Atorvastatin (Lipitor)

What is atorvastatin (Lipitor)?

Atorvastatin is part of a class of drugs commonly referred to as statins. Its role is to reduce the amount of cholesterol made by the liver. Cholesterol is comprised of HDL, the “good” cholesterol, and LDL, the “bad” cholesterol. The body uses cholesterol to make various hormones and other substances. However, if a person has too much LDL, it can cause a buildup in the arteries, leading to stroke, heart attack, or other health problems. The regular use of statins can reduce the risk of such cardiovascular disease. 

Can atorvastatin help in long COVID?

Atorvastatin possesses anti-inflammatory and modifying effects on the immune system [1]. A recent study conducted in vitro (in test tubes) showed that atorvastatin reduced levels of pro-inflammatory proteins and inhibited human cells from being infected with COVID-19. Additionally, atorvastatin was one of the statins that showed the most promise in restoring a COVID-19 state to a healthy state [2]. Further, an observational study suggested that patients who regularly used statins were less likely to die and more likely to have better outcomes when hospitalized for an acute COVID-19 infection [3].

However, statins can also upregulate or increase an enzyme called ACE2. ACE2 is how COVID-19 makes its way into the cells, leading to an influx of disease [4]. For those who suffer from long-COVID, the effects of statins may theoretically prolong illness. Hallmarks of long COVID include chronic fatigue, exercise intolerance, muscle weakness, and muscle pain (myalgia). Muscle weakness or muscle pain are also potential side effects associated with the use of statins.  If such a side effect occurs, the use of statins may exacerbate long COVID symptoms. Additionally, statins can decrease the amount of CoQ10 available for use by the body. CoQ10 is an antioxidant that has a role in the cells’ energy production [5]. For those suffering from long COVID and already with a decreased energy reserve, statin use could further exacerbate this problem.

Additional research is needed to better understand the role of statins in long COVID. In the meantime, a benefit versus risk assessment for every patient should be considered to assess whether the cardio-protection of statins outweighs potential prolonged negative effects on long COVID symptoms.

References:

¹https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9520195/

²https://journals.plos.org/ploscompbiol/article?id=10.1371/journal.pcbi.1011050

³https://pubmed.ncbi.nlm.nih.gov/36753725

⁴https://jamanetwork.com/journals/jama/fullarticle/2780872

⁵ https://www.mdpi.com/2077-0383/12/14/4659

Active Clinical Trials: Long COVID, statin | Card Results | ClinicalTrials.gov