Statins — the class of cholesterol-lowering drugs that are among the most popular medications in the United States — have been the subject of extensive research in recent decades. Over the years, it has become clear that these drugs lead to a significantly lower risk of death in people who take them. What’s less clear is how much of this benefit comes from the cholesterol reductions they cause.
In fact, statins have long been suspected of having benefits that aren’t directly related to their effect on cholesterol or other blood lipids, such as triglycerides. Many studies have shown that they reduce measures of inflammation throughout the body, and it’s possible that the lower overall risk of death in people who take statins is related to their wider anti-inflammatory effects.
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Now, a study shows that statins may have a newly recognized benefit in people with diabetes: a lower risk of death from COVID-19 in people hospitalized with the viral infection.
Less inflammation in severe COVID-19
As noted in the new study, published in the Journal of the American Heart Association, severe COVID-19 is characterized by a high level of inflammation throughout the body. Inflammation is the result of high activity by the body’s immune system, which is working to fight the viral infection. But it is believed that this high level of inflammation may cause severe damage in many people with severe COVID-19, contributing to the risk of death.
Doctors take whatever steps they believe are necessary to reduce harmful inflammation in people with severe COVID-19, including using steroid drugs. But how much inflammation occurs may also depend on whether the patients took statins before developing the viral infection, the study suggests.
The new study was observational, meaning that it compared hospitalized patients who already did or didn’t take statins. A total of 4,252 people were hospitalized for COVID-19 during the study period, including 2,266 people with diabetes. Within this group of people with diabetes, those who took a statin (983 people) were a couple of years older, on average, than those who didn’t take a statin (1,283 people). They also had lower levels, on average, of a marker of inflammation called C-reactive protein in their blood.
Overall, people with diabetes had a lower risk of death from COVID-19 if they took a statin (24% death risk) than if they didn’t take a statin (39% death risk). This benefit tied to statins wasn’t seen in people without diabetes, who saw only a slightly smaller death risk if they took statins (20% death risk) than if they didn’t take statins (21% death risk) — such a small difference that it could have been due to chance.
When the researchers adjusted for differences between the patients with diabetes who took statins and those who didn’t — such as age and other factors known to influence the risk of death from COVID-19 — they found that taking statins was associated with a 12% lower risk of death from the viral infection.
Statins for more people?
This study suggests that people with diabetes may benefit uniquely from taking statins, especially when it comes to experiencing better outcomes from COVID-19. Since people with diabetes — both type 1 and type 2 — have been shown to have worse outcomes from COVID-19 than people without diabetes, the study authors suggest that statins may have a wider role to play in people with diabetes during the COVID-19 era.
Many doctors have long been hesitant to prescribed statins in people who don’t meet the ordinary cholesterol-related criteria for taking them, despite the wider benefits associated with these drugs. And many people with diabetes, if they have borderline-high cholesterol, may be reluctant to take yet another drug and opt instead to delay taking a statin.
But with the unprecedented danger that people with diabetes face during the COVID-19 pandemic, it may be time for both doctors and patients to reconsider the potential benefits of taking statins.