Type 2 diabetes is a risk factor for severe COVID-19 disease, according to the U.S. Centers for Disease Control and Prevention.1 And, it is clear that people with diabetes have a much higher risk of death within the first week of hospitalization for COVID-19 than people without diabetes.2 However, recent data from two different studies analyzing the association between statin use, diabetes and severity of disease with COVID-19 have found conflicting results.3
Researchers believe there is a relationship between statins, diabetes and an increased risk of severe disease from COVID-19. But there was a relationship between the drug and the health condition that predates the current pandemic.
Statin drugs are one of the most prescribed medications.4 According to a study in JAMA Cardiology, the number of people using statins jumped from 21.8 million in 2002-2003 to 39.2 million in 2012-2013, the most current data available.5 Annual prescriptions rose from 134 million to 221 million during the same time, which represented a 64.9% increase.
According to the American Diabetes Association, the prevalence of diabetes in the U.S. in 2018 was 10.5% of the population or 34.2 million people.6 In this group, 26.8 million had a diagnosis of diabetes and 7.3 million were as yet undiagnosed. Every year, 1.5 million more people are diagnosed with diabetes.
The numbers are overwhelming and itâ€™s likely you know someone who has diabetes, takes statin drugs or both. Thankfully there are ways to help reduce or eliminate your use of medication and subsequently lower your risk of severe disease from SARS-CoV-2, the virus that causes COVID-19.
Statin Use by Diabetics With COVID-19 Raises Mortality Rate
From the beginning of the pandemic, experts have recognized there were groups of individuals who had a higher risk of experiencing severe disease and death. The CDC maintains a list of health conditions that increase a personâ€™s risk that includes obesity, Type 2 diabetes and heart conditions.7
Many of these health conditions are also risk factors for other infectious diseases as they significantly impact your immune response. In March 2020, a group of scientists from Nantes University Hospital in France listed a study on Clinical Trials called COVID-19 and Diabetes Outcomes (CORONADO), to measure the prevalence of severe COVID-19 in hospitalized patients who had diabetes.8
The study included children, adults and older adults. Initial results were published in Diabetes and Metabolism,9 in which researchers analyzed data gathered from participants in 68 hospitals in France with the primary outcome of intubation or death within seven days or 28 days of admission.
The researchers analyzed 2,449 patients with Type 2 diabetes, of whom 48.7% were using statins before they were admitted to the hospital. Without adjustment of confounding factors, patients who were taking statins had similar primary outcome measures to those who did not take statins.
However, the data also showed that mortality rates were significantly higher within seven days and 28 days compared to people who were not using statins. The researchers acknowledged those taking the drug were older, more frequently male and often had more comorbidities, including high blood pressure, heart failure and complications of diabetes.
They found the results surprising since other observational studies had found a potentially beneficial effect of statin medications in people who had COVID-19. They wrote a potential explanation was their focus on people with a known risk factor for severe disease, Type 2 diabetes.
Additionally, patients in the CORONADO study who were taking statin medications had a higher number of comorbidities than nonusers. However, despite the limitations, the researchers found enough evidence in the over 2,400 participants to conclude:10
â€œâ€¦ our present results do not support the hypothesis of a protective role of routine statin use against COVID-19, at least not in hospitalized patients with T2DM (Type 2 diabetes mellitus).
Indeed, the potentially deleterious effects of routine statin treatment on COVID-19-related mortality demands further investigation and, as recently highlighted, only appropriately designed and powered randomized controlled trials will be able to properly address this important issue.â€�
Statins, Diabetes and COVID-19
On the other hand, a second observational study published in the Journal of the American Heart Association found results that were similar to past studies, linking statins with lower mortality in people hospitalized with COVID-19.11
While the two studies appear to find contradictory evidence, Dr. Daniel Drucker from Mount Sinai Hospital, Toronto, commented that it was not uncommon for data to reveal different results in observational studies, making it a challenge to find meaningful, causal inferences.12
The second study,13 led by Dr. Omar Saeed from Montefiore Medical Center in New York, gathered data from 4,252 patients with a confirmed diagnosis of COVID-19. In this study, only 53% had diabetes and 32% had been treated with statins, as compared to 100% of patients in the CORONADO study who had diabetes.
The data from Saeedâ€™s study showed patients taking statins had a 23% chance of dying in the hospital, versus 27% in those who were not taking statins. The data also showed people with diabetes who had been taking statins had a 24% chance of mortality versus 39% in diabetics who were not taking statins.
Data from the CORONADO study published earlier in the year14 revealed 10% of people with diabetes who were hospitalized with COVID-19 died within a week and nearly 33% required mechanical ventilation. The data showed an individual’s:15
â€œâ€¦ body mass index (BMI) was independently associated with death or intubation at 7 days, while A1c and use of renin-angiotensin-aldosterone system (RAAS) blockers and dipeptidyl peptidase-4 inhibitors were not.â€�
The scientists in the CORONADO study were encouraged by the fact there were no deaths in people with Type 1 diabetes who were under the age of 65. One scientist from the team, Dr. Samy Hadjadj, spoke with Medscape Medical News about the results, saying:16
“Before the CORONADO study it was ‘all diabetes [patients] are the same.’ Now we can surely consider more precisely the risk, taking age, sex, BMI, complications, and [obstructive sleep apnea] as clear ‘very high-risk situations.'”
