Talasaz Azita H, Sadeghipour Parham, Aghakouchakzadeh Maryam, Dreyfus Isaac, Kakavand Hessam, Ariannejad Hamid, Gupta Aakriti, Madhavan Mahesh V, Van Tassell Benjamin W, Jimenez David, Monreal Manuel, Vaduganathan Muthiah, Fanikos John, Dixon Dave L, Piazza Gregory, Parikh Sahil A, Bhatt Deepak L, Lip Gregory Yh, Stone Gregg W, Krumholz Harlan M, Libby Peter, Goldhaber Samuel Z, Bikdeli Behnood
medRxiv. 2021 May 4:2021.05.03.21256468. doi: 10.1101/2021.05.03.21256468.
Coronavirus disease 2019 (COVID-19) is associated with systemic inflammation, endothelial activation, and multi-organ manifestations. Lipid modulating agents may be useful in treating patients with COVID-19. They may inhibit viral entry by lipid raft disruption or ameliorate the inflammatory response and endothelial activation. In addition, dyslipidemia with lower high-density lipoprotein cholesterol and higher triglycerides portends worse outcome in patients with COVID-19. Upon a systematic search, 40 RCTs with lipid modulating agents were identified, including 17 statin trials, 14 omega-3 fatty acids RCTs, 3 fibrates RCTs, 5 niacin RCTs, and 1 dalcetrapib RCT for management or prevention of COVID-19. This manuscript summarizes the ongoing or completed randomized controlled trials (RCTs) of lipid modulating agents in COVID-19 and the implications of these trials for patient management.
2019冠状病毒病(COVID-19)与全身炎症、内皮激活及多器官表现相关。脂质调节剂可能对治疗COVID-19患者有用。它们可能通过破坏脂筏抑制病毒进入,或改善炎症反应及内皮激活。此外,高密度脂蛋白胆固醇降低和甘油三酯升高的血脂异常预示着COVID-19患者的预后更差。经过系统检索,共识别出40项使用脂质调节剂的随机对照试验(RCT),包括17项他汀类试验、14项ω-3脂肪酸RCT、3项贝特类RCT、5项烟酸RCT和1项达塞曲匹RCT,用于COVID-19的管理或预防。本文总结了脂质调节剂在COVID-19中正在进行或已完成的随机对照试验(RCT)以及这些试验对患者管理的意义。