Kashour Tarek, Halwani Rabih, Arabi Yaseen M, Sohail M Rizwan, O'Horo John C, Badley Andrew D, Tleyjeh Imad M
Department of Cardiac Sciences, King Fahad Cardiac Center, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia.
Clinical Sciences Department, College of Medicine, University of Sharjah, Sharjah, UAE.
Immunopharmacol Immunotoxicol. 2021 Feb;43(1):37-50. doi: 10.1080/08923973.2020.1863984. Epub 2021 Jan 6.
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that causes the coronavirus disease 2019 (COVID-19) has infected millions of individuals and has claimed hundreds of thousands of human lives worldwide. Patients with underlying cardiovascular conditions are at high risk for SARS-CoV-2 infection, and COVID-19 patients have high incidence of cardiovascular complications such as acute cardiac injury, arrhythmias, heart failure, and thromboembolism. The disease has no approved proven effective therapy and hence repurposing of existing approved drugs has been considered as the fastest treatment approach. Statins have been shown to exhibit lipid lowering dependent and independent cardiovascular protective effects as well as favorable effects in various other pathophysiological states. These beneficial properties of statins are a result of their multiple pleotropic effects that include, anti-inflammatory, immunomodulatory, antithrombotic and antimicrobial properties. In this review, we provide a comprehensive description of the mechanisms of the pleotropic effects of statins, the relevant pre-clinical and clinical data pertinent to their role in infections and acute lung injury, the possible cardiovascular benefits of statins in COVID-19, and the implications of the therapeutic potential of statins in COVID-19 disease. We conclude with the rationale for conducting randomized controlled trials of statins in COVID-19 disease.
导致2019冠状病毒病（COVID-19）的严重急性呼吸综合征冠状病毒2（SARS-CoV-2）已感染数百万人，并在全球夺走了数十万人的生命。患有潜在心血管疾病的患者感染SARS-CoV-2的风险很高，而COVID-19患者心血管并发症的发生率很高，如急性心脏损伤、心律失常、心力衰竭和血栓栓塞。该疾病尚无经批准的有效治疗方法，因此将现有已批准药物重新用于治疗被认为是最快的治疗途径。他汀类药物已被证明具有依赖降脂和独立于降脂的心血管保护作用，以及在各种其他病理生理状态下的有益作用。他汀类药物的这些有益特性是其多种多效性作用的结果，这些作用包括抗炎、免疫调节、抗血栓形成和抗菌特性。在本综述中，我们全面描述了他汀类药物多效性作用的机制、与其在感染和急性肺损伤中的作用相关的临床前和临床数据、他汀类药物在COVID-19中可能的心血管益处，以及他汀类药物治疗潜力在COVID-19疾病中的意义。我们最后阐述了在COVID-19疾病中开展他汀类药物随机对照试验的基本原理。
