The Role of Statins in Respiratory Diseases

Feldman, Charles

doi:10.1097/cpm.0b013e31819b3a41

Cited by 7 publications

(7 citation statements)

References 95 publications

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“…Pleiotropic effects of statins have been reported in several malignancies, especially respiratory infections [ 47 , 48 ], acute lung injury [ 49 ], pulmonary hypertension [ 50 ], community-acquired pneumonia, chronic obstructive pulmonary disease [ 51 ], and interstitial lung disease [ 52 ]. Statins have shown various beneficial anti-inflammatory and immunomodulatory properties by affecting intracellular signaling pathways [ 53 , 54 ] that are independent of their lipid-lowering ability [ 55 ].…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2021

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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.

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Section: Discussionmentioning

confidence: 99%

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

et al. 2021

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“…32 These observations support the hypothesis that a reduction in mortality associated with statin use might be attributable to an alternative biological pathway rather than cholesterol reduction and a reduced incidence of fatal CVD. Indeed, it is well known that statins have much wider actions than their effect on cholesterol -including anti-oxidant, anti-neoplastic (apoptotic), and immune modulating effects [11][12][13][14] -and statins reduce both pulmonary inflammation and systemic inflammation.…”

Section: Interpretation Of Findings In Relation To Previously Publishmentioning

confidence: 99%

“…However, laboratory-based and animal research has shown that statins have a diverse range of 'pleiotropic effects' including antiinflammatory actions, anti-thrombotic properties, anti-oxidant effects, and immunomodulatory effects. [10][11][12][13] Recent evidence suggests that statins reduce pulmonary inflammation and may suppress the inflammation associated with cigarette smoke and ameliorate the associated structural and functional abnormalities in the lung. 12,14 It is therefore possible that these effects may result in therapeutic benefits in patients with COPD over and See linked editorial by Pearson on pg 5 above reducing their risk of CVD.…”

Section: Introductionmentioning

confidence: 99%

Statin use in COPD patients is associated with a reduction in mortality: a national cohort study

Lawes

Thornley

Young

et al. 2012

Primary Care Respiratory Journal

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Aims: To assess whether statin use is associated with reduced mortality in patients with chronic obstructive pulmonary disease (COPD).Methods: Hospitalisation, drug dispensing, and mortality records were linked for New Zealanders aged 50-80 years discharged from hospital with a first admission with COPD in 2006. Patients were classified according to whether or not they were prescribed statins prior to admission. Baseline characteristics were compared and hazard ratios calculated for statin users versus statin non-users for all-cause mortality over follow-up of up to 4 years.Results: A total of 1,687 patients (mean age 70.6 years) were followed, including 596 statin users and 1,091 non-users. There were more men in the statin user group (58.4% vs. 48.5%), and statin users were more likely to have a history of cardiovascular disease (58.6% vs. 25.1%), prescription for frusemide as a proxy for heart failure (47.7% vs. 24.5%) or diabetes (35.4% vs.11.6%) than statin non-users (p<0.001). A total of 671 deaths occurred during the follow-up period. After adjustment for age, sex, ethnic group, history of cardiovascular disease, diabetes, and prescription for frusemide, the hazard ratio for statin users vs. statin non-users for all-cause mortality was 0.69 (95% CI 0.58 to 0.84).Conclusions: Statin use is associated with a 30% reduction in all-cause mortality at 3-4 years after first admission for COPD, irrespective of a past history of cardiovascular disease and diabetes.

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“…Pleiotropic effects of statins have been reported in several malignancies, especially respiratory infections [43,44], acute lung injury [45], pulmonary hypertension [46], community-acquired pneumonia, chronic obstructive pulmonary disease [47], and interstitial lung disease [48]. Statins have shown various bene cial anti-in ammatory and immunomodulatory properties by affecting intracellular signaling pathways [49,50] that are independent of their lipid-lowering ability [51].…”

Section: Discussionmentioning

confidence: 99%

Statins in Patients with COVID-19: A Retrospective Cohort Study in Iranian COVID-19 Patients

Peymani

Dehesh

Aligolighasemabadi

et al. 2020

Preprint

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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 spreading at an alarming rate globally. 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 many 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 had 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 validate the potential beneficial effects of statin treatment on clinical symptoms and mortality rates associated with COVID-19.

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The Role of Statins in Respiratory Diseases

Abstract: Statin drugs inhibit 3-hydroxy-3

Cited by 7 publications

References 95 publications

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

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

Statin use in COPD patients is associated with a reduction in mortality: a national cohort study

Statins in Patients with COVID-19: A Retrospective Cohort Study in Iranian COVID-19 Patients

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