Cholesterol-lowering drugs called statins have proven controversial in the past, but they may reduce the risk of dying from Covid-19, a new study suggests.
Researchers in San Diego analyzed anonymized medical records from a national U.S. registry during the pandemic.
The sample consisted of people who had or had not taken statins before contracting Covid-19 and being hospitalized.
Researchers found that the drug — which is taken as a pill and is available over the counter in some areas — reduces the risk of dying in hospital from Covid-19 by 41 percent.
Statins are a class of drugs that lower ‘bad’ LDL (low density lipoprotein) cholesterol, which can lead to hardening and narrowing of the arteries, leading to heart attacks and strokes.
Lowering LDL cholesterol by taking statins may have anti-inflammatory effects, as LDL itself greatly promotes inflammation, potentially making patients more likely to survive the inflammatory symptoms of Covid.
Statins are a group of medicines that can help lower the level of low-density lipoprotein (LDL) cholesterol in the blood
The study was led by Lori Daniels, professor and director of the Cardiovascular Intensive Care Unit at UC San Diego Health.
WHAT IS ACE2?
ACE2 is an enzyme attached to the cell membranes of cells in the arteries and lungs.
ACE2 also serves as a gateway to cells for some coronaviruses.
SARS-CoV-2, the coronavirus that causes Covid-19, attaches to ACE2 to infect our healthy cells.
It is thought that the more of these receptors you have, the more entry points there are for the virus.
Covid-fighting properties of statins may also be linked to angiotensin-converting enzyme 2 (ACE2), the researchers claim.
ACE2 – an enzyme attached to the cell membranes of cells in the arteries and lungs – is already known as the ‘gateway’ for coronavirus infection.
SARS-CoV-2 has a peak on the surface of its envelope called an S protein, which allows it to bind with the ACE2 receptor on human cells.
Once the spike has opened the door for the virus to enter the cell, SARS-CoV-2’s genetic material, its RNA, binds to numerous proteins and begins to replicate.
“When we were confronted with this virus at the beginning of the pandemic, there was a lot of speculation about certain drugs that affect the body’s ACE2 receptor, including statins, and whether they can affect Covid-19 risk,” said Professor Daniels.
“At the time, we thought that statins could inhibit SARS-CoV-2 infection through their known anti-inflammatory effects and binding properties, which could potentially halt the progression of the virus.”
Illustration of SARS-CoV-2 virus binding to ACE2 receptors on a human cell, the initial stage of Covid infection
For their research, the experts used data from the American Heart Association’s Covid-19 Cardiovascular Disease Registry.
This database contains anonymized health data from patients treated for Covid in more than 140 participating hospitals across the country.
As of July 2021, data from more than 49,000 patient records had been added to the platform.
The research team analyzed anonymized medical records of 10,541 patients on the registry who were admitted to 104 different U.S. hospitals for Covid over a nine-month period, from January to September 2020.
“Based on this data, we conducted more sophisticated analyzes while trying to control for coexisting medical conditions, socioeconomic status and hospital factors,” said Professor Daniels.
“This confirmed our previous findings that statins are associated with a reduced risk of death from Covid-19 in patients hospitalized for Covid-19.”
Those who benefited the most seemed to have good medical reasons for taking statins, such as a history of cardiovascular disease or high blood pressure.
WHAT IS HYPERTENSION?
Hypertension is also known as high blood pressure.
Blood pressure is a measure of the force the heart uses to pump blood around the body, and it rises and falls in a cycle with each pulse.
It is measured in millimeters of mercury (mmHg), and the reading is always given as two numbers: systolic pressure (the pressure when the heart pushes blood out) and diastolic pressure (the pressure when the heart rests between beats).
The systolic value represents the maximum blood pressure and the diastolic value is the minimum blood pressure.
High systolic blood pressure in one arm alone indicates hypertension.
According to the research team, the use of statins or an antihypertensive drug was associated with a 32 percent lower risk of death in Covid patients with a history of cardiovascular disease or hypertension.
