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- A new study suggests that taking statins may help reduce the risk of dying from severe COVID-19.
- In the study, people who took statins regularly before developing COVID-19 were about 50% less likely to die in hospital than people who did not.
- The use of statins has also appeared to reduce the levels of C-reactive protein in patients, a marker for inflammation.
- If further studies support these findings, it could provide a cost-effective, widely available, and low-risk treatment option for COVID-19.
Some 40 million people living in the United States take statins to help lower their cholesterol levels and their risk of heart disease.
But statins can also have potent anti-inflammatory, anti-blood clotting, and antiviral effects, all of which can help limit complications associated with severe COVID-19.
This is why researchers are trying to determine whether the use of statins has an impact on the outcome of COVID-19.
In a new study, a group of researchers, including cardiologists caring for COVID-19 hospital patients in New York City, set out to compare patient outcomes between people who had used statins before hospitalization and those who didn’t.
“Our study is one of the most important studies confirming this hypothesis, and the data lays the foundation for future randomized clinical trials needed to confirm the benefit of statins in COVID-19,” says study co-lead author , Dr. Aakriti Gupta, MD, cardiologist at NewYork-Presbyterian / Columbia University Irving Medical Center.
If a successful clinical trial validates the researchers’ results, statins could represent an inexpensive, easily accessible and relatively safe treatment option for COVID-19.
Currently, the Food and Drug Administration (FDA) has approved only one drug to treat COVID-19 – remdesivir (Veklury). However, certain other drugs may be of benefit at certain stages of the disease.
The study appears in Nature communications.
Statins are the most common type of medication used to lower cholesterol levels.
According to the American Heart Association, they work primarily by blocking a specific cholesterol-producing enzyme, which reduces the production and release of cholesterol.
But statins also appear to have a powerful anti-inflammatory, anti-coagulant, and anti-viral effect. They can also help improve wound healing in organs such as the lungs.
The researchers also investigated whether statins could help treat viral infections that can lead to major complications, such as generalized inflammation, clotting, and associated cell damage.
One of the most serious complications associated with COVID-19 and other respiratory infections is acute respiratory distress syndrome (ARDS). However, research evaluating the impact of statin use on ARDS has shown no large-scale benefits.
Despite this, a 2018 study found that using statins improved outcomes in people with a hyperinflammatory subtype of ARDS.
A 2017 study found that people taking statins when they were admitted to hospital with community-acquired pneumonia were less likely to die than people not taking them.
Researchers are now trying to assess whether statins might be helpful in the context of COVID-19.
A 2020 study in Singapore found that people taking statins were less likely to be admitted to an intensive care unit (ICU) than people not taking them.
Additional research found that people with COVID-19 who started taking statins after being hospitalized but not undergoing intensive care unit treatment were 47% less likely to die.
US researchers also recently discovered that using statins before hospitalization can reduce the risk of developing severe COVID-19 by 50%.
The study also noted that people with COVID-19 who took statins before they were admitted to hospital saw improved recovery times.
Scientists believe this could be because in addition to reducing inflammation, the risk of clots, and cell damage, statins also remove cholesterol from the outer membranes of cells.
SARS-CoV-2, the virus that causes COVID-19, binds and enters cells by attaching viral spike proteins to angiotensin-converting enzyme 2 (ACE-2) receptors in a cell.
These receptors are found in a lipid raft, a part of the cell membrane that contains cholesterol, proteins like ACE-2, and other fats and proteins.
And studies show that removing cholesterol from these lipid rafts means coronaviruses cannot enter cells even after binding.
In the new study, researchers compared the results of 648 patients with COVID-19 hospitalized in the first 18 weeks of the pandemic who normally used statins and 648 patients who did not.
They also matched patients from each group to reduce major differences in demographics, use of other drugs, and conditions that increase the risk of severe COVID-19.
Based on their analysis, in the study, 14.8% of people taking statins died in hospital within one month of admission compared to 26.5% of patients not taking statins.
Once the researchers took into account the major differences between patients, they found that using statins reduced the risk of in-hospital mortality within a month of hospitalization by about 50%. .
People taking statins also had lower levels of compounds associated with inflammation, such as C-reactive protein.
The current study represents one of the largest Western studies of its kind to indicate a positive link between COVID-19 survival and statin use.
But researchers need to confirm these findings with larger randomized trials that reduce the risk of unexplained or unaccounted for influencing factors. For example, in the retrospective study, it was not clear how long people taking statins had been using them or by how much they were taking them.
“If their beneficial effect is confirmed in randomized clinical trials, statins could prove to be an inexpensive and effective treatment strategy for COVID-19,” said study co-author Dr Mahesh V. Madhavan, MD, a cardiologist at NewYork-Presbyterian / Columbia University Irving Medical Center.
Researchers will also need to determine whether the effectiveness or usefulness of statins in treating COVID-19 varies across populations and countries.
Currently, several randomized studies are underway to find out whether the use of statins can reduce the risk of hospitalization for COVID-19 and the risk of death in hospitalized patients.
One of the study’s authors, Dr. Behnood Bikdeli, a vascular medicine researcher at Brigham and Women’s Hospital in Boston, MA, is conducting a randomized trial exploring the impact of statin use in patients with COVID- 19 ICU in Iran.
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