Medication that reduce cholesterol levels may reduce COVID-19 severity

Researchers from the University of California San Diego School of Medicine revealed that individuals on statin drugs had a 41% decreased incidence of COVID-19-related in-hospital death. The findings were published in PLOS ONE on July 15, 2021, and they build on previous study done at UC San Diego Health in 2020.

Statins are routinely used to lower blood cholesterol levels by inhibiting the production of cholesterol by liver enzymes. They're widely recommended: According to the Centers for Disease Control and Prevention, 93 percent of patients who take a cholesterol-lowering medication also take a statin.

"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 when faced with this virus at the beginning of the pandemic," said Lori Daniels, MD, lead study author, professor, and director of the Cardiovascular Intensive Care Unit at UC San Diego Health.

"At the time, we hypothesized that statins could be able to prevent SARS-CoV-2 infection due to their anti-inflammatory and binding properties, which could potentially block the virus's progression."

UC San Diego researchers applied their original findings to a considerably larger cohort: more than 10,000 hospitalized COVID-19 patients across the United States, using data from the American Heart Association's COVID-19 Cardiovascular Disease Registry.

Researchers looked examined the anonymised medical data of 10,541 individuals admitted for COVID-19 at 104 different hospitals over a nine-month period from January to September 2020.

"We ran more extensive analyses on this data, attempting to adjust for concurrent medical illnesses, socioeconomic status, and hospital characteristics," Daniels explained. "By doing so, we were able to corroborate our previous findings that statins are linked to a lower risk of death from COVID-19 in COVID-19 patients."

According to Daniels, the majority of the benefit appears to be among patients who are taking statins for medical reasons, such as a history of cardiovascular disease or high blood pressure. The use of statins or an anti-hypertension medicine was linked to a 32 percent lower risk of death among COVID-19 inpatients with a history of cardiovascular disease or hypertension, according to the researchers.

Statistical matching techniques were utilized in the study to compare the outcomes of individuals who took statins or an anti-hypertension drug to those who did not.

"We used hospital site, month of admission, age, race, ethnicity, gender, and a list of pre-existing conditions to match each patient to one or more similar patients in order to make the two groups as comparable as possible," said Karen Messer, PhD, study co-author and professor of biostatistics at UC San Diego School of Medicine.

The ACE2 receptor, also known as the'statin regulatory target,' aids in blood pressure management. SARS-CoV-2 virus predominantly employs the same receptor to reach lung cells, according to research published in 2020.

Statins and antihypertensive drugs, according to researchers, stabilize the underlying conditions for which they are administered, making patients more likely to recover from COVID-19.

"We can't say for sure that the associations we describe between statin use and reduced severity of COVID-19 infection are due to the statins themselves," Daniels said. "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 findings would encourage people to continue taking their medications."

In the first study, 170 anonymised medical records from UC San Diego Health patients were used. Researchers discovered that taking statins before being admitted to the hospital for COVID-19 reduced the risk of having a serious infection by more than half.

The COVID-19 Cardiovascular Disease Registry of the American Heart Association provides de-identified health data on COVID-19 patients treated at more than 140 member institutions across the US. Data from around 49,000 patient records had been provided to the portal as of July 2021.