There are no Food and Drug Administration (FDA)-approved treatments for COVID-19, the pandemic infection caused by a novel coronavirus.
While several therapies are being tested in clinical trials, the current standard of care involves providing patients with fluids and fever-reducing medications.
To speed the search for new COVID-19 therapies, researchers are testing repurposed drugs—medicines are already known to be safe for human use because they are FDA-approved for other conditions—for their abilities to mitigate the virus.
In a new study, researchers found statins—widely used cholesterol-lowering medications—are linked to a reduced risk of developing severe COVID-19 disease, as well as faster recovery times.
Second research has uncovered evidence that helps explains why: In short, removing cholesterol from cell membranes prevents the coronavirus from getting in.
The research was conducted by a team at UC San Diego Health and elsewhere.
A molecule known as ACE2 sits like a doorknob on the outer surfaces of many human cells, where it helps regulate and lower blood pressure.
ACE2 can be affected by prescription statins and other medications used for cardiovascular disease.
But, in January 2020, researchers discovered a new role for ACE2: SARS-CoV-2, the coronavirus that causes COVID-19, primarily uses the receptor to enter lung cells and establish respiratory infections.
In the study, the team analyzed the electronic medical records of 170 patients with COVID-19 and 5,281 COVID-negative control patients hospitalized at UC San Diego Health between February and June 2020.
They collected anonymized data that included the patients’ disease severity, length of hospital stay, outcome, and use of statins, angiotensin-converting enzyme (ACE) inhibitors, and angiotensin II receptor blockers (ARBs) within 30 days prior to hospital admission.
Among the patients with COVID-19, 27% were actively taking statins on admission, while 21% were on an ACE inhibitor and 12% on an ARB. The median length of hospital stay was 9.7 days for patients with COVID-19.
The researchers found that statin use prior to hospital admission for COVID-19 was linked to a more than 50% reduction in risk of developing severe COVID-19, compared to those with COVID-19 but not taking statins.
Patients with COVID-19 who were taking statins prior to hospitalization also recovered faster than those not taking the cholesterol-lowering medication.
The findings showed that statins are not only safe but potentially protective against severe COVID-19 infection.
Statins specifically may inhibit SARS-CoV-2 infection through its known anti-inflammatory effects and binding capabilities as that could potentially stop the progression of the virus.
While SARS-CoV-2 uses the ACE2 receptor to initially dock on a cell, the research suggests that the virus also needs cholesterol (normally found in cell membranes) in order to fuse with and enter the cell.
Statins are likely beneficial in preventing or reducing the severity of SARS-CoV-2 infection because, while intended to remove cholesterol from blood vessels, they are also removing cholesterol from cell membranes. As a result, the coronavirus can’t get in.
But like all medications, statins can cause negative side effects, including digestive problems and muscle pains, and may not be an option for many people with COVID-19.
One author of the study is Lori Daniels, MD, a professor and director of the Cardiovascular Intensive Care Unit at UC San Diego Health.
The study findings are published in The American Journal of Cardiology and The EMBO Journal.
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