Will they help with COVID-19?

In a new study, researchers examined the electronic medical records of more than 38,000 patients hospitalized for COVID-19 in the United States between January and September 2020.

This was before the COVID-19 vaccine was approved by the US Food and Drug Administration.

Of the patients in the study, 30% were using statins regularly to treat high cholesterol.

U.S. Preventive Services Task Force Recommendation Statins for adults aged 40 to 75 years with certain risk factors for cardiovascular disease. Between 2017 and 2020, an estimated 45% of eligible Americans People over 40 use statins.

By examining patients’ medical records, the authors of a new study found that people using statins were 37% less likely to die of COVID-19 than those who did not use statins. did.

In addition, regular statin users were less likely to be discharged to hospice, admitted to the intensive care unit, or develop blood clots. I have less time to do it.

“Our results suggest that statins may be an additional cost-effective solution to COVID-19 disease severity and warrants further research,” study author Dr. . Ettore CrimiA professor of anesthesiology and critical care medicine at the University of Central Florida in Orlando said: news release.

This study was published on October 22nd. 2022 American Society of Anesthesiologists Annual MeetingNot yet peer-reviewed.

Several mechanism Statins have been proposed to reduce the severity and mortality risk of COVID-19.

Statins have anti-inflammatory effects on the body. This may help during COVID-19. COVID-19 affects organs and blood vessel lining.

these drugs too block A coronavirus that infects cells in the body and causes COVID-19.

However, statins may benefit COVID-19 patients in the same way as those without COVID-19.

“Most of the time I think [statins] It stabilizes atherosclerotic plaques that are likely to cause heart attacks and strokes, reducing the risk of these complications. Matthew S. Durstenfeldcardiologist and assistant professor of medicine at the University of California, San Francisco.

Other observational studies, some of which are larger than the newer studies, show similar, but sometimes mixed, results.

and study Of the more than 230,000 U.S. veterans who tested positive for COVID-19 between March 2020 and March 2021, statin users compared to nonusers had less than 30 days nearly 20% less likely to die from any cause

But when researchers looked at veterans who didn’t test positive for COVID-19, the benefits of statins were much stronger.

This suggests that the effects of statins on mortality risk are not “specific” for COVID-19 patients, the researchers wrote.

another study Of the more than 10,500 patients hospitalized with COVID-19 from the start of the pandemic through September 2020, those taking statins were found to be more than 40% less likely to die in hospital.

However, the statin benefit in this study was stronger in people with underlying cardiovascular disease.

“Statins reduce the risk of heart attack and stroke in people at cardiovascular risk, and we know that COVID-19 increases the risk of these events,” said Durstenfeld. “Therefore, people with cardiovascular disease are more likely to benefit from statin therapy during COVID-19.”

Most of the observational studies examining the benefits of statins for COVID-19 patients have been retrospective, with investigators reviewing patients’ medical records after the visit.

This type of research can help identify potentially effective treatments, but these studies have certain limitations.

“While such study designs can help identify important information quickly, it is not uncommon to see variability in results based on demographics, geographic region, and disease severity of the patients studied.” Dr. John D. They Need ItDirector of General, Consultative and Preventive Cardiology at the University of Michigan Frankel Cardiovascular Center in Ann Arbor.

A stronger type of study design is the randomized controlled trial (RCT), in which patients are randomly assigned to different groups, such as receiving statins or an inactive placebo.

but, “[RCTs] It takes more time and effort than a retrospective trial, and time is critical when dealing with new diseases like COVID-19,” said Bisognano, who is also a professor of internal medicine at the University of Michigan School of Medicine.

Several RCTs of statins as a treatment for COVID-19 have already been completed, but without promising results.

in one studyCOVID-19 patients admitted to the ICU received either a statin or an inactive placebo. studyhospitalized COVID-19 patients received statins, aspirin, or both.

In both studies, patients who received statins had similar COVID-19 outcomes to those who did not.

“One of the reasons that these two randomized trials did not yield a statistically significant benefit is that they included individuals at low cardiovascular risk who were less likely to benefit from statins.” Durstenfeld said.

Again, this suggests that the COVID-related benefits of statins are stronger for people with underlying cardiovascular disease.

Other RCTs are ongoing, but results have not yet been reported.

Durstenfeld said that until these trials are complete, “we are still inconclusive” about whether statins can reduce the risk of severe COVID-19. It’s also unclear whether statin therapy can reduce the risk of: long covid Or can be used to treat it.

Therefore, while waiting [results from] The rest of the statin trials, excluding COVID-19, suggest that anyone who has a reason to take a statin should probably continue or start statin therapy,” he said.

“But I won’t start [statin therapy] Specifically, trying to improve COVID-19 outcomes outside the context of clinical trials,” he added.

Despite the need for additional research on statins, they have already proven a way to reduce the risk of severe COVID-19 and the risk of death from COVID-19.

“For people who want to minimize the risk of adverse consequences of COVID-19, the best strategy is vaccination, including booster doses where recommended, and drugs like Paxlovid for those at high risk. take a drug Anne Marie NavarreCardiologist and Associate Professor at UT Southwestern Medical Center in Dallas.

Additionally, numerous studies have shown that statins definitely benefit people with cardiovascular disease.

“There are decades of clinical trial data showing that statins prevent heart attack and stroke and reduce the risk of death in people with heart disease or at high risk of heart disease,” Navar said. says.

“As a cardiologist, [statins] It’s somewhat irrelevant that it has a stand-alone benefit in COVID-19,” she added. “I use statins to prevent cardiovascular complications.”

Managing existing cardiovascular disease may also help combat other illnesses and conditions such as seasonal flu, pneumonia, cancer and trauma, Bisognano said.

“Cardiovascular disease of all kinds can make fighting other medical conditions more difficult,” he said. “It doesn’t just apply to COVID-19.”

He recommends that people with cardiovascular disease and other risk factors such as high blood pressure, high cholesterol and obesity reduce their risk by maintaining a healthy weight and taking statins and blood pressure medications if recommended by their doctor. We recommend that you take steps to

“Keeping yourself healthy increases your chances of fighting illnesses and conditions,” he said.