Patients hospitalized with COVID-19 who take statin drugs are less likely to die and less likely to need mechanical ventilation than those who don’t take the cholesterol-lowering drugs, according to a study led by Chinese researchers in collaboration with UCLA’s Yibin Wang, PhD, professor of molecular biology.
Among two groups of COVID-19 patients with matching clinical characteristics other than statin usage, hospitalized patients taking statins had a 5.2 percent mortality rate, compared with a 9.4 percent mortality rate for patients not taking statins. Statin use also was linked to lower levels of inflammation, as well as a lower incidence of acute respiratory distress syndrome and admission to intensive care units.
Dr. Wang notes this is the first time a link has been observed between statin use and COVID-19 mortality based on a large-scale retrospective group analysis. The study also found that patients taking statins showed a comparably lower risk of dying or suffering other negative outcomes whether or not they were taking one of two classes of blood pressure-lowering drugs — angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs).
Repurposing existing approved drugs is viewed as an important interim strategy until the development of a vaccine or drug to effectively prevent or treat severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, which causes COVID-19. Statins are cholesterollowering drugs associated with a very good safety profile, low cost and potent anti-inflammatory effects, suggesting they could be beneficial to counter SARS-CoV-2 infection. In the clinic, they often are prescribed along with ACE inhibitors and ARBs for individuals with high blood pressure or cardiac pathologies.
Earlier this year, the same group of researchers reported that people with COVID-19 taking ACE inhibitors and ARBs were at a lower risk of mortality than those not treated. Despite this, there were some concerns about the benefits of these drugs in COVID-19 patients, because animal studies had shown that statins, ACE inhibitors, and ARBs increase the expression of angiotensin-converting enzyme II (ACE2), the receptor that SARS-CoV-2 uses to infect host cells. Thus, a closer look was needed to determine how clinical outcomes in patients with COVID-19 could be affected by the use of statins, either alone or in combination therapy.
The researchers looked back at the records of 13,981 COVID-19 patients admitted to 21 hospitals in Hubei Province, China. Of those patients, 1,219 were given statins for an average of 25 days during hospitalization. Among patients with hypertension, 319 used statins combined with ACE inhibitors or ARBs, and 603 used statins combined with other antihypertensive drugs. The researchers analyzed mortality rates as well as secondary outcomes, including the need for mechanical ventilation, admission to intensive care units and acute respiratory distress syndrome. They also measured the levels of three inflammation biomarkers – circulating C reactive protein, interleukin 6 and neutrophil counts – selected to represent the overall status of systemic inflammation in the body.
Because participants receiving statins were older and had a greater incidence of medical conditions such as hypertension, lung lesions, and diabetes, the researchers analyzed patients who were matched for baseline characteristics such as age, disease severity, and preexisting conditions.
The results of the study, Dr. Wang says, support the potential benefits of statin use in hospitalized patients with COVID-19 and show the safety of proceeding with future studies involving statins for the treatment of COVID-19.
— Sandra Capellera Garcia
“In-hospital Use of Statins Is Associated with a Reduced Risk of Mortality among Individuals with COVID-19,” Cell Metabolism, August 4, 2020