peng F, Xu B, Zhao J, Liu H, Peng J, et al. Risk factors of critical & mortal COVID-19 cases: A systematic literature review and meta-analysis. J Infect. 2020; 81 (2): e16-e25.
9. Wu C, Chen X, Cai Y, Zhou X, Xu S, Huang H, et al. Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan, China. JAMA Intern Med. 2020; 180 (7): 934-43.
10. Nicin L, Abplanalp WT, Mellentin H, Kattih B, Tombor L, John D, et al. Cell type-specific expression of the putative SARS-CoV-2 receptor ACE2 in human hearts. Eur Heart J. 2020; 41 (19): 1804-6.
11. Hoffmann M, Kleine-Weber H, Schroeder S, Krüger N, Herrler T, Erichsen S, et al. SARS-CoV-2 cell entry depends on ACE2 and TMPRSS2 and is blocked by a clinically proven protease inhibitor. Cell. 2020; 181 (2): 271-80. e8.
12. Castiglione V, Chiriacò M, Emdin M, Taddei S, Vergaro G. Statin therapy in COVID-19 infection. Eur Heart J Cardiovasc Pharmacother. 2020; 6 (4): 258-9.
13. Musial J, Undas A, Gajewski P, Jankowski M, Sydor W, Szczeklik A. Anti-inflammatory effects of simvastatin in subjects with hypercholesterolemia. Int J Cardiol. 2001; 77 (2-3): 247-53.
14. Ridker PM, Rifai N, Lowenthal SP. Rapid reduction in C-reactive protein with cerivastatin among 785 patients with primary hypercholesterolemia. Circulation. 2001; 103 (9): 1191-3.
15. Ridker PM, Rifai N, Pfeffer MA, Sacks F, Braunwald E. Long-Term Effects of Pravastatin on Plasma Concentration of C-reactive Protein. Circulation. 1999; 100 (3): 230-5.
16. Vaughan CJ, Gotto AM, Basson CT. The evolving role of statins in the management of atherosclerosis. J Am Coll Cardiol. 2000; 35 (1): 1-10.
17. Kwak B, Mulhaupt F, Myit S, Mach F. Statins as a newly recognized type of immunomodulator. Nat Med. 2000; 6 (12): 1399-402.
18. Mulhaupt F, Matter CM, Kwak BR, Pelli G, Veillard NR, Burger F, et al. Statins (HMG-CoA reductase inhibitors) reduce CD40 expression in human vascular cells. Cardiovasc Res. 2003; 59 (3): 755-66.
19. Fedson DS. A practical treatment for patients with Ebola virus disease. J Infect Dis. 2015; 211 (4): 661-2.
20. Reiner Ž, Hatamipour M, Banach M, Pirro M, Al-Rasadi K, Jamialahmadi T, et al. Statins and the COVID-19 main protease: in silico evidence on direct interaction. Arch Med Sci. 2020; 16 (3): 490.
21. Fernandez R, De Pedro VJ, Artigas A. Statin therapy prior to ICU admission: protection against infection or a severity marker? Intensive Care Med. 2006; 32 (1): 160-4.
22. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009; 6 (7): e1000097.
23. Brunt EM, Wong VW, Nobili V, Day CP, Sookoian S, Maher JJ, et al. Nonalcoholic fatty liver disease. Nat Rev Dis Primers. 2015; 1: 15080.
24. Kim JA, Choi KM. Sarcopenia and fatty liver disease. Hepatol Int. 2019; 13 (6): 674-87.
25. Ghazanfarpour M, Kashani ZA, Pakzad R, Abdi F, Rahnemaei FA, Akbari PA, et al. Effect of electromagnetic field on abortion: A systematic review and meta-analysis. Open Med (Wars). 2021; 16 (1): 1628-41.
26. Aparisi Á, Amat-Santos IJ, López Otero D, Marcos-Mangas M, González-Juanatey JR, San Román JA. [Impact of statins in patients with COVID-19]. Rev Esp Cardiol. 2021; 74 (7): 637-40.
