COVID-19 Drugs: University Of California Study Confirms That Statins Used To Reduce Cholesterol Levels Can Also Decrease COVID-19 Mortality

COVID-19 Drugs: A new study by researchers from the University of California-San Diego School Of medicine-USA has confirmed that patients taking statin medications had a 41 percent lower risk of in-hospital death from COVID-19.

According to the study team, statins have anti-inflammatory and immunomodulatory effects that may reduce the severity of the COVID-19 disease, in which organ dysfunction is mediated by severe inflammation. Large studies with diverse populations evaluating statin use and outcomes in COVID-19 are lacking.
 
The study team used data from 10,541 patients hospitalized with COVID-19 through September 2020 at 104 US hospitals enrolled in the American Heart Association’s COVID-19 Cardiovascular Disease (CVD) Registry to evaluate the associations between statin use and outcomes. Prior to admission, 42% of subjects (n = 4,449) used statins (7% on statins alone, 35% on statins plus anti-hypertensives). Death (or discharge to hospice) occurred in 2,212 subjects (21%).
 
Outpatient use of statins, either alone or with anti-hypertensives, was associated with a reduced risk of death (adjusted odds ratio [aOR] 0.59, 95% CI 0.50–0.69), adjusting for demographic characteristics, insurance status, hospital site, and concurrent medications by logistic regression. In propensity-matched analyses, use of statins and/or anti-hypertensives was associated with a reduced risk of death among those with a history of CVD and/or hypertension (aOR 0.68, 95% CI 0.58–0.81). An observed 16% reduction in odds of death among those without CVD and/or hypertension was not statistically significant.
 
The Statins-COVID-19 use study findings concluded that patients taking statins prior to hospitalization for COVID-19 had substantially lower odds of death, primarily among individuals with a history of CVD and/or hypertension.
 
These observations support the continuation and aggressive initiation of statin and anti-hypertensive therapies among patients at risk for COVID-19, if these treatments are indicated based upon underlying medical conditions.
 
The study findings were published in the peer reviewed journal: PLOS One. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0254635
 
Statins, also known as HMG-CoA reductase inhibitors, are a class of lipid-lowering medications that reduce illness and mortality in those who are at high risk of cardiovascular disease. They are the most common cholesterol-lowering drugs.
 
LDL or Low-density lipoprotein carriers of cholesterol play a key role in the development of atherosclerosis and coronary heart disease via the mechanisms described by the lipid hypothesis. Statins are effective in lowering LDL cholesterol and so are widely used for primary prevention in people at high risk of cardiovascular disease, as well as in secondary prevention for those who have developed cardiovascular disease.
 
Common side effects of statins include muscle pain, increas ed risk of diabetes mellitus, and abnormal blood levels of liver enzymes. Additionally, they have rare but severe adverse effects, particularly muscle damage. They inhibit the enzyme HMG-CoA reductase which plays a central role in the production of cholesterol. High cholesterol levels have been associated with cardiovascular disease.
 
There are various forms of statins, some of which include atorvastatin, fluvastatin, lovastatin, pitavastatin, pravastatin, rosuvastatin, and simvastatin.
 
Utilizing anonymized medical records from a national registry, the medical scientist from University of California-San Diego confirmed earlier findings that statins may substantially minimize adverse outcomes from SARS-CoV-2 infection
 
The study findings confirmed that patients taking statin medications had a 41 percent lower risk of in-hospital death from COVID-19.
 
The study findings expanded upon prior research conducted at UC San Diego Health in 2020. https://www.thailandmedical.news/news/covid-19-treatments-studies-by-university-of-california-show-that-statin-usage-reduces-covid-19-severity-and-indirectly-affects-virus-cell-entry
 
Typically statins are commonly used to reduce blood cholesterol levels by blocking liver enzymes responsible for making cholesterol. They are widely prescribed: The Centers for Disease Control estimates that 93 percent of patients who use a cholesterol-lowering drug use a statin.
 
Dr Lori Daniels, MD, lead study author, professor and director of the Cardiovascular Intensive Care Unit at UC San Diego Health told Thailand Medical News,  “When faced with this virus at the beginning of the pandemic, there was a lot of speculation surrounding certain medications that affect the body’s ACE2 receptor, including statins, and whether they may influence COVID-19 risk.”
 
She further added, “At the time, we thought that statins may inhibit SARS-CoV-2 infection through their known anti-inflammatory effects and binding capabilities, which could potentially stop progression of the virus.”
 
By utilizing data from the American Heart Association’s COVID-19 Cardiovascular Disease Registry, the study team at University of California- San Diego applied their original findings to a much larger cohort: more than 10,000 hospitalized COVID-19 patients across the United States.
 
Importantly, the study team analyzed anonymized medical records of 10,541 patients admitted for COVID-19 over a nine-month period, January through September 2020, at 104 different hospitals. 
 
Dr Daniels added, “From this data, we performed more advanced analyses as we attempted to control for coexisting medical conditions, socioeconomic status and hospital factors. In doing so, we confirmed our prior findings that statins are associated with a reduced risk of death from COVID-19 among patients hospitalized for COVID-19.”
 
Dr Daniels said it appears most of the benefit is among patients with good medical reasons to be taking statins, such as a history of cardiovascular disease or high blood pressure.
 
According to the research team, the use of statins or an anti-hypertension medication was associated with a 32 percent lower risk of death among COVID-19 inpatients with a history of cardiovascular disease or hypertension.
 
For the research, statistical matching techniques were used to compare outcomes for patients who used statins or an anti-hypertension medication with similar patients who did not. 
 
Dr Karen Messer, PhD, study co-author and professor of biostatistics at University of California-San Diego School of Medicine added,  “We matched each patient to one or more similar patients, using hospital site, month of admission, age, race, ethnicity, gender, and a list of pre-existing conditions, in order to make the two groups as comparable as possible.”
 
It is already know that the ACE2 receptor which is the regulatory target of statins helps control blood pressure. In 2020, it was discovered that SARS-CoV-2 virus primarily uses the same receptor to enter lung cells. 
 
The study team says that statins and anti-hypertension medications stabilize the underlying diseases for which they are prescribed, making patients more likely to recover from COVID-19.
 
Dr Daniels further added, “As with any observational study, we cannot say for certain that the associations we describe between statin use and reduced severity of COVID-19 infection are definitely due to the statins themselves; however, we can now say with very strong evidence that they may play a role in substantially lowering a patient’s risk of death from COVID-19.We hope that our study findings are an incentive for patients to continue with their medication.”
 
It should be noted that the initial study in 2020 included 170 anonymized medical records from patients receiving care at UC San Diego Health.
 
The study findings then found that statin use prior to hospital admission for COVID-19 resulted in a more than 50 percent reduction in risk of developing severe infection.
 
For reference purposes, it should be noted that the American Heart Association’s COVID-19 Cardiovascular Disease Registry contains de-identified health data on patients treated for COVID-19 at more than 140 participating hospitals across the country.
 
 It was reported that as of July 2021, data from more than 49,000 patient records had been contributed into the platform.
 
The other researchers in the study team and co-authors of the study include: Dr Junting Ren, Dr Quan M. Bui, Dr Jing Zhang, Dr Xinlian Zhang, Dr Christopher A. Longhurst, all at UC San Diego; Dr Kris Kumar, Knight Cardiovascular Institute; Dr Mariem A. Sawan, Emory University School of Medicine; and Dr Howard Eisen, Pennsylvania State Health.
 
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