Investigating Lipid-Modulating Agents for Prevention or Treatment of COVID-19: JACC State-of-the-Art Review.
Investigating Lipid-Modulating Agents for Prevention or Treatment of COVID-19: JACC State-of-the-Art Review.
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DOI：
10.1016/j.jacc.2021.08.021
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发表时间：
2021-10-19
影响因子：
24
通讯作者：
Bikdeli B
中科院分区：
文献类型：
--
作者：
Talasaz AH;Sadeghipour P;Aghakouchakzadeh M;Dreyfus I;Kakavand H;Ariannejad H;Gupta A;Madhavan MV;Van Tassell BW;Jimenez D;Monreal M;Vaduganathan M;Fanikos J;Dixon DL;Piazza G;Parikh SA;Bhatt DL;Lip GYH;Stone GW;Krumholz HM;Libby P;Goldhaber SZ;Bikdeli B
2019冠状病毒病（COVID-19）与全身性炎症、内皮激活和多器官表现相关。调脂剂可用于治疗COVID-19患者。这些药物可以通过破坏脂筏来抑制病毒进入或改善炎症反应和内皮活化。此外，伴有较低高密度脂蛋白胆固醇和较高甘油三酯水平的血脂异常预示着COVID-19患者的预后更差。通过系统检索，确定了40项关于调脂药物的随机对照试验（RCT），包括17项他汀类药物试验、14项omega-3脂肪酸RCT、3项贝特类RCT、5项烟酸RCT和1项达塞曲匹RCT，用于管理或预防COVID-19。在这40项随机对照试验中，只有2项报告了初步结果，其他大多数正在进行中。本文总结了正在进行或已完成的调脂药物治疗COVID-19的RCT，以及这些试验对患者管理的影响。
Coronavirus disease-2019 (COVID-19) is associated with systemic inflammation, endothelial activation, and multiorgan manifestations. Lipid-modulating agents may be useful in treating patients with COVID-19. These agents 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 triglyceride levels portend worse outcomes in patients with COVID-19. Upon a systematic search, 40 randomized controlled trials (RCTs) with lipid-modulating agents were identified, including 17 statin trials, 14 omega-3 fatty acids RCTs, 3 fibrate RCTs, 5 niacin RCTs, and 1 dalcetrapib RCT for the management or prevention of COVID-19. From these 40 RCTs, only 2 have reported preliminary results, and most others are ongoing. This paper summarizes the ongoing or completed RCTs of lipid-modulating agents in COVID-19 and the implications of these trials for patient management.
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