27. Bui A-TN, Tyan K, Giobbie-Hurder A, Klein IA, Manos MP, Zubiri L, et al. Impact of COVID-19 on Patients with Cancer Receiving Immune Checkpoint Inhibitors. J Immunother Precis Oncol. 2021; 4 (2): 35-44.
28. Butt JH, Gerds TA, Schou M, Kragholm K, Phelps M, Havers-Borgersen E, et al. Association between statin use and outcomes in patients with coronavirus disease 2019 (COVID-19): a nationwide cohort study. BMJ Open. 2020; 10 (12): e044421.
29. Byttebier G, Belmans L, Alexander M, Saxberg BEH, De Spiegeleer B, De Spiegeleer A, et al. Hospital mortality in COVID-19 patients in Belgium treated with statins, ACE inhibitors and/or ARBs. Hum Vaccin Immunother. 2021; 17 (9): 2841-50.
30. Cabezón Villalba G, Amat-Santos IJ, Dueñas C, Lopez Otero D, Catala P, Aparisi A, et al. Impact of the presence of heart disease, cardiovascular medications and cardiac events on outcome in COVID-19. Cardiol J. 2021; 28 (3): 360-8.
31. Cariou B, Goronflot T, Rimbert A, Boullu S, Le May C, Moulin P, et al. Routine use of statins and increased COVID-19 related mortality in inpatients with type 2 diabetes: Results from the CORONADO study. Diabetes Metab. 2021; 47 (2): 101202.
32. Cariou B, Hadjadj S, Wargny M, Pichelin M, Al-Salameh A, Allix I, et al. Phenotypic characteristics and prognosis of inpatients with COVID-19 and diabetes: the CORONADO study. Diabetologia. 2020; 63 (8): 1500-15.
33. Chacko SR, DeJoy R, 3rd, Lo KB, Albano J, Peterson E, Bhargav R, et al. Association of Pre-Admission Statin Use With Reduced In-Hospital Mortality in COVID-19. Am J Med Sci. 2021; 361 (6): 725-30.
34. Daniels LB, Ren J, Kumar K, Bui QM, Zhang J, Zhang X, et al. Relation of prior statin and anti-hypertensive use to severity of disease among patients hospitalized with COVID-19: Findings from the American Heart Association's COVID-19 Cardiovascular Disease Registry. PLoS One. 2021; 16 (7): e0254635.
35. Daniels LB, Sitapati AM, Zhang J, Zou J, Bui QM, Ren J, et al. Relation of Statin Use Prior to Admission to Severity and Recovery Among COVID-19 Inpatients. Am J Cardiol. 2020; 136: 149-55.
36. De Spiegeleer A, Bronselaer A, Teo JT, Byttebier G, De Tré G, Belmans L, et al. The Effects of ARBs, ACEis, and Statins on Clinical Outcomes of COVID-19 Infection Among Nursing Home Residents. J Am Med Dir Assoc. 2020; 21 (7): 909-14.e2.
37. Fan Y, Guo T, Yan F, Gong M, Zhang XA, Li C, et al. Association of Statin Use With the In-Hospital Outcomes of 2019-Coronavirus Disease Patients: A Retrospective Study. Front Med (Lausanne). 2020; 7: 584870.
38. Grasselli G, Greco M, Zanella A, Albano G, Antonelli M, Bellani G, et al. Risk Factors Associated With Mortality Among Patients With COVID-19 in Intensive Care Units in Lombardy, Italy. JAMA Intern Med. 2020; 180 (10): 1345-55.
39. Greco S, D'Amuri A, Giorgini E, Luciani F, Lopreiato M, Fortunato V, et al. Role of Statins in Coronavirus-Related Disease (COVID-19): A Retrospective Cohort Study in Northern Italy. High Blood Press Cardiovasc Prev. 2021; 28 (4): 355-64.
