Statin therapy in patients with community-acquired pneumonia

Grudzinska, Frances; Dosanjh, Davinder; Parekh, Dhruv; Dancer, Rachel; Patel, Jaimin; Nightingale, Peter; Walton, Georgia M; Sapey, Elizabeth; Thickett, David

doi:10.7861/clinmedicine.17-5-403

Cited by 32 publications

(22 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our recent data has reported a beneficial of effect of statins in vitro and in vivo in restoring neutrophil migratory accuracy which declines with advancing age (Sapey et al 2017 ). That this may be clinically relevant is supported by data showing that patients admitted to hospital with pneumonia who are already on statin medication have reduced mortality compared to those not taking statins (Grudzinska et al 2017 ; Bruyere et al 2014 ). Additionally, statins are now also recognised as modulators of telomerase activity in study conducted on 230 older adults and can slow telomere shortening, they showed that with every 1 year increment in age a decline by 0.058 Kb was observed in the no statin group compared with 0.033 Kb in the statin group (Boccardi et al 2013 ).…”

Section: Pharmacological Interventions To Reduce Immunesenescencementioning

confidence: 91%

Reversing the immune ageing clock: lifestyle modifications and pharmacological interventions

Duggal

2018

Biogerontology

View full text Add to dashboard Cite

It is widely accepted that ageing is accompanied by remodelling of the immune system, including reduced numbers of naïve T cells, increased senescent or exhausted T cells, compromise to monocyte, neutrophil and natural killer cell function and an increase in systemic inflammation. In combination these changes result in increased risk of infection, reduced immune memory, reduced immune tolerance and immune surveillance, with significant impacts upon health in old age. More recently it has become clear that the rate of decline in the immune system is malleable and can be influenced by environmental factors such as physical activity as well as pharmacological interventions. This review discusses briefly our current understanding of immunesenescence and then focuses on lifestyle interventions and therapeutic strategies that have been shown to restore immune functioning in aged individuals.

show abstract

Section: Pharmacological Interventions To Reduce Immunesenescencementioning

confidence: 91%

Reversing the immune ageing clock: lifestyle modifications and pharmacological interventions

Duggal

2018

Biogerontology

View full text Add to dashboard Cite

show abstract

“…A systematic review from 2019 concluded that in ARDS patients, statins make little or no difference to early mortality or duration of ventilation, suggesting their safety in this setting [ 38 ]. A UK-based observational study of 2067 patients suggested that statins may impart a mortality benefit in patients with community acquired pneumonia [ 39 ]. In contrast, however, a multicentre cohort study from the United States found no evidence of protection conferred by statins on clinical outcomes in a similar cohort [ 40 ].…”

Section: Recommendationsmentioning

confidence: 99%

Managing hyperlipidaemia in patients with COVID-19 and during its pandemic: An expert panel position statement from HEART UK

Iqbal

Adam

et al. 2020

Atherosclerosis

View full text Add to dashboard Cite

Background & aims The emergence of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) which causes Coronavirus Disease 2019 (COVID-19) has resulted in a worldwide pandemic. SARS-CoV-2 is highly contagious and its severity highly variable. The fatality rate is unpredictable but is amplified by several factors including advancing age, atherosclerotic cardiovascular disease, diabetes mellitus, hypertension and obesity. A large proportion of patients with these conditions are treated with lipid lowering medication and questions regarding the safety of continuing lipid-lowering medication in patients infected with COVID-19 have arisen. Some have suggested they may exacerbate their condition. It is important to consider known interactions with lipid-lowering agents and with specific therapies for COVID-19. This statement aims to collate current evidence surrounding the safety of lipid-lowering medications in patients, who have COVID-19. We offer a consensus view based on current knowledge and we rated the strength and level of evidence for these recommendations. Methods Pubmed, Google scholar and Web of Science were searched extensively for articles using search terms: SARS-CoV-2, COVID-19, coronavirus, Lipids, Statin, Fibrates, Ezetimibe, PCSK9 monoclonal antibodies, nicotinic acid, bile acid sequestrate, nutraceuticals, red yeast rice, Omega-3-Fatty acids, Lomitapide, hypercholesterolaemia, dyslipidaemia and Volanesorsen. Results & Conclusions : There is no evidence currently that lipid lowering therapy is unsafe in patients with COVID-19 infection. Lipid-lowering therapy should not be interrupted because of the pandemic or in patients at increased risk of COVID-19 infection. In patients with confirmed COVID-19, care should be taken to avoid drug interactions, between lipid-lowering medications and drugs that may be used to treat COVID-19, especially in patients with abnormalities in liver function tests.

show abstract

“…To date, a number of studies have evaluated the use of statins in the treatment of pneumonia and ARDS 5,[14][15][16][17][18][19][20] . While primary results of randomized clinical trials evaluating statins in ARDS have not indicated a bene t 19,20 , secondary analysis of 540 individuals from the HARP-2 (Hydroxymethylglutaryl-CoA Reductase Inhibition with Simvastatin in Acute Lung Injury to Reduce Pulmonary trial demonstrated improved survival with statin treatment in patients with a hyperin ammatory phenotype 15 .…”

Section: Introductionmentioning

confidence: 99%

Association Between Antecedent Statin Use and Decreased Mortality in Hospitalized Patients with COVID-19

Gupta

Madhavan

Poterucha

et al. 2020

Preprint

View full text Add to dashboard Cite

The coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), can result in a hyperinflammatory state, leading to acute respiratory distress syndrome (ARDS), myocardial injury, and thrombotic complications, among other sequelae. Statins, which are known to have anti-inflammatory and antithrombotic properties, have been studied in the setting of other viral infections and ARDS, but their benefit has not been assessed in COVID-19. Thus, we sought to determine whether antecedent statin use is associated with lower in-hospital mortality in patients hospitalized for COVID-19. This is a retrospective analysis of patients admitted with COVID-19 from February 1st through May 12th, 2020 with study period ending on June 11th, 2020. Antecedent statin use was assessed using medication information available in the electronic medical record. We constructed a multivariable logistic regression model to predict the propensity of receiving statins, adjusting for baseline socio-demographic and clinical characteristics, and outpatient medications. The primary endpoint included in-hospital mortality within 30 days. A total of 2626 patients were admitted during the study period, of whom 951 (36.2%) were antecedent statin users. Among 1296 patients (648 statin users, 648 non-statin users) identified with 1:1 propensity-score matching, demographic, baseline, and outpatient medication information were well balanced. Statin use was significantly associated with lower odds of the primary endpoint in the propensity-matched cohort (OR 0.48, 95% CI 0.36 – 0.64, p<0.001). We conclude that antecedent statin use in patients hospitalized with COVID-19 was associated with lower inpatient mortality. Randomized clinical trials evaluating the utility of statin therapy in patients with COVID-19 are needed.

show abstract

Statin therapy in patients with community-acquired pneumonia

Cited by 32 publications

References 27 publications

Reversing the immune ageing clock: lifestyle modifications and pharmacological interventions

Reversing the immune ageing clock: lifestyle modifications and pharmacological interventions

Managing hyperlipidaemia in patients with COVID-19 and during its pandemic: An expert panel position statement from HEART UK

Association Between Antecedent Statin Use and Decreased Mortality in Hospitalized Patients with COVID-19

Contact Info

Product

Resources

About