key: cord-0987651-pjvgzj2b
authors: Karalis, Dean G.
title: Are Statins Safe in Patients With COVID-19?
date: 2020-06-22
journal: J Clin Lipidol
DOI: 10.1016/j.jacl.2020.06.009
sha: bd13b9a9bc410ca36ffbf4d5942d700328836967
doc_id: 987651
cord_uid: pjvgzj2b

nan

When starting a patient on a statin in the era of COVID-19, patients may develop side effects from the statin that mimic the symptoms of COVID-19. Statins may lead to muscle-related symptoms, and muscle symptoms have been described with COVID-19. However, fever, cough and shortness of breath which are more common presenting symptoms of COVID-19 do not occur with statins and should allow the clinician a means to distinguish between symptoms of COVID-19 and statin-associated side effects, as will more access to rapid testing to exclude or confirm acute COVID-19 infection.

Statins have been shown to be safe and improve CVD outcomes. In the era of COVID-19, statins should continue to be prescribed when indicated by current guidelines. Since patients with underlying CVD are at increased risk of serious complications and death from COVID-19, reducing the burden of CVD in our patients should improve outcomes in those who become infected with COVID-19. On the other hand, the shortest period of time over which reduction of cardiovascular events has been observed with statin treatment is about 8 weeks (11).

Symptomatic or survival benefit has not been confirmed for statin treatment over shorter periods in any clinical setting. Rhabdomyolysis has occurred in severely ill COVID-19 patients, and COVID-19-induced liver dysfunction may also change statin metabolism leading to myopathic peripheral blood levels. Weakening of stressed respiratory muscles is possible. Whether statin therapy should be continued in COVID-19 patients sick enough to be hospitalized is uncertain.

Current data suggests, however, that statins are safe and might provide benefit in the setting of uncomplicated COVID-19.

Although there are no randomized clinical trials with statins on risk of infection or complications with COVID-19, the observational evidence along with that from patients infected with other coronaviruses provide support for the safety of statins in the era of COVID-19. Once vaccines are available, COVID-19 may no longer be a health care issue; however, CVD will remain, and our conviction to reduce CVD risk in our patients with statins must not waver.

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