40. Gupta A, Madhavan MV, Poterucha TJ, DeFilippis EM, Hennessey JA, Redfors B, et al. Association between antecedent statin use and decreased mortality in hospitalized patients with COVID-19. Nat Commun. 2021; 12 (1): 1325.
41. Haji Aghajani M, Moradi O, Azhdari Tehrani H, Amini H, Pourheidar E, Hatami F, et al. Promising effects of atorvastatin on mortality and need for mechanical ventilation in patients with severe COVID-19; a retrospective cohort study. Int J Clin Pract. 2021; 75 (9): e14434.
42. Higuchi T, Nishida T, Iwahashi H, Morimura O, Otani Y, Okauchi Y, et al. Early clinical factors predicting the development of critical disease in Japanese patients with COVID-19: A single-center, retrospective, observational study. J Med Virol. 2021; 93 (4): 2141-8.
43. Holt A, Mizrak I, Lamberts M, Lav Madsen P. Influence of inhibitors of the renin-angiotensin system on risk of acute respiratory distress syndrome in Danish hospitalized COVID-19 patients. J Hypertens. 2020; 38 (8): 1612-3.
44. Huh K, Ji W, Kang M, Hong J, Bae GH, Lee R, et al. Association of previous medications with the risk of COVID-19: a nationwide claims-based study from South Korea. MedRxiv. 2020.
45. Ikari Y, Matsue Y, Torii S, Hasegawa M, Aihara K, Kuroda S, et al. Association between statin use prior to admission and lower coronavirus disease 2019 (COVID-19) severity in patients with cardiovascular disease or risk factors. Circ. 2021; 85 (6): 939-43.
46. Israel A, Schäffer AA, Cicurel A, Feldhamer I, Tal A, Cheng K, et al. Identification of drugs associated with reduced severity of COVID-19 – a case-control study in a large population. eLife. 2021; 10: e68165.
47. Jakob CE, Borgmann S, Duygu F, Behrends U, Hower M, Merle U, et al. First results of the “lean European open survey on SARS-CoV-2-infected patients (LEOSS)”. Infection. 2021; 49 (1): 63-73.
48. Jia X, Virani SS. Statins in COVID-19 infection: A rehash of old themes or truly a new hope? J Clin Lipidol. 2021; 15 (3): 399-401.
49. Khalili S, Sabaghian T, Sedaghat M, Soroureddin Z, Askari E, Khalili N. Prevalence, risk factors and outcomes associated with acute kidney injury in patients hospitalized for COVID-19: a comparative study between diabetic and nondiabetic patients. J Diabetes Res. 2021; 2021.
50. Lala A, Johnson KW, Januzzi JL, Russak AJ, Paranjpe I, Richter F, et al. Prevalence and impact of myocardial injury in patients hospitalized with COVID-19 infection. J Am Coll Cardiol. 2020; 76 (5): 533-46.
51. Lee H-Y, Ahn J, Park J, Kyung Kang C, Won S-H, Wook Kim D, et al. Beneficial effect of statins in COVID-19–related outcomes—brief report: a national population-based cohort study. Arterioscler Thromb Vasc Biol. 2021; 41 (3): e175-e82.
52. Lohia P, Kapur S, Benjaram S, Cantor Z, Mahabadi N, Mir T, et al. Statins and clinical outcomes in hospitalized COVID-19 patients with and without Diabetes Mellitus: a retrospective cohort study with propensity score matching. Cardiovasc Diabetol. 2021; 20 (1): 1-15.
53. Lohia P, Kapur S, Benjaram S, Mir T. Association between antecedent statin use and severe disease outcomes in COVID-19: a retrospective study with propensity score matching. J Clin Lipidol. 2021; 15 (3): 451-9.
