Lipid-lowering drugs not a risk factor in COVID-19
Statins do not increase infectivity or viral replication of SARS-CoV-2
Cholesterol-lowering drugs do not promote infection with the novel coronavirus SARS-CoV-2. This is the conclusion of a team of researchers from TWINCORE - Center for Experimental and Clinical Infection Research and the University of Veterinary Medicine Hannover Foundation, led by Prof Gisa Gerold, together with colleagues from the Helmholtz Centre for Infection Research (HZI) in Braunschweig and Umea University in Sweden. The scientists have studied several lipid-lowering agents from the group of statins in a cell culture model. They have now published their results in the journal iScience. The TWINCORE-Centre for Experimental and Clinical Infection Research is a joint institution of the Hannover MEdical School (MHH) and the HZI.
Statins are prescribed to lower cholesterol levels. High blood lipid levels are often associated with diseases of the cardiovascular system. Patients taking these drugs therefore belong to the particularly vulnerable risk group for severe courses of COVID-19 infection. On the one hand, previous studies have shown that there is an association between statin use and lower COVID-19 mortality. On the other hand, statins are thought to enhance expression of the ACE2 receptor of SARS-CoV-2, which the virus uses to dock to the cell membrane. What influence this has on cell entry and replication of the virus was not known until now.
Gisa Gerold's team first investigated how well cells pre-treated with various lipid-lowering agents can be infected with coronavirus 229E in the laboratory. This harmless cold virus is closely related to SARS-CoV-2. "Cells that were treated with statins were infected with coronavirus 229E to a lesser extent," says Gerold, a virologist. "We observed this effect most clearly for the drug fluvastatin."
The researchers then verified these observations in experiments with the "real" SARS-CoV-2 in the high-security laboratory. "In particular, we measured lower concentrations of the virus in the culture fluid of cells pretreated with fluvastatin," Gerold says. This suggests that fluvastatin does not have an enhancing effect on the susceptibility of cells to the virus, he said. These findings were confirmed in airway epithelial cultures from three donors. However, since statins can also modulate immune responses, the team plans to test more complex SARS-CoV-2 infection models for the effect of statins in follow-up studies.
In summary, Gisa Gerold says, "We were able to show that statin therapy has no adverse effects on the potential infection of lung epithelial cells with the new SARS coronavirus. Even though we observed only a mild positive effect, we can at least conclude that statin use can be safely continued."
Francisco J. Zapatero-Belinchón, Rebecca Moeller, Lisa Lasswitz, Marco van Ham, Miriam Becker, Graham Brogden, Ebba Rosendal, Wenjie Bi, Belén Carriquí-Madroñal, Koushikul Islam, Annasara Lenman, Antonia P. Gunesch, Jared Kirui, Thomas Pietschmann, Anna K. Överby, Lothar Jänsch, Gisa Gerold. Fluvastatin mitigates SARS-CoV-2 infection in human lung cells. iScience, DOI: 10.1016/j.isci.2021.103469