SynthesisAnnals of medicine2021

The use of statins was associated with reduced COVID-19 mortality: a systematic review and meta-analysis.

Kuan-Sheng Wu, Pei-Chin Lin, Yao-Shen Chen, Tzu-Cheng Pan, Pei-Ling Tang

Open access · goldFull text readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in Annals of medicine, 2021. The graph read 1 number from its abstract, feeding 1 cell of the map, but none could be read as for or against, so it casts no vote. It also reports an association that does not count as treatment evidence, such as OR 0.71 (0.55 to 0.92) for all-cause mortality. Cited by 28 papers, 3 of them syntheses that pooled it.

1number the graph read from it
0cells of the map it votes in
28citing papers in PubMed, 3 pooled it
2.8field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

Read, but not usablea number the graph found but could not read as for or against

All-cause mortalityan association or prognostic statement, not a treatment comparison · ascvdfeeds one cell of the map
OR 0.710.55 to 0.92
The use of statins was significantly associated with decreased mortality (odds ratio [OR] = 0.71, 95% confidence interval [CI]: 0.55-0.92, CONCLUSIONS: The use of statins was significantly associated with a reduced need for IMV and decreased mortality among individuals with COVID-19.

clause the extractor read what became the number

2 · Its place on the map

Where it lands on the map

Rows are treatments, columns are outcomes. The coloured squares are the cells this paper feeds, coloured by the vote it casts there. Click one to jump to what this paper adds to it.

supports the treatmentfavours the comparatorno clear differenceread, but no usable result
3 · What it changes

What it adds to each cell

For every cell the paper feeds: the belief in the claim with and without this paper, and this paper's estimate drawn against every other readable study in the cell. The ringed dot is this paper.

Statins×all-cause mortality

No readable resultOpen on the map →What to test next →

13 readable studies in this cell: 3 favour the treatment, 8 find no difference, 2 favour the comparator.

Belief with this paper
0.50contested · 3 families support, 2 contradict · against placebo
Without itNot a counted family in this claim, so removing it changes nothing.
← favours the treatmentfavours the comparator →
1 · no effect
NCT023442907,769 enrolled · 2015
HR 0.880.70 to 1.12
HR 1.010.91 to 1.11
NCT03944512102 enrolled · 2019
RR 0.670.37 to 1.19
RR 0.990.89 to 1.11

This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.

4 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

5 · Its place in the literature

Who cites it

28 citing papers in PubMed, 3 syntheses or guidelines pooled it, 48 citations in OpenAlex.

  1. Pooled it
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  10. Drug-drug interaction with oral antivirals for early treatment of COVID-19 - Authors' reply.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2023
    Article
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  13. Review
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6 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

7 · Who and what money

Authors and funding

5 authors at 3 institutions in 1 country.

Kuan-Sheng WuDepartment of Internal Medicine, Division of Infectious Diseases, Kaohsiung Veterans General Hospital, Kaohsiung City, ROC.
Pei-Chin LinDepartment of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung City, ROC.
Yao-Shen ChenFaculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, ROC.
Tzu-Cheng PanResearch Center of Medical Informatics, Kaohsiung Veterans General Hospital, Kaohsiung City, ROC.
Pei-Ling TangResearch Center of Medical Informatics, Kaohsiung Veterans General Hospital, Kaohsiung City, ROC.ORCID 0000-0002-5312-1477
Kaohsiung Medical University · TWNational Yang Ming Chiao Tung University · TWKaohsiung Veterans General Hospital · TW

Funding

No grant is acknowledged in the PubMed record.

8 · The paper itself

Abstract

The marked sentences are the ones the graph read a number from.

backgroundStatins are widely used to treat people with metabolic and cardiovascular disorders. The effect of statins on coronavirus disease 2019 (COVID-19) is unclear. To investigate the association between statins and COVID-19 outcomes and, if possible, identify the subgroup population that benefits most from statin use. MATERIALS AND

methodsA systematic review and meta-analysis of published studies that included statin users and described COVID-19 outcomes through 10 November 2020. This study used the generic inverse variance method to perform meta-analyses with random-effects modelling. The main outcomes were evaluation of the need for invasive mechanical ventilator (IMV) support, the need for intensive care unit (ICU) care and death. All outcomes were measured as dichotomous variables.

resultsA total of 28 observational studies, covering data from 63,537 individuals with COVID-19, were included. The use of statins was significantly associated with decreased mortality (odds ratio [OR] = 0.71, 95% confidence interval [CI]: 0.55-0.92,

conclusionsThe use of statins was significantly associated with a reduced need for IMV and decreased mortality among individuals with COVID-19. Statins may not need to be discontinued because of concern for COVID-19 on admission. Further randomized controlled trial (RCTs) are needed to clarify the causal effect between statin use and severe COVID-19 outcomes.Key messagesParticipants in five types of studies were shown to have even lower odds of death when taking statins.The use of statins was significantly associated with a reduced need for invasive mechanical ventilation and decreased all-cause mortality among individuals with COVID-19. However, statin use did not prevent participants from needing care in the intensive care unit.The results justify performing randomized controlled trials (RCTs) to validate the benefits of statins on COVID-19 outcomes.

Indexed as

Cardiovascular DiseasesCOVID-19HumansHydroxymethylglutaryl-CoA Reductase InhibitorsIntensive Care UnitsRandomized Controlled Trials as TopicRespiration, ArtificialHydroxymethylglutaryl-CoA Reductase InhibitorsCOVID-19mechanical ventilatormeta-analysismortalitySARS-CoV-2statin

Identifiers

PMID34096808
PMCPMC8189130
OpenAlexW3166740974

What Socratic holds

Textfull text, public
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.