The use of cholesterol-lowering drugs called statins is associated with a lower death rate and a lesser incidence of mechanical ventilation in hospitalised COVID-19 patients, according to a study.
The findings, published in the journal Cell Metabolism, also showed that mortality risk and other negative outcomes were not increased by combination therapy consisting of statins and blood pressure-lowering drugs called angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs).
“These results support the safety and potential benefits of statin therapy in hospitalised patients with COVID-19 and provide a rationale for prospective studies to determine whether statins confer protection against COVID-19-associated mortality,” said senior study author Hongliang Li of the Wuhan University in China.
Currently, there is no vaccine or specific antiviral drug approved to prevent or treat severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, which causes COVID-19.
Because a vaccine or drugs for COVID-19 will likely not be available for months or even years, repurposing clinically approved therapies might be a more attractive option.
Statins may serve such a purpose because these drugs slow the progression of lung injury in animals, improve immune cell responses, and strongly reduce inflammation, which is likely responsible for severe COVID-19 complications such as organ damage.
Although statins generally have an excellent safety profile in humans, animal studies have shown that they increase the expression of angiotensin-converting enzyme II (ACE2) — the receptor that SARS-CoV-2 binds to and uses to enter host cells.
On the other hand, animal studies have also shown that ACE2 protects organs such as the lungs against virus-induced injury.
As a result, it has not been clear how clinical outcomes in patients with COVID-19 are affected by the use of statins, either alone or in combination with ACE inhibitors and ARBs, which are commonly prescribed with statins and also increase ACE2 expression in animals.
To address this gap in knowledge, Li and his collaborators carried out a retrospective study of 13,981 corona patients admitted to 21 hospitals in Hubei Province, China.
Among these patients, 1,219 used statins, primarily atorvastatin at an average dose of 20 mg per day.
Among patients with hypertension, 319 used statins combined with ACE inhibitors or ARBs, and 603 used statins combined with other antihypertensive drugs.
Over a 28-day follow-up period, statin use was associated with a lower death rate and a lower incidence of mechanical ventilation.
Statin use was associated with 5.5 per cent mortality rate, compared to 6.8 per cent without statin use, representing a 19 per cent decrease, said the study.