54. Mallow PJ, Belk KW, Topmiller M, Hooker EA. Outcomes of hospitalized COVID-19 patients by risk factors: results from a United States hospital claims database. J Health Econ Outcomes Res. 2020; 7 (2): 165.
55. Marić I, Oskotsky T, Kosti I, Le B, Wong RJ, Shaw GM, et al. Decreased mortality rate among COVID-19 patients prescribed statins: data from electronic health records in the US. Front Med (Lausanne). 2021; 8: 30.
56. Masana L, Correig E, Rodríguez-Borjabad C, Anoro E, Arroyo JA, Jericó C, et al. Effect of statin therapy on SARS-CoV-2 infection-related mortality in hospitalized patients. Eur Heart J Cardiovasc Pharmacother. 2022; 8 (2): 157-64.
57. Meintrup D, Borgmann S, Seidl K, Stecher M, Jakob CEM, Pilgram L, et al. Specific Risk Factors for Fatal Outcome in Critically Ill COVID-19 Patients: Results from a European Multicenter Study. J Clin Med. 2021; 10 (17).
58. Memel ZN, Lee JJ, Foulkes AS, Chung RT, Thaweethai T, Bloom PP. Association of Statins and 28-Day Mortality Rates in Patients Hospitalized With Severe Acute Respiratory Syndrome Coronavirus 2 Infection. J Infect Dis. 2022 1 (1): 19–29.
59. Mitacchione G, Schiavone M, Curnis A, Arca M, Antinori S, Gasperetti A, et al. Impact of prior statin use on clinical outcomes in COVID-19 patients: data from tertiary referral hospitals during COVID-19 pandemic in Italy. J Clin Lipidol. 2021; 15 (1): 68-78.
60. Nguyen AB, Upadhyay GA, Chung B, Smith B, Besser SA, Johnson JA, et al. Outcomes and cardiovascular comorbidities in a predominantly African-American population with COVID-19. medRxiv. 2020.
61. Nicholson CJ, Wooster L, Sigurslid HH, Li RH, Jiang W, Tian W, et al. Estimating risk of mechanical ventilation and in-hospital mortality among adult COVID-19 patients admitted to Mass General Brigham: The VICE and DICE scores. EClinicalMedicine. 2021; 33: 100765.
62. Oddy C, McCaul J, Keeling P, Allington J, Senn D, Soni N, et al. Pharmacological Predictors of Morbidity and Mortality in COVID‐19. J Clin Pharmacol. 2021; 61 (10): 1286-300.
63. Oh TK, Song I, Jeon Y-T. Statin therapy and the risk of COVID-19: a cohort study of the National Health Insurance Service in South Korea. J Pers Med. 2021; 11 (2): 116.
64. Pareek M, Singh A, Vadlamani L, Eder M, Pacor J, Park J, et al. Relation of cardiovascular risk factors to mortality and cardiovascular events in hospitalized patients with coronavirus disease 2019 (from the Yale COVID-19 Cardiovascular Registry). Am J Cardiol. 2021; 146: 99-106.
65. Peymani P, Dehesh T, Aligolighasemabadi F, Sadeghdoust M, Kotfis K, Ahmadi M, et al. Statins in patients with COVID-19: a retrospective cohort study in Iranian COVID-19 patients. Transl Med Commun. 2021; 6 (1): 1-14.
66. Ramos-Rincón JM, Pérez-Belmonte LM, Carrasco-Sánchez FJ, Jansen-Chaparro S, De-Sousa-Baena M, Bueno-Fonseca J, et al. Cardiometabolic therapy and mortality in very old patients with diabetes hospitalized due to COVID-19. J Gerontol A Biol Sci Med Sci. 2021; 76 (8): e102-e9.
67. Rodriguez-Nava G, Trelles-Garcia DP, Yanez-Bello MA, Chung CW, Trelles-Garcia VP, Friedman HJ. Atorvastatin associated with decreased hazard for death in COVID-19 patients admitted to an ICU: a retrospective cohort study. Crit Care. 2020; 24 (1): 1-2.
