Background and Aims: We aim to study the association of hyperlipidemia and statin use with COVID-19 severity.
Methods: We analysed a retrospective cohort of 717 patients admitted to a tertiary centre in Singapore for COVID-19 infection. Clinical outcomes of interest were oxygen saturation ≤94% requiring supplemental oxygen, intensive-care unit (ICU) admission , invasive mechanical-ventilation and death. Logistic regression models were used to study the association between hyperlipidemia and clinical outcomes adjusted for age, gender and ethnicity. Statin treatment effect was determined , in a nested case-control design, through logistic treatment models with 1:3 propensity matching for age, gender and ethnicity. All statistical tests were two-sided, and statistical significance was taken as p < 0.05.
Results: One hundred fifty-six (21.8%) patients had hyperlipidemia and 97% were on statins. There were no significant associations between hyperlipidemia and clinical outcomes. Logistic treatment models showed a lower chance of ICU admission for statin users when compared to non-statin users (ATET: b-0.12(-0.23,-0.01); p=0.028). There were no other significant differences in other outcomes.
Conclusion: Treated hyperlipidemia was not an independent risk factor for severe COVID-19. Statin use independently associated with lower ICU admission. This supports current practice to continue prescription of statins in COVID-19 patients.