COVID-19 Mortality Risk Was Found To Be Reduced By 22-25 Percent In Individuals Taking Statins According To Spanish Study

COVID-19 Mortality risk was found to be reduced by 22% to 25% in individuals taking statins according to a Spanish study.



The retrospective observational study involved patients taking statins who were 11 years older and had significantly more comorbidities than patients who were not taking statins. A genetic matching (GM) procedure was performed prior to analysis of the mortality risk. A Cox proportional hazards model was used for the cause-specific hazard (CSH) function, and a competing-risks Fine and Gray (FG) model was also used to study the direct effects of statins on risk.
 
Test results from reverse transcription-polymerase chain reaction-confirmed 2157 SARS-CoV-2-infected patients (1234 men, 923 women; age: 67 y/o (IQR 54-78)) admitted to the hospital were retrieved from the clinical records in anonymized manner. 353 deaths occurred. 581 patients were taking statins. Univariate test after GM showed a significantly lower mortality rate in patients on statin therapy than the matched non-statin group (19.8% vs. 25.4%, χ2 with Yates continuity correction: p = 0.027). The mortality rate was even lower in patients (n = 336) who maintained their statin treatments during hospitalization compared to the GM non-statin group (17.4%; p = 0.045). The Cox model applied to the CSH function (HR = 0.58(CI: 0.39-0.89); p = 0.01) and the competing risks FG model (HR = 0.60(CI: 0.39-0.92); p = 0.02) suggest that statins are associated with reduced COVID-19-related mortality.
 
The study team concluded that a lower SARS-CoV-2 infection-related mortality was observed in patients treated with statin therapy prior to hospitalization. Statin therapy should not be discontinued due to the global concern of the pandemic or in patients hospitalized for COVID-19.
 
The study findings were published in the European Heart Journal - Cardiovascular Pharmacotherapy. https://academic.oup.com/ehjcvp/advance-article/doi/10.1093/ehjcvp/pvaa128/5949102
 
The SARS-CoV-2 coronavirus has infected more than 48.2 million individuals around the world and has caused more than 1.22 million deaths in less than a year. Moreover, it is still not clear why some individuals who contract the SARS-Cov-2 coronavirus show no symptoms whereas others may die or suffer very severe consequences.
 
Despite the fact that  age, illnesses and previous treatments can be used to give a prognosis in some cases, it is still not possible to state for certain how each case of coronavirus will evolve. One of the treatments that have been discussed in regard to their role in the evolution of COVID-19 has been statins.
 
Statins helps to reduce cholesterol in the blood and thus prevent cardiovascular diseases. It is currently taken by one in four people and is the most widely used medicine among the general public.
 
The new research by the Universitat Rovira i Virgili (URV) and Pere Virgili Institut (IISPV) led by Lluís Masana has found that individuals who are being treated with statins have a 22% to 25% lower risk of dying from COVID -19.
 
The research was carried out through the Network of Lipid and Arteriosclerosis Units of Catalonia and collected information from 2,159 patients infected with SARS-CoV-2 from 19 hospitals in Catalonia during the first wave of the pandemic from March to May.
 
The study team evaluated one hundred clinical variables per patient such as age, sex, previous illnesses, cholesterol levels, evolution of the virus, treatments used for COVID-19, and so on.
 
The team then compared death rates of patients being treated with statins with death rates among those who were not and they also analyzed the effect of withdrawing statins when the patient was admitted to hospital.
 
Corresponding author Dr Lluis Masana who has coordinated the study from the Lipid and Arteriosclerosis Research Unit at the URV's Department of Medicine and Surgery explained to Thailand Medical News, "In our comparison, we adjusted the groups so that they were comparable in terms of age, sex and the existence of earlier illnesses.”
 
The Lipid and Arteriosclerosis Research Unit at the URV's Department of Medicine and Surgery is a member of the CIBERDEM Network bringing together research groups working on diabetes and metabolism in Spain. Dr Masana is also a researcher at the Sant Joan University Hospital in Reus.
 
Importantly the percentage of patients who died in the group not treated with statins was 25.4%, whereas it was 19.8% among those who were, that is to say 22% lower.
 
Dr Masana added, "The data indicate that treatment with statins prevents one in five deaths.”
 
Significantly, it was found that if treatment with this medicine continued during hospitalization, mortality fell by up to 25%, thus preventing one in four deaths.
 
Dr Masana went on to say that "not only do these findings demonstrate that treatment with statins has no negative on the evolution of COVID-19, they also show that it significantly reduces patient mortality".
 
It was reported that one of the indirect effects of the pandemic is that some people have stopped taking preventive measures aimed at combatting chronic diseases or maintaining general health, and this has been the case with statins.
 
Dr Masana commented, "Some health professionals have even advised their withdrawal in the belief that they could worsen the effects of COVID-19.”
 
Dr Masana warned that in this regard, in addition the virus to directly causing death in some patients, complications and overall mortality can increase due to the withdrawal of these drugs and regular monitoring of the use of this medicine.
 
Dr Masana added that in the case of statins, studies have demonstrated that fear of the pandemic should never be used as an excuse to suspend treatment.
 
Though the study was never intended to demonstrate that administering statins to COVID-19 patients would reduce the risk of death, it does open the way for studies that may confirm this finding.
 
The study team said, “In conclusion, background statin therapy exerted a beneficial effect on the in-hospital mortality of SARS-CoV-2-infected patients. The maintenance of statin therapy during admission correlated with an even better prognosis. The potential beneficial effect of statin therapy on mortality rates in patients with COVID-19 should be considered hypothesis-generating evidence that requires confirmation in a prospective randomized controlled trial. The evidence does not support the discontinuation of statin therapy during the COVID-19 pandemic.”
 
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