68. Russo V, Silverio A, Scudiero F, Attena E, D'Andrea A, Nunziata L, et al. Preadmission Statin Therapy and Clinical Outcome in Hospitalized Patients With COVID-19: An Italian Multicenter Observational Study. J Cardiovasc Pharmacol. 2021; 78 (1): e94.
69. Saeed O, Castagna F, Agalliu I, Xue X, Patel SR, Rochlani Y, et al. Statin Use and In-Hospital Mortality in Patients With Diabetes Mellitus and COVID-19. J Am Heart Assoc. 2020; 9 (24): e018475.
70. Salvador P, Oliveira P, Costa T, Fidalgo M, Neto R, Silva ML, et al. Clinical Features and Prognostic Factors of 245 Portuguese Patients Hospitalized With COVID-19. Cureus. 2021; 13 (3): e13687.
71. Satué-Gracia EM, Vila-Córcoles A, de Diego-Cabanes C, Vila-Rovira A, Torrente-Fraga C, Gómez-Bertomeu F, et al. Susceptibility and risk of SARS-COV-2 infection among middle-aged and older adults in Tarragona area, Spain. Med Clin (Barc). 2022; 158 (6): 251-9.
72. Soldevila L, Valerio-Sallent L, Roure S, Pérez-Quílez O, Mas M, Miralles R, et al. Drug exposure may have a substantial influence on COVID-19 prognosis among residents of long-term care facilities: an exploratory analysis. Int J Infect Dis. 2021; 109: 192-4.
73. Soleimani A, Kazemian S, Karbalai Saleh S, Aminorroaya A, Shajari Z, Hadadi A, et al. Effects of angiotensin receptor blockers (ARBs) on in-hospital outcomes of patients with hypertension and confirmed or clinically suspected COVID-19. Am J Hypertens. 2020; 33 (12): 1102-11.
74. Song SL, Hays SB, Panton CE, Mylona EK, Kalligeros M, Shehadeh F, et al. Statin use is associated with decreased risk of invasive mechanical ventilation in COVID-19 patients: a preliminary study. Pathogens. 2020; 9 (9): 759.
75. Strandberg TE, Kivimäki M. Increased mortality risk associated with statins in the CORONADO study. Diabetes Metab. 2021.
76. Terlecki M, Wojciechowska W, Klocek M, Olszanecka A, Stolarz-Skrzypek K, Grodzicki T, et al. Association between cardiovascular disease, cardiovascular drug therapy, and in-hospital outcomes in patients with COVID-19: data from a large single-center registry in Poland. Kardiol Pol. 2021; 79 (7-8): 773-80.
77. Tignanelli CJ, Bramante CT, Dutta N, Tamariz L, Usher MG, Ikramuddin S. Metabolic surgery may protect against admission for COVID-19 in persons with nonalcoholic fatty liver disease. Surg Obes Relat Dis. 2021; 17 (10): 1780-6.
78. Torres-Peña JD, Pérez-Belmonte LM, Fuentes-Jiménez F, López Carmona M, Pérez-Martinez P, López-Miranda J, et al. Prior treatment with statins is associated with improved outcomes of patients with COVID-19: data from the SEMI-COVID-19 Registry. Drugs. 2021; 81 (6): 685-95.
79. Valeri AM, Robbins-Juarez SY, Stevens JS, Ahn W, Rao MK, Radhakrishnan J, et al. Presentation and Outcomes of Patients with ESKD and COVID-19. J Am Soc Nephrol. 2020; 31 (7): 1409-15.
80. Wander PL, Lowy E, Beste LA, Tulloch-Palomino L, Korpak A, Peterson AC, et al. Risk factors for adverse outcomes among 35 879 veterans with and without diabetes after diagnosis with COVID-19. BMJ Open Diabetes Res Care. 2021; 9 (1).
