Statin use is associated with lower disease severity in COVID-19 infection

Tan, Wilnard Yeong Tze; Young, Barnaby Edward; Lye, David C.; Chew, Daniel Ek Kwang; Dalan, Rinkoo

doi:10.1038/s41598-020-74492-0

Cited by 104 publications

(98 citation statements)

References 55 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our study found an unexpected association between reporting symptoms in keeping with COVID-19 in the previous 6 months and the use of statins, which have previously been associated with a reduced severity of COVID-19 (25). It's possible that our sample method selected out those who suffered severe COVID -19, and that statins should rather be considered marker of comorbidity (and therefore higher risk for symptomatic COVID-19) in this population.…”

Section: Discussionmentioning

confidence: 59%

Higher SARS-CoV-2 Seroprevalence in Workers with Lower Socioeconomic Status in Cape Town, South Africa.

Shaw

Meiring

Cummins

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: South Africa has a high degree of inequality between population groups. The first wave of COVID-19 may have affected people in lower socioeconomic groups worse than the affluent. The SARS-CoV-2 seroprevalence and the specificity of anti-SARS-CoV-2 antibody tests in South Africa is not known. Methods: We tested 405 volunteers representing all socioeconomic strata from the workforce of a popular shopping and tourist complex in central Cape Town with the Abbott SARS-CoV-2 IgG assay. We assessed the association between antibody positivity and COVID-19 symptom status, medical history, and sociodemographic variables. We tested 137 serum samples from healthy controls collected in Cape Town prior to the COVID-19 pandemic, to confirm the specificity of the assay in the local population.Results: Of the 405 volunteers tested one month after the first peak of the epidemic in Cape Town, 96(23.7%) were SARS-CoV-2 IgG positive. Of those who tested positive, 46(47.9%) reported no symptoms of COVID-19 in the previous 6 months. Seropositivity was significantly associated with living in informal housing, residing in a subdistrict with low income-per household, and having a low-earning occupation. The specificity of the assay was 98.54%(95%CI 94.82%-99.82%) in the pre-COVID controls.Conclusions: There is a high background seroprevalence in Cape Town, particularly in people of lower socioeconomic status. Half of cases are asymptomatic, and therefore undiagnosed by local testing strategies. These results cannot be explained by low assay specificity.

show abstract

Section: Discussionmentioning

confidence: 59%

Higher SARS-CoV-2 Seroprevalence in Workers with Lower Socioeconomic Status in Cape Town, South Africa.

Shaw

Meiring

Cummins

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Furthermore, a recent investigation showed that statin use decreased the in-hospital mortality in COVID-19 patients with diabetes [ 41 ]. It has also been reported that for patients using statin during hospitalization the risk of ICU admission is reduced when compared to non-statin users [ 42 ], and that statin use decreased the risk of invasive mechanical ventilation in COVID-19 patients [ 43 ].…”

Section: Discussionmentioning

confidence: 99%

Statins in patients with COVID-19: a retrospective cohort study in Iranian COVID-19 patients

et al. 2021

View full text Add to dashboard Cite

Background The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has profoundly affected the lives of millions of people. To date, there is no approved vaccine or specific drug to prevent or treat COVID-19, while the infection is globally spreading at an alarming rate. Because the development of effective vaccines or novel drugs could take several months (if not years), repurposing existing drugs is considered a more efficient strategy that could save lives now. Statins constitute a class of lipid-lowering drugs with proven safety profiles and various known beneficial pleiotropic effects. Our previous investigations showed that statins have antiviral effects and are involved in the process of wound healing in the lung. This triggered us to evaluate if statin use reduces mortality in COVID-19 patients. Results After initial recruitment of 459 patients with COVID-19 (Shiraz province, Iran) and careful consideration of the exclusion criteria, a total of 150 patients, of which 75 received statins, were included in our retrospective study. Cox proportional-hazards regression models were used to estimate the association between statin use and rate of death. After propensity score matching, we found that statin use appeared to be associated with a lower risk of morbidity [HR = 0.85, 95% CI = (0.02, 3.93), P = 0.762] and lower risk of death [(HR = 0.76; 95% CI = (0.16, 3.72), P = 0.735)]; however, these associations did not reach statistical significance. Furthermore, statin use reduced the chance of being subjected to mechanical ventilation [OR = 0.96, 95% CI = (0.61–2.99), P = 0.942] and patients on statins showed a more normal computed tomography (CT) scan result [OR = 0.41, 95% CI = (0.07–2.33), P = 0.312]. Conclusions Although we could not demonstrate a significant association between statin use and a reduction in mortality in patients with COVID19, we do feel that our results are promising and of clinical relevance and warrant the need for prospective randomized controlled trials and extensive retrospective studies to further evaluate and validate the potential beneficial effects of statin treatment on clinical symptoms and mortality rates associated with COVID-19.

show abstract

“…Several groups have raised the idea that statins can be used as early therapy to mitigate COVID-19-associated ARDS and cytokine storm syndrome [34][35][36] . Several recent reports showed that inhospital use of statins is associated with a reduced risk of mortality among individuals with COVID-19 [37][38][39] . There were more than 20 statins available in clinical use.…”

Section: Discussionmentioning

confidence: 99%

Direct activation of endothelial cells by SARS-CoV-2 nucleocapsid protein is blocked by Simvastatin

Qian

Lei

Patel

et al. 2021

Preprint

View full text Add to dashboard Cite

Emerging evidence suggests that endothelial activation plays a central role in the pathogenesis of acute respiratory distress syndrome (ARDS) and multi-organ failure in patients with COVID-19. However, the molecular mechanisms underlying endothelial activation in COVID-19 patients remain unclear. In this study, the SARS-CoV-2 viral proteins that potently activate human endothelial cells were screened to elucidate the molecular mechanisms involved with endothelial activation. It was found that nucleocapsid protein (NP) of SARS-CoV-2 significantly activated human endothelial cells through TLR2/NF-κB and MAPK signaling pathways. Moreover, by screening a natural microbial compound library containing 154 natural compounds, simvastatin was identified as a potent inhibitor of NP-induced endothelial activation. Remarkablely, though the protein sequences of N proteins from coronaviruses are highly conserved, only NP from SARS-CoV-2 induced endothelial activation. The NPs from other coronaviruses such as SARS-CoV, MERS-CoV, HUB1-CoV and influenza virus H1N1 did not affect endothelial activation. These findings are well consistent with the results from clinical investigations showing broad endotheliitis and organ injury in severe COVID-19 patients. In conclusion, the study provides insights on SARS-CoV-2-induced vasculopathy and coagulopathy, and suggests that simvastatin, an FDA-approved lipid-lowering drug, may benefit to prevent the pathogenesis and improve the outcome of COVID-19 patients.

show abstract

Statin use is associated with lower disease severity in COVID-19 infection

Cited by 104 publications

References 55 publications

Higher SARS-CoV-2 Seroprevalence in Workers with Lower Socioeconomic Status in Cape Town, South Africa.

Higher SARS-CoV-2 Seroprevalence in Workers with Lower Socioeconomic Status in Cape Town, South Africa.

Statins in patients with COVID-19: a retrospective cohort study in Iranian COVID-19 patients

Direct activation of endothelial cells by SARS-CoV-2 nucleocapsid protein is blocked by Simvastatin

Contact Info

Product

Resources

About