Statins improve 28-day mortality in hospitalized patients with COVID-19

Amid coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), people with comorbidities have a higher risk of developing severe disease.

In the fight against COVID-19, scientists are racing to determine effective treatments to reduce mortality among infected people.

Researchers at Harvard Medical School have now shown that statin use reduces 28-day mortality in patients hospitalized with COVID-19. Both new statin initiation and continued statin therapy reduced the risk of mortality.

Study background

Statins are drugs that help lower the levels of low-density lipoprotein (LDL) cholesterol in the blood. High levels of LDL cholesterol can increase the risk of hardening and narrowing of arteries and cardiovascular disease.

SARS-CoV-2 infection has resulted in millions of deaths. More than 100 unusual and experimental drugs were used to treat patients with COVID-19 during the initial rush to treatment.

At a Massachusetts General Hospital, a statin is used for many reasons. First, there were cardiac complications due to COVID-19, and second, statins have cardioprotective properties. Furthermore, statins are affordable and safe and can stop the hyperinflammatory response to infection.

Statins have been shown to block the infectivity of SARS-CoV-2 by binding to a major protease that mediates viral entry, blocking the virus’s ability to infect cells. However, the safety and efficacy of statins for the treatment of hospitalized patients with COVID-19 remain unclear.

Study

To arrive at the study findings that appeared on the overprint server medRxiv *, the team conducted a single-center cohort study on 1,179 hospitalized patients with COVID-19. They observed patient death, admission to the intensive care unit, or discharge from the hospital. The team also reported on statin use, laboratory data, and patient comorbidities.

Overall, 360 patients never took statins, 311 were newly started on statins, 466 continued to take statins, and 42 stopped. The most commonly used drug was atorvastatin before and during hospitalization.

The study found that 13.1 percent of patients died within 28 days. The team also found that statin use reduced the risk of 28-day mortality. Also, new cell initiation and continued statin use reduced the risk of death from COVID-19 within 28 days.

“Overall, the new findings presented here are that statin therapy during hospitalization, whether it is a new or continuous prescription, is associated with improved mortality,” the study team concluded.

However, the duration of stain therapy required to achieve mortality benefits in COVID-19 is still unclear. The study suggests that statins are linked to the benefit of survival even after short-term use during hospitalization.

Benefits of statins

The researchers noted that the reasons why statins effectively reduce mortality in patients with COVID-19 include endothelial stabilization and their effect on inflammation.

Giving a statin while taking it, even for a short time, could have a positive effect on the cardiovascular system. COVID-19 elicits a hyperinflammatory response that triggers cardiovascular disorders.

Also, the ability of the drug to control and inhibit hydroxymethylglutaryl-coenzyme A reductase is another reason to consider. This can interfere with the virus’s ability to attack and infect cells.

“If statins improve COVID-19 outcomes by inhibiting viral cell invasion, the benefit may be increased when statins are prescribed before infection,” the study team wrote.

The team also found a link between statin use and mortality benefits in adults over 65, but not in patients over 65.

Because statins can help reduce mortality in patients with COVID-19, clinical trials are needed to determine the safety of the drug.

* Important notice

medRxiv publishes preliminary scientific reports that have not been reviewed and, therefore, should not be considered definitive, guide clinical practice / health-related behavior, or be treated as established information.

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