Reducing the severity of COVID-19, but also faster recovery of patients seems to be achieved by taking these widely used drugs before hospitalization

We all already know that so far there are no approved treatments for COVID-19, researchers are now examining the properties of drugs already used to investigate their potential effectiveness in reducing the severity of coronavirus infection.

More specifically, scientists from the University of California recently reported that Statins, drugs widely used to lower cholesterol, are associated with a reduced risk of developing serious infection with COVID-19, but also faster recovery. A second study by the scientific team revealed evidence that helps explain the above phenomenon, which shows that the removal of cholesterol from cell membranes prevents the coronavirus from entering cells.

The clinical study, published in the American Journal of Cardiology, was led by Lori Daniels and Karen Messer, professors at the University of California, while the engineering study, published in The EMBO Journal, was led by Tariq Rana, a professor at the same university.

Patients with COVID-19 taking statins had better results

A molecule known as ACE2 is found on the outer surfaces of many cells, helping to regulate blood pressure. ACE2 can be affected by Statins and other medications used to treat cardiovascular disease.

However, last January researchers discovered a new role for ACE2: SARS-CoV-2, the coronavirus that causes COVID-19 disease, initially uses this receptor to enter the lung cells and spread infections.

“When faced with this novel virus at the beginning of the pandemic, there was a lot of speculation surrounding certain medications that affect ACE2, including statins, and if they may influence COVID-19 risk. We needed to confirm whether or not the use of statins has an impact on a person’s severity of SARS-CoV-2 infection and determine if it was safe for our patients to continue with their medications,” explains Dr Daniels.

To do this, the scientists retrospectively analyzed the electronic records of 170 COVID-19 patients and 5,281 people who were hospitalized between February and June and tested for coronavirus and tested negative. They collected anonymous data on the severity of the disease, length of hospital stay, results and use of statins, angiotensin-converting enzyme (ACE) inhibitors or angiotensinogen II receptor blockers (ARBs) within 30 days prior to admission to hospital.

Among patients with COVID-19, 27% received statins, 21% received ACE inhibitors and 12% received ARB. The average length of hospital stay was 9.7 days.

The researchers found that the use of statins before hospitalization for COVID-19 was associated with a more than 50% reduction in the risk of developing a serious infection from the disease, compared with patients who did not receive statins. Also, those who took the drug before hospitalization recovered faster.

“We found that statins are not only safe but potentially protective against a 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 progression of the virus,” adds Dr Daniels.

Removing cholesterol from cell membranes prevents the entry of SARS-CoV-2

The scientific team under the supervision of Dr Rana began studying genes that are activated in lung cells in response to SARS-CoV-2 infection and found that the CH25H gene, which encodes a cholesterol-modifying enzyme, blocks the virus’ ability to enter human cells.

CH25H’s enzymatic activity produces a modified form of cholesterol called 25-hydroxycholesterol (25HC). This in turn activates another enzyme, ACAT, which is found inside the cells, which then depletes the accessible cholesterol to the cell membrane, a process that occurs normally and begins during certain viral infections.

Scientists started examining 25HC as part of SARS-CoV-2, and to find out what happens to lung cells with and without 25HC when first exposed to a non-infectious virus carrying the coronavirus protein spike or the same SARS-CoV-2.

Regardless of the procedure, the added 25HC inhibited the virus’s ability to enter the cells, almost completely preventing infection.

Although SARS-CoV-2 uses the ACE2 receptor to enter a cell, this study suggests that the virus also needs cholesterol (normally found in cell membranes) to fuse and enter cells. 25HC, therefore, removes much of this membrane cholesterol, preventing the virus from entering.

In conclusion, the scientists report that if it can be developed into a therapeutic method, 25HC can function even better as an antiviral than statins, because it acts focused on the cholesterol of the cell membrane. They also note that, like all other medications, statins can cause side effects, such as digestive problems and muscle aches, and may not be a good choice for many COVID-19 patients.