Coronavirus News: Malaysian Study Shows That Statins Like Atorvastatin Can Reduce Risk Of COVID-19 Disease Severity And Mortality
: Malaysian researchers from the International Medical University-Kuala Lumpur and also involving another Malaysian researcher from the University of Huddersfield-UK have found from a study involving meta-analysis of data of more than 9000 COVID-19 patients that statin usage was associated with a reduced risk of a severe or fatal course of COVID-19 by about 30%.
The study findings were published in the American Journal of Cardiology. https://www.ajconline.org/article/S0002-9149(20)30823-7/fulltext#%20
The meta-analysis of four published studies, one of ‘moderate’ quality and three of ‘good’ quality included a total of 8990 COVID-19 patients showed that there was a significantly reduced risk for fatal or severe COVID-19 among patients who were users of statins compared with non-users (pooled hazard ratio [HR], 0.70; 95% CI, 0.53 - 0.94).
Co-researcher, Chia Siang Kow, MPharm from the International Medical University at Kuala Lumpur told Thailand Medical News, “Based on the study findings it may be time we shift our focus to statins as the potential therapeutic options in COVID-19 patients."
Dr Syed Shahzad Hasan, PhD, a Malaysian currently based at the University of Huddersfield, UK, was the other co-researcher of the study.
The meta-analysis study included four studies published up to July 27 of this year. Eligible studies included those with a cohort or case-control designs, enrolled patients with confirmed COVID-19, and had data available allowing comparison of the risk of severe illness and/or mortality among statin users vs non-users in adjusted analyses.
The study findings also "discredited the suggestion of harms with the use of statins in COVID-19 patients.”
Dr Hasan also stressed, "As our study included a fairly large total number of COVID-19 patients from four studies in which three are large-scale studies that adjusted extensively for multiple potential confounding factors, the findings can be considered reliable.”
He further added, “Based on the results, moderate-to-high intensity statin therapy is likely to be beneficial in patients with COVID-19.”
He however cautioned that more data from prospective studies are needed to substantiate the findings and to determine the appropriate regimen for a statin in COVID-19 patients.
Medical experts elsewhere commented that although the scope of this meta-analysis was "quite limited, the conclusion was not unexpected, as most of the clinical analysis so far reported supports the benefits or safety of statin usage in COVID-19 patients."
Although there is ‘almost no contention’ about the safety of continuing statin therapy in COVID-19 patients, it remains to be determined if statin therapy can be implemented as an adjuvant or independent therapy and a part of the standard care for COVID-19 patients regardless of their hyperlipidemia status, most medical experts said.
It must be noted that although statin usage is associated with several beneficial effects s
uch as anti-inflammation and cytoprotection, these effects are usually observed from long-term usage rather than short-term/acute administration.
Hence, prospective studies and randomized trials should be conducted to test the efficacy of stain usage for COVID-19 patients with mild to severe symptoms.
It must also be noted that taking into considerations statins track record as a safe drug that is already approved and has been on the market for ages along with the fact that it is relatively cheap, it is certainly a worthwhile effort to consider its broad-based usage for COVID-19 in order to lower the overall death and severe complications.
Significantly the retrospective single-center study found slower progression to death associated with atorvastatin in older patients with COVID-19 admitted to the intensive care unit.
The researchers strongly urge that other entities globally also conduct further investigations as to whether atorvastatin is effective against COVID-19 and that clinicians should consider at least continuing them in patients with COVID-19.
It should be noted that another earlier study by researchers from the Perelman School of Medicine at the University of Pennsylvania also advocated the study and also use of statins as adjuvants for COVID-19 treatment protocols. https://www.cell.com/cell-metabolism/fulltext/S1550-4131(20)30364-8?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS1550413120303648%3Fshowall%3Dtrue
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