ROSUVASTATIN

What is rosuvastatin (Crestor)?

Rosuvastatin is part of a class of drugs commonly referred to as “statins,” whose role is to reduce the amount of cholesterol the liver makes. Cholesterol comprises HDL, the “good” cholesterol, and LDL, the “bad” cholesterol. It is used by the body to produce 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.

How does rosuvastatin relate to long-COVID?

Rosuvastatin possesses anti-inflammatory and modifying effects on the immune system (1). A recent study conducted in vitro (in test tubes) showed that simvastatin reduced levels of pro-inflammatory proteins and inhibited human cells from being infected with COVID-19 (2). 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 ( 3).

For those who suffer from long-COVID, the effects of statins may prolong illness even further. Highlights of long-COVID include chronic fatigue, exercise intolerance, and muscle weakness. Muscle weakness or muscle pain (myalgia) is also a primary side effect associated with the use of statins. Therefore, many believe that statins are exaggerating long-COVID in patients. Additionally, statins can decrease the amount of CoQ10 available for use by the body. CoQ10 is an antioxidant that has a role in cell energy production (4). For those suffering from long-COVID and already with a decreased energy reserve, statin use could only exacerbate this problem further.

Although currently, there is no definitive answer regarding the role of rosuvastatin use in patients with long-COVID, the consensus is to aid on the side of caution. A benefit versus risk scenario for every patient should be warranted for providers to assess whether the cardio-protective use of statins outweighs the prolonged effects of long-COVID in patients.

References:

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

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

³https://jamanetwork.com/journals/jama/fullarticle/2780872

⁴ https://www.mdpi.com/2077-0383/12/14/4659