Abstract

BACKGROUND AND AIMS: Despite high global vaccination coverage and widespread statin use, it remains unclear how the interplay of anti-SARS-CoV-2-antibodies and statin treatment (ST) affect inflammation levels in COVID-19. It is further unclear whether the combination of ST and antibody levels affect COVID-19-related mortality risk.

METHODS: We conducted a prospective, propensity-score-matched, multicenter-cohort study including 1144 COVID-19 patients hospitalized August 2021-April 2022. Anti-SARS-CoV-2-spike antibodies, interleukin-6, and CRP were measured on hospital admission. The pre-specified primary endpoint was all-cause in-hospital mortality.

RESULTS: Median follow-up was 90 days (IQR48-90). In matched patients, mortality risk increased incrementally from the lowest risk group of patients on ST exhibiting high antibody levels to the highest risk group of patients without ST and low antibody levels. The highest risk group also presented with the highest inflammation levels. After adjusting for potential confounders, matched patients not receiving statins with low antibody levels were approximately 7.9 times more likely to die than patients on ST with high antibody levels (aHR 7.922, 95 %CI 2.777-22.605, p < 0.001).

CONCLUSION: Hospitalized COVID-19 patients with low antibody levels and lack of statin treatment exhibited the highest mortality risks. The combination of ST and antibodies showed a stronger association with mortality risk than either factor individually.