Statin use is associated with reduced mortality after respiratory viral infection

Franco‐Peláez, Juan Antonio; Esteban-Lucia, L; Chacon, Maria De Los Angeles Zambrano; Pello-Lázaro, Ana María; Rodriguez, A M Venegas; Nieto-Roca, Luis; García-Talavera, Camila; Mayor, Andrea Kallmeyer; Álvarez, Felipe Villar; Roblas, Ricardo Fernández; González-Lorenzo, Óscar; Tuñón, José; Ibáñez, Borja; Aceña, Álvaro

doi:10.1183/23120541.00365-2020

Cited by 4 publications

(2 citation statements)

References 30 publications

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“…On the other hand, it has been demonstrated that statins significantly suppressed the activation of NF-κB and exert anti-inflammatory actions (10)(11)(12). Observational studies have reported that treatment with statins was associated with a reduced mortality rate in hospitalized patients with influenza (13). Previous studies have shown that statins may be also useful in the treatment of COVID-19 due to their pleotropic effect (14)(15)(16)(17)(18).…”

Section: Introductionmentioning

confidence: 99%

Statin Use in COVID-19 Hospitalized Patients and Outcomes: A Retrospective Study

Kouhpeikar

Tabasi

Khazir

et al. 2022

Front. Cardiovasc. Med.

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BackgroundCoronavirus disease 2019 (COVID-19) might affect everyone, but people with comorbidities such as hypertension and cardiovascular disease (CVD) may often have more severe complications and worse outcomes. Although vaccinations are being performed worldwide, it will take a long time until the entire population of the world is vaccinated. On the other hand, we are witnessing the emergence of new variants of this virus. Therefore, effective therapeutic approaches still need to be considered. Statins are well-known lipid-lowering drugs, but they have also anti-inflammatory and immunomodulatory effects. This study aimed to investigate the effects of statins on the survival of COVID-19 hospitalized patients.MethodsThis retrospective study was performed on 583 patients admitted to a highly referenced hospital in Tabas, Iran, between February 2020 and December 2020. One hundred sixty-two patients were treated with statins and 421 patients were not. Demographic information, clinical signs, and the results of laboratory, and comorbidities were extracted from patients' medical records and mortality and survival rates were assessed in these two groups.ResultsThe results of the Cox crude regression model showed that statins reduced mortality in COVID-19 patients (HR = 0.56, 95% CI: 0.32, 0.97; p = 0.040), although this reduction was not significant in the adjusted model (HRs=0.51, 95%CI: 0.22, 1.17; p = 0.114). Using a composite outcome comprising intubation, ICU admission, and mortality, both crude (HR = 0.43; 95% CI: 0.26, 0.73; p = 0.002) and adjusted (HR = 0.57; 95% CI: 0.33, 0.99; p = 0.048) models suggested a significant protective effect of statin therapy.ConclusionDue to anti-inflammatory properties of statins, these drugs can be effective as an adjunct therapy in the treatment of COVID-19 patients.

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Section: Introductionmentioning

confidence: 99%

Statin Use in COVID-19 Hospitalized Patients and Outcomes: A Retrospective Study

Kouhpeikar

Tabasi

Khazir

et al. 2022

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

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“…Statins, by virtue of their pleiotropic properties reduce pneumonia and ASCVD-related mortality [13][14][15][16][17] by modulating acute lung injury [18], neutrophil function [19], thrombosis [20], inflammation [21] and endothelial dysfunction [22]. Several studies [8,[23][24][25][26][27] have shown improvement in clinical outcomes from respiratory infections in statin users (Table 1).…”

Section: Introductionmentioning

confidence: 99%

The impact of atherosclerotic cardiovascular disease, dyslipidaemia and lipid lowering therapy on Coronavirus disease 2019 outcomes: an examination of the available evidence

Adam

Bashir

et al. 2021

Current Opinion in Lipidology

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Purpose of review Coronavirus Disease 2019 (COVID19) has caused significant global morbidity and mortality, especially in persons with underlying cardiovascular disease. There have been concerns that lipid-lowering therapy (LLT) increases angiotensin-converting enzyme 2 levels. Conversely, pleiotropic effects of statins can theoretically protect against severe COVID19 infection, supporting evidence from other respiratory illnesses in which statin use probably confers benefit. Recent findings There is an abundance of studies that show that statins are safe and potentially protect against severe COVID19 infection (critical illness and death), even when adjustment for potential confounders is undertaken. However, the evidence is limited to retrospective cohorts. The benefit for patients with diabetes is less clear. There is a paucity of evidence for other LLT agents. Available clinical guidelines recommend the ongoing use of LLT in patients with COVID19 (unless specifically contra-indicated) and the data from available studies support these. Summary In patients with COVID19 infection, LLT should be continued. However, the current findings need substantiating in larger prospective clinical studies with specific examination of the possible mechanisms by which LLT confers benefit from COVID19.

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Adjunctive therapy with lipid-lowering agents in COVID-19: a systematic review and meta-analysis of randomized controlled trials

et al. 2023

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Background Many commonly used drugs were evaluated as repurposed treatment options since the emergence of the COVID-19 pandemic. The benefit of lipid-lowering agents has been controversial in this regard. In this systematic review, we assessed the effect of these medications as adjunctive therapy in COVID-19 by the inclusion of randomized controlled trials (RCTs). Methods We searched four international databases including PubMed, the Web of Science, Scopus, and Embase for RCTs in April 2023. The primary outcome was mortality, while other efficacy indices were considered secondary outcomes. In order to estimate the pooled effect size of the outcomes, considering the odds ratio (OR) or standardized mean difference (SMD) and 95% confidence interval (CI), random-effect meta-analyses was conducted. Results Ten studies involving 2,167 COVID-19 patients using statins, omega-3 fatty acids, fenofibrate, PCSK9 inhibitors, and nicotinamide as intervention compared to control or placebo, were included. No significant difference was found in terms of mortality (OR 0.96, 95% CI 0.58 to 1.59, p-value = 0.86, I2 = 20.4%) or length of hospital stay (SMD -0.10, 95% CI -0.78 to 0.59, p-value = 0.78, I2 = 92.4%) by adding a statin to the standard of care. The trend was similar for fenofibrate and nicotinamide. PCSK9 inhibition, however, led to decreased mortality and an overall better prognosis. Omega-3 supplementation showed contradicting results in two trials, suggesting the need for further evaluation. Conclusion Although some observational studies found improved outcomes in patients using lipid-lowering agents, our study found no benefit in adding statins, fenofibrate, or nicotinamide to COVID-19 treatment. On the other hand, PCSK9 inhibitors can be a good candidate for further assessment. Finally, there are major limitations in the use of omega-3 supplements in treating COVID-19 and more trials are warranted to evaluate this efficacy.

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Statin use is associated with reduced mortality after respiratory viral infection

Cited by 4 publications

References 30 publications

Statin Use in COVID-19 Hospitalized Patients and Outcomes: A Retrospective Study

Statin Use in COVID-19 Hospitalized Patients and Outcomes: A Retrospective Study

The impact of atherosclerotic cardiovascular disease, dyslipidaemia and lipid lowering therapy on Coronavirus disease 2019 outcomes: an examination of the available evidence

Adjunctive therapy with lipid-lowering agents in COVID-19: a systematic review and meta-analysis of randomized controlled trials

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