This can also be attributed to the ACE2 receptor, which helps control blood pressure.
Patients on statin use (alone or in combination with antihypertensive medications) had a 41 percent lower risk of death.
Compared with those who took neither type of medication, patients taking a statin alone had a 46 percent lower chance of death, while those on both statin and antihypertensive drugs had a 40 percent lower chance.
Statistical matching techniques were used to compare outcomes for patients taking statins or antihypertensive drugs with comparable patients who did not.
“We matched each patient with one or more similar patients, using hospital location, month of admission, age, race, ethnicity, gender, and a list of pre-existing conditions, to make the two groups as similar as possible,” said Co. -author Professor Karen Messer.
But the study did not confirm that statins were definitely the cause of survival.
“As with any observational study, we cannot say for sure that the associations we describe between statin use and reduced severity of Covid-19 infection are certainly due to the statins themselves,” said Professor Daniels.
“However, we can now say with very strong evidence that they can play a role in significantly lowering a patient’s risk of death from Covid-19.
‘We hope that our research results will provide an incentive for patients to continue with their medication.’
This new study builds on research published last year by UC San Diego Health that contained only 170 anonymized medical records of patients who specifically received care at UC San Diego Health.
Hypertension – high blood pressure – is one of the main risk factors for cardiovascular disease
At the time, researchers found that statin use prior to hospitalization for Covid resulted in a more than 50 percent reduction in the risk of developing a serious infection.
Statins are widely prescribed — the Centers for Disease Control estimates that 93 percent of patients taking a cholesterol-lowering drug take them.
While statins are generally well tolerated, many people report aches and pains as a side effect, which may cause some to stop taking the drug.
They cause some minor side effects, such as diarrhoea, headache and nausea, according to the NHS, but they can prevent serious health problems.
The new study, published in the journal PLOS One, a lot of research follows on their various benefits.
Last year, experts at VA Boston Health Care System, a division of hospitals in Massachusetts, found that deaths from any cause were 25 percent lower for those taking statins, out of a sample of 300,000 veterans age 75 or older.
In 2019, another study found that up to 8,000 deaths a year in the UK could be avoided if everyone over the age of 75 got statins.
Men taking statins are 24 percent less likely to develop a deadly form of prostate cancer studying in 2019 also revealed.
And in 2017, a 20-year review by UK researchers found that the pills reduced the risk of premature death by 28 percent.
Despite this, there has long been controversy about whether statins should be routinely taken by the elderly.
‘This topic has been controversial with several mixed results in the past showing little or no benefit from statins in this age group,’ said Dr Riyaz Patel, associate professor of cardiology at University College London.
“This, in turn, has led to uncertainty as to whether statins should be started or even stopped in older people.”
WHY ARE STATINS CONTROVERSIAL?
Statins are the most commonly prescribed drug in the world, and an estimated 30 percent of all adults over the age of 40 are eligible to use them.
The cholesterol-lowering drugs are given to people who are believed to have a 10 percent or greater risk of developing cardiovascular disease or having a heart attack or stroke within the next 10 years.
They have been proven to help people who have had heart problems in the past, but experts say the thresholds may be too high, meaning the benefits outweigh the side effects for many people.
Nearly all men cross the 10 percent threshold by age 65 and all women do so by age 70, regardless of health.
Commonly reported side effects include headache, muscle aches, and nausea, and statins can also increase your risk of developing type 2 diabetes, hepatitis, pancreatitis, and vision problems or memory loss.
Research published last year in the Pharmaceutical Journal found that taking a daily statin for five years after a heart attack extends your life by just four days, new research reveals.
and dr. Rita Redberg, a professor at the University of California, San Francisco, told CNN in January that of 100 people who take statins for five years without having had a heart attack or stroke, “best estimates are that one or two people will avoid a heart attack.” attack, and no one will live longer by taking statins.