He further cautioned:
“â€¦ even in diabetes, each increase in BMI is associated with an increase in the risk of intubation and/or death in the 7 days following admission for COVID-19. So let’s target this population as a really important population to keep social distancing and stay alert on avoiding the virus.”
Statins Are a Waste of Money and Resources
Whether statins raise the risk of mortality in severe COVID-19 or not, they do not protect you against cardiovascular disease as intended and do increase your risk of other negative health conditions. Since there are strategies you can use at home to reduce your risk of severe disease and protect your health, it is typically unnecessary and likely dangerous to seek out statin drugs.
In 2014, Maryanne Demasi, Ph.D., produced a documentary, â€œHeart of The Matter: Dietary Villains.â€�17 The film exposed the cholesterol and saturated fat myth that Big Pharma uses to bolster the prescription rate of statin medications and the financial links that support the pharmaceutical industry.
Ultimately, ABC TV expunged the documentary under pressure from Australian Heart Foundation and the Cholesterol Treatment Trialists Collaboration (CTT).18 ABC stopped Demasi from writing opinion pieces, talking to journalists or going to medical conferences. By 2016, she and her colleagues were out of a job.
Although cholesterol and saturated fat have been the villains of heart disease for four decades, studies do not support the claim. Since the release of the documentary, the evidence against statins and the theory that cholesterol is the foundation of heart disease has only continued to grow.
In a recent scientific review of the literature in the journal BMJ Evidence-Based Medicine, researchers found lowering LDL cholesterol does not lower your risk of heart disease and stroke, writing: â€œDecades of research have failed to show any consistent benefit for this approach.â€�19 In other words, billions of dollars are spent on medications that are ineffective and potentially harmful.
Since the commercialization of statin drugs in the late ’80s (lovastatin was the first one that gained approval in 1987),20 total sales have reached nearly $1 trillion.21,22 Lipitor â€” which is just one of several brand name statin drugs â€” was named the most profitable drug in the history of medicine to date.23,24
Yet these drugs have done nothing to derail the rising trend of heart disease, which remains the leading cause of death.25 The BMJ study authors argue that since dozens of randomized controlled trials looking at LDL-cholesterol reduction “have failed to demonstrate a consistent benefit, we should question the validity of this theory,”26 going on to say:
“In most fields of science the existence of contradictory evidence usually leads to a paradigm shift or modification of the theory in question, but in this case the contradictory evidence has been largely ignored, simply because it doesn’t fit the prevailing paradigm.”
â€œThe negative results of numerous cholesterol lowering randomised controlled trials call into question the validity of using low density lipoprotein cholesterol as a surrogate target for the prevention of cardiovascular disease.â€�
Statins Sabotage Your Health and Raise Diabetes Risk
In addition to not being helpful in preventing or delaying heart attacks and strokes, statins are dangerous to your long-term health. A stunning review of statin trials published in 2015 found that in primary prevention, the median postponement of death in those taking statins was a mere 3.2 days.28
As damaging, the study found in those using statins for secondary prevention to reduce the risk of second heart attack, the median postponement of death was 4.1 days. While taking a pill to potentially extend life by three to four days already seems questionable, those taking statins are also at increased risk for the following, adding even more controversy to their use:
Dementia, neurodegenerative diseases and psychiatric problems such as depression, anxiety and aggression32,33
Consider Making Dietary and Lifestyle Changes
Using simple strategies at home may help normalize your cholesterol and blood sugar levels. I believe a total cholesterol measurement has little benefit in evaluating your risk for heart disease, unless the total number is over 300.
In some instances, high cholesterol may indicate a problem when your LDL or triglycerides are high, and your HDL is low. Youâ€™ll be better able to evaluate your risk by looking at the two ratios below, in combination with other lifestyle factors such as iron level and diet.
- HDL/Cholesterol ratio â€” Divide your HDL level by your cholesterol. This ratio should ideally be above 24%
- Triglyceride/HDL ratio â€” Divide your triglyceride level by your HDL. This ratio should ideally be below 239
You may lower your risk of heart disease by following suggestions that affect your lifestyle and exposure to environmental toxins. In my article, â€œCholesterol Managers Want to Double Statin Prescriptions,â€� I share a list to help minimize your toxic exposure and improve your body’s ability to maintain good heart health.
Additionally, in my article â€œNearly Half of American Adults Have Cardiovascular Disease,â€� I summarize further strategies to improve microcirculation in your heart. I also talk about mitochondrial function and insulin resistance, which are related to strong heart health.
It is difficult to control Type 2 diabetes when you rely strictly on medication and do not change the underlying lifestyle factors that have caused the problem. If properly addressed, Type 2 diabetes can be entirely reversible in most people.
The reason is because Type 2 diabetes is a diet-derived condition rooted in insulin resistance and faulty leptin signaling. Because of this it can effectively be treated and reversed through dietary and lifestyle means. I discuss this further, with suggestions for changes, in â€œDiabetes Can Increase Complications of COVID-19.â€