Coronavirus: Could statins reduce risk of death?

Giving hospitalised Covid-19 patients statins could cut their risk of dying or needing to be hooked up to a ventilator, a study has suggested.

Chinese researchers found severely-ill patients given the cholesterol-busting drugs – which can cost just pennies – were up to 45 per cent less likely to die.

And data showed statins cut the risk of patients needing mechanical ventilation, being admitted to intensive care or suffering a deadly complication.

Doctors are desperate for more weapons in their arsenal to treat Covid-19, which has killed almost 500,000 people worldwide in just six months.

Only one drug – £5 steroid dexamethasone – has so far been proven to boost survival odds for coronavirus patients who are admitted to hospital.

Dozens of other medicines are being tested in Britain and around the world, in the hope of saving lives and safely ease the world back into normal life.

Scientists behind the statins study at Wuhan University – based in the Chinese city where the pandemic began in December – called for more trials to prove the link.

Chinese researchers found severely-ill patients given the cholesterol-busting drugs – which can cost just pennies – were up to 45 per cent less likely to die

A wealth of research has proven the pills – taken by an estimated 6million Britons with high levels of ‘bad’ LDL cholesterol – save lives from heart attacks and strokes.

But statins are controversial among the medical community because of their potential side effects, including muscle pain and memory loss.

Doctors are desperate for ways to treat Covid-19, which studies conducted worldwide have suggested kills up to 1 per cent of all infected cases.

Statins have been found to slow the progression of lung injury in animals, improve immune cell responses and cut inflammation.

The Wuhan study – which looked at nearly 14,000 patients – was not a randomised control trial, considered the gold-standard of scientific research.

It means the observational results, published in the journal Cell Metabolism, cannot prove that statins improved the survival odds.

Dr Hongliang Li and colleagues found 6.8 per cent of the hospitalised Covid-19 patients who didn’t take statins died after 28 days.

In comparison, the rate among the entirety of hospitalised patients who had been given statins was 5.5 per cent – statistically a fifth lower.

This is despite patients on statins tending to be older and having underlying conditions, two known factors that raise the risk of dying from the coronavirus.

DEXAMETHASONE: THE FIRST DRUG PROVEN TO SAVE LIVES FROM COVID-19 

The NHS two weeks ago approved dexamethasone to treat Covid-19 after a major British trial revealed the steroid could reduce the risk of death in patients hooked up to ventilators by up to a third.

In the biggest medical breakthrough since the pandemic began, scientists found the £5 drug also cut the odds of dying by a fifth for patients needing any form of oxygen during their battle against the disease.

Health Secretary Matt Hancock described the results — which prompted officials to instantly approve the drug — as ‘astounding’, claiming it will help to ‘save thousands of lives while we deal with this terrible virus’.  

England’s Chief Medical Officer Professor Chris Whitty called it the ‘most important trial result’ so far, while Number 10’s Chief Scientific Adviser Sir Patrick Vallance said it was ‘tremendous news’.

Dexamethasone, first created in the 1950s, is usually given to treat ulcerative colitis, arthritis and some types of cancer.

Results of the RECOVERY trial, which involved 6,000 Covid-19 patients and was led by Oxford University scientists, suggest the steroid can prevent death in one in eight ventilated coronavirus patients and one in 25 on breathing support. It is the first trial to show a treatment provides significant impact in reducing the risk of death.

But the drug — given as either an injection or once-a-day tablet on the NHS — had no benefit for people who were hospitalised with the virus but did not require oxygen. 

Dexamethasone is now the second drug available in the NHS arsenal to treat Covid-19, after Ebola medicine remdesivir was last month given the green light in another scientific breakthrough.  

The steroid prevents the release of substances in the body that cause inflammation, a nasty Covid-19 complication that makes breathing difficult. In seriously unwell patients, the lungs become so inflamed they struggle to work.    

Results were even stronger when the data was split into two groups matched to be of a similar age, disease severity and pre-existing conditions.

Data showed 9.4 per cent of patients not given statins died, compared to 5.2 per cent of those who had taken the cholesterol-busting drugs.

Statins were also linked to lower rates of patients being admitted to intensive care or suffering acute respiratory distress – a life-threatening Covid-19 complication.

Results also suggested that ACE inhibitors and angiotensin II receptor blockers – drugs given to high blood pressure patients – did not worsen disease severity.

One expert said: ‘There was a certain amount of evidence to suggest they might be associated with lower risk, though that evidence is not clear.’

The findings debunk claims made early on in the crisis by experts in Greece and Switzerland, given the drugs both increase the expression of ACE-2 receptors.

SARS-CoV-2, the virus behind Covid-19, is thought to enter the body and cause infection through the receptors, which are found throughout the body.

Dr Li said the findings warrant the need for further trials to investigate the link between statins and Covid-19 survival rates.

Independent scientists called for caution over the findings, pointing to flaws within the research that may wrongly allude to statins being protective.

University College London cardiologist Dr Riyaz Patel said patients on statins may have been in hospital as a precaution because their co-morbidities left them at high risk.

This could mean patients who weren’t given statins were admitted to hospital with more severe bouts of the disease, which may explain why they were more likely to die.

Professor Naveed Sattar, of the University of Glasgow, said the results far from proved statins lowered the risk of dying from Covid-19.

He added: ‘Only randomised trials can settle this question. If further observational studies point in same direction, then such trials should be conducted.’

Professor Kevin McConway, an Open University statistician, called the results ‘interesting’ but also warned they don’t prove statins are Covid-19 life-savers.

He said: ‘People weren’t asked to take, or not take, statins by the researchers. The statin users were people who were prescribed statins anyway.’

Professor McConway said the two groups would likely have had many different characteristics, which could have been behind the differences in death rates.

The study also provides ‘useful evidence’ on the safety of ACE inhibitors and ARBs in Covid-19 patients, according to experts.

Professor McConway said the results do offer ‘a certain amount of reassurance that they are unlikely to be harmful in Covid-19 patients’. 

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