Statins were associated with lower mortality rates in hospital patients with neo-coronary pneumonia

in a June 24 report in Cell Metabolism, a journal of Cell Press Cell Press,
researchers say that the use of cholesterol-lowering drugs called statins in hospital patients with COVID-19 can reduce mortality and mechanical aeration rates. The large-scale retrospective study also showed that a combination of statins and blood pressure-lowering drugs, angiotensin conversion enzyme (ACE) inhibitors and angiotensin blockers (ARBs), did not increase the risk of death and other adverse outcomes.
" results support the safety and potential benefits of statins in treating COVID-19 hospitalized patients and provide a basis for prospective studies to determine whether statins can prevent COVID-19-related deaths. "In addition, our findings make an important contribution to the accumulation of clinical evidence on the beneficial or adverse effects of ACE inhibitors or ARBs prescriptions on patients with COVID-19," said Li Hongliang, a professor at Wuhan University and author of the paper. At
, no vaccine or antiviral drug has been approved for the prevention or treatment of new coronavirus infections. Since vaccines or drugs for COVID-19 may not be available for months or even years, re-use of clinically approved therapies may be a more attractive option. Statins may achieve this because they can slow the progression of lung damage in animals, improve immune cell response, and significantly reduce inflammation, which can be the cause of serious COVID-19 complications, such as organ damage.
Although statins are generally extremely safe in humans, animal studies have shown that they increase the expression of angiotensin-converting enzyme II (ACE2), with which the new coronavirus binds and enters the host cell's digestor. On the other hand, animal studies have shown that ACE2 protects organs such as the lungs from virus-induced damage. Therefore, it is not clear whether statin use alone, or in association with ACE inhibitors/ARBs, has an effect on the clinical efficacy of COVID-19 patients, which are usually used in with statins and also increase the expression of ACE2 in animals.
to fill this knowledge gap, Li Hongliang and his collaborators conducted a retrospective study of 13,981 COVID-19 patients at 21 hospitals in Hubei Province, China. Of these patients, 1,219 used statins, mainly attovastatin, at an average dose of 20 mg/day. In patients with high blood pressure, 319 people used statins combined with ACE inhibitors or ARBs, and 603 people used statins combined with other antihypertensive drugs.
researchers analyzed mortality and secondary output, including the incidence of invasive mechanical ventilation, access to intensive care units, acute respiratory distress syndrome, and liver, kidney or heart damage. Because of the older age of patients taking statins and the higher incidence of lung lesions and chronic diseases, the researchers also analyzed sub-groups of patients who matched baseline characteristics, including age, disease severity, and past medical history.
statin use was associated with lower mortality and mechanical airfly rates during the 28-day follow-up period. Compared to the 6.8 per cent mortality rate for patients who did not use statins, the mortality rate for those who used statins was 5.5 per cent, a 19 per cent reduction. When the researchers examined matching queues of 861 patients in the statin group and 3,444 patients in the non-statin group, statin use was associated with a 45 percent reduction in mortality, from 9.4 percent to 5.2 percent. In the matching sample, statin use was also associated with lower levels of 3 inflammatory biomarkers, the rate of acute respiratory distress syndrome, and the occupancy rate in intensive care units.
In the mismatched sample, statins combined with ACE inhibitors or ARBs had no effect on 28-day mortality and secondary outcomes compared to a combined treatment consisting of statins and other antihypertensive drugs. But in the matching queue of 204 patients in each group, the mortality rate was 65 percent lower (3.4 percent for the former and 9.8 percent for acute respiratory distress syndrome) compared to other antihypertensive drugs, using statins combined with ACE inhibitors or ARBs, and the incidence of heart damage and acute respiratory distress syndrome was lower.
the use of ACE inhibitors or ARBs has been speculated to be potentially harmful to PATIENT-19 patients, some professional associations recommend that these drugs continue to be used to treat COVID-19 patients with high blood pressure," the report said. "As far as we know, this study is the first to provide clinical evidence that the use of ACE inhibitors or ARBs in a combined treatment with statins does not increase the risk of death in patients with COVID-19. How
ever, the study did not prove that the low mortality rate in COVID-19 patients was directly caused by statins (used alone or in association with ACE inhibitors/ARBs). It is unclear whether these findings apply to non-hospitalized COVID-19 patients. In addition, the results of retrospective studies should be interpreted with caution, Li said. "While these data do provide supporting evidence for the safety of statins, or their co-treatment with ACE inhibitors/ARBs, COVID-19, further randomized controlled trials are needed to explore the efficacy of statins for COVID-19."
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