81. Yan H, Valdes AM, Vijay A, Wang S, Liang L, Yang S, et al. Role of Drugs Used for Chronic Disease Management on Susceptibility and Severity of COVID-19: A Large Case-Control Study. Clin Pharmacol Ther. 2020; 108 (6): 1185-94.
82. Yetmar ZA, Challener DW, Tleyjeh IM, Sohail MR, Cerhan JR, Badley AD, et al. Association Between Chronic Statin Use and 30-Day Mortality in Hospitalized Patients With COVID-19. Mayo Clin Proc Innov Qual Outcomes. 2021; 5 (2): 442-6.
83. Zhang XJ, Qin JJ, Cheng X, Shen L, Zhao YC, Yuan Y, et al. In-Hospital Use of Statins Is Associated with a Reduced Risk of Mortality among Individuals with COVID-19. Cell Metab. 2020; 32 (2): 176-87.e4.
84. Wang B, Van Oekelen O, Mouhieddine TH, Del Valle DM, Richter J, Cho HJ, et al. A tertiary center experience of multiple myeloma patients with COVID-19: Lessons learned and the path forward. J Hematol Oncol. 2020; 13 (1).
85. Huang I, Lim MA, Pranata R. Diabetes mellitus is associated with increased mortality and severity of disease in COVID-19 pneumonia - A systematic review, meta-analysis, and meta-regression. Diabetes Metab Syndr. 2020; 14 (4): 395-403.
86. Sorokin AV, Karathanasis SK, Yang ZH, Freeman L, Kotani K, Remaley AT. COVID-19-Associated dyslipidemia: Implications for mechanism of impaired resolution and novel therapeutic approaches. Faseb j. 2020; 34 (8): 9843-53.
87. Dashti-Khavidaki S, Khalili H. Considerations for Statin Therapy in Patients with COVID-19. Pharmacotherapy. 2020; 40 (5): 484-6.
88. Stancel N, Chen CC, Ke LY, Chu CS, Lu J, Sawamura T, et al. Interplay between CRP, Atherogenic LDL, and LOX-1 and Its Potential Role in the Pathogenesis of Atherosclerosis. Clin Chem. 2016; 62 (2): 320-7.
89. Hossain MF, Hasana S, Mamun AA, Uddin MS, Wahed MII, Sarker S, et al. COVID-19 Outbreak: Pathogenesis, Current Therapies, and Potentials for Future Management. Front Pharmacol. 2020; 11.
90. Kumar R, Lee MH, Mickael C, Kassa B, Pasha Q, Tuder R, et al. Pathophysiology and potential future therapeutic targets using preclinical models of COVID-19. ERJ Open Res. 2020; 6 (4): 00405-2020.
91. Li YH, Wang QX, Zhou JW, Chu XM, Man YL, Liu P, et al. Effects of rosuvastatin on expression of angiotensin-converting enzyme 2 after vascular balloon injury in rats. J Geriatr Cardiol. 2013; 10 (2): 151-8.
92. South AM, Diz DI, Chappell MC. COVID-19, ACE2, and the cardiovascular consequences. Am J Physiol Heart Circ Physiol. 2020; 318 (5): H1084-h90.
93. Lim MA, Oehadian A, Alisjahbana B. Ther Adv Respir Dis.
94. Ward NC, Watts GF, Eckel RH. Statin Toxicity. Circ Res. 2019; 124 (2): 328-50.
IssueVol 8 No 4 (2022) QRcode
Clinical outcome COVID-19 Meta-Analysis Mortality Statin therapy Systematic Review.

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
Moharerzadeh Kurd D, Seidkhani nahal A, Noori-zadeh A, Sheikhabbasi A, Heydari F, Pakzad I, Pakzad R. Association Of Statin Therapy On Clinical Outcomes In Covid-19 Patients: An Updated Systematic Review And Meta-Analysis On All Related Evidences. JBE. 2022;8(4):407-434.