Pros and cons for use of statins in people with coronavirus disease-19 (COVID-19)
Pros and cons for use of statins in people with coronavirus disease-19 (COVID-19)
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DOI：
10.1016/j.dsx.2020.07.011
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发表时间：
2020-09-01
影响因子：
10
通讯作者：
Kalyan, Gangopadhyay K.
中科院分区：
文献类型：
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作者：
Subir, Ray;Jagat, Mukherjee J.;Kalyan, Gangopadhyay K.
背景和目标：糖尿病 (DM)、高血压和心血管疾病 (CVD) 患者中 2019 年冠状病毒病 (COVID-19) 的发病率和死亡率较高。大多数 DM 和 CVD 患者都使用他汀类药物。这篇小综述讨论了目前对在 COVID-19 中使用他汀类药物的获益风险比的理解。方法：我们使用与我们的目标相关的特定关键词搜索了 PubMed 数据库，截至 2020 年 6 月 12 日。检索并审查了以英文发表的相关文章的全文。结果：他汀类药物具有免疫调节、抗炎、抗血栓和抗氧化特性，有可能降低肺损伤的严重程度和死亡率严重急性呼吸综合征-冠状病毒 2 (SARS-CoV2) 感染。他汀类药物诱导的血管紧张素转换酶 2 (ACE2) 上调有可能减少过量血管紧张素 II 引起的肺损伤。通过破坏脂筏，他汀类药物有可能减少病毒进入细胞。然而，其与 MYD88 基因表达的复杂相互作用对 COVID-19 结果的获益风险比，以及低血清 LDL 胆固醇在 SARS-CoV2 感染严重程度增加中的推定作用，需要进一步澄清。结论：已经因潜在共病而服用他汀类药物的 COVID-19 患者应继续服用他汀类药物，除非有特定禁忌症。对没有潜在合并症的 COVID-19 患者重新使用他汀类药物可能是有益的，但有待临床试验的证实；在那之前，他汀类药物在 COVID 19 中的重新使用应仅限于临床试验环境。 (C) 2020 年印度糖尿病。由爱思唯尔有限公司出版。保留所有权利。
Background and aims: Morbidity and mortality from coronavirus disease 2019 (COVID-19) is higher among people with diabetes mellitus (DM), hypertension, and cardiovascular disease (CVD). Statins are used in the majority of people with DM and CVD. This mini-review discusses the current understanding of benefit-risk ratio of use of statins in COVID-19.Methods: We searched PubMed database using specific keywords related to our aims till June 12, 2020. Full text of relevant articles published in English language were retrieved and reviewed.Results: Statins, with their immunomodulatory, anti-inflammatory, anti-thrombotic, and anti-oxidant properties, have the potential to reduce severity of lung injury in, and mortality from, severe acute respiratory syndrome-coronavirus 2 (SARS-CoV2) infections. Statin-induced upregulation of angiotensinconverting enzyme-2 (ACE2) has the potential to reduce lung injury from excess angiotensin II. By disrupting lipid rafts, statins have the potential to reduce viral entry into cells. However, benefit-risk ratio of its complex interaction with MYD88 gene expression on outcomes in COVID-19, and the putative role of low serum LDL cholesterol in increasing severity of SARS-CoV2 infection need further clarification.Conclusions: People with COVID-19, who are already on statins for an underlying co-morbid condition, should continue on it unless there are specific contraindications. De-novo use of statins in people with COVID-19 with no underlying co-morbidity might be beneficial but awaits substantiation in clinical trials; till that time, de novo use of statins in COVID 19 should be limited to a clinical trial setting. (C) 2020 Diabetes India. Published by Elsevier Ltd. All rights reserved.