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Study: Use of statins linked to lower death rate in COVID-19 patients
Animal studies have also shown that ACE2 protects organs such as the lungs against virus-induced injury, the researchers explained. It has not been clear how clinical outcomes in patients with COVID-19 are affected by the use of statins, either alone or in combination with ACE inhibitors and ARBs, which are commonly prescribed with statins and also increase ACE2 expression in animals, they said.
The researchers carried out a retrospective study of 13,981 COVID-19 patients admitted to 21 hospitals in Hubei Province, China. Among these patients, 1,219 used statins, primarily atorvastatin at an average dose of 20 mg/day. Among patients with hypertension or high blood pressure, 319 used statins combined with ACE inhibitors or ARBs, and 603 used statins combined with other antihypertensive drugs. The researchers analysed mortality rates and secondary outcomes, including the incidence of invasive mechanical ventilation, admission to intensive care units, acute respiratory distress syndrome, and liver, kidney, or heart injury.
Over a 28-day follow-up period, statin use was associated with a lower death rate and a lower incidence of mechanical ventilation, the study found. Statin use was associated with 5.5 per cent mortality rate, compared to 6.8 per cent without statin use, representing a 19 per cent decrease, they said. When the researchers examined the matched cohort of 861 patients in the statin group and 3,444 patients in the non-statin group, statin use was associated with a 45 per cent decrease in the mortality rate, from 9.4 per cent to 5.2 per cent. In the matched cases, statin use was also associated with lower levels of three inflammation biomarkers, and a lower incidence of acute respiratory distress syndrome and admission to intensive care units, the researchers said.
In the unmatched sample, mortality and secondary outcomes over 28 days were not affected by the use of statins combined with ACE inhibitors or ARBs, compared to combination therapy consisting of statins and other antihypertensive drugs. However, in the matched cohort with 204 patients in each group, the use of statins combined with ACE inhibitors or ARBs versus other antihypertensive drugs was associated with a 65 per cent drop in the death rate, and a lower incidence of heart injury and acute respiratory distress syndrome.
However, the study does not prove that the lower death rate of patients with COVID-19 is directly caused by the use of statins, either alone or in combination with ACE inhibitors or ARBs, the researchers said. Researchers said it is also unclear whether the findings apply to non-hospitalised patients with COVID-19, adding that the results of retrospective studies should be interpreted with caution.
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