New research led by a team from Johns Hopkins Medicine has found no evidence statin use can reduce a person’s risk of severe COVID-19 or death. Countering several small studies suggesting statins may be somewhat protective against severe COVID-19, the study indicates those taking statins could actually be at a slightly higher risk of serious illness.
From improving breast cancer survival to reducing rates of psychiatric events statin use has been linked to a number of health benefits over the past few years, beyond simply lowering levels of bad cholesterol. And as the COVID-19 pandemic swept the globe in 2020 some observational studies began to detect links between statin use and improved COVID-19 outcomes.
“Despite the apparent beneficial effect of statins on the outcomes of various infectious diseases, our study revealed that their specific use to treat COVID-19 is probably not merited,” explains Petros Karakousis, senior study author. “Compared with earlier research, we looked at a larger and more widely varied inpatient population, and had better criteria for defining disease severity, thereby enabling our results to be more relevant for predicting the impact of statins on COVID-19 outcomes in hospitalized patients.”
The retrospective research looked at records from 4,447 hospitalized COVID-19 patients, of which 13 percent were taking statins at the time of admission. The researchers found no difference in mortality rates between statin users and patients not taking statins.
In fact, the study did detect signs statin users were at a slightly higher risk of severe disease. Those on the drug were 18 percent more likely to experience severe COVID-19, defined by a hospital stay of over seven days.
It is unclear whether the statin use can be directly attributed to the slight uptick in severe disease outcomes detected in the study, but Karakousis does point out there is a plausible mechanism by which statins could amplify severe COVID-19 outcomes.
“One plausible explanation for this finding is that statins increase cellular production of angiotensin-converting enzyme 2 [commonly known as ACE2], the receptor on a cell’s surface through which SARS-CoV-2 gains entry,” Karakousis explains. “Therefore, statins may lower a cell’s resistance to infection and in turn, increase the odds that the patient will have a more severe case of COVID-19.”
On the other hand, Karakousis does note it is just as reasonable to presume other factors are responsible for the worse disease outcomes detected in the study. Many statin users suffer from several pre-existing conditions such as obesity or diabetes, Karakousis says, and these conditions of course can predispose one to severe COVID-19 outcomes.
Karakousis says a robust clinical trial is the only way to get real clarity on whether statins help or hinder COVID-19. One clinical trial, with results yet to be peer-reviewed and published, has tested the statin hypothesis in a cohort of 600.
The results, presented earlier this year at a cardiology conference, found no difference between patients given statins for 30 days as they were admitted into intensive care and patients given a placebo. On the bright side, this clinical trial did not detect worse outcomes in the statin group compared to placebo.
The new research was published in the journal PLOS One.
Source: Johns Hopkins Medicine
