Abstract

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.

摘要

导致2019年冠状病毒病（COVID-19）的严重急性呼吸系统综合症冠状病毒2（SARS-CoV-2）感染了数百万个人，并夺走了全球数十万人的生命。患有潜在心血管疾病的患者极有可能感染SARS-CoV-2，而COVID-19患者的心血管并发症发生率很高，例如急性心脏损伤，心律不齐，心力衰竭和血栓栓塞。该疾病没有经过批准的行之有效的治疗方法，因此重新利用现有的经批准的药物已被视为最快的治疗方法。他汀类药物已显示出对脂质降低具有依赖性和独立性的心血管保护作用，以及在各种其他病理生理状态下的有利作用。他汀类药物的这些有益特性是其多种多效性效应的结果，包括抗炎，免疫调节，抗血栓形成和抗微生物特性。在这篇综述中，我们提供了他汀类药物的多效性作用机制，与其在感染和急性肺损伤中的作用有关的相关临床前和临床数据，他汀类药物在COVID-19中可能带来的心血管益处以及他汀类药物在COVID-19疾病中的治疗潜力的意义。我们得出在COVID-19疾病中进行他汀类药物随机对照试验的基本原理。我们提供了他汀类药物的多效性作用机制，与其在感染和急性肺损伤中的作用有关的相关临床前和临床数据，他汀类药物在COVID-19中可能带来的心血管益处以及其影响的全面描述。他汀类药物在COVID-19疾病中的治疗潜力。我们得出在COVID-19疾病中进行他汀类药物随机对照试验的基本原理。我们提供了他汀类药物的多效性作用机制，与其在感染和急性肺损伤中的作用有关的相关临床前和临床数据，他汀类药物在COVID-19中可能带来的心血管益处以及其影响的全面描述。他汀类药物在COVID-19疾病中的治疗潜力。我们得出在COVID-19疾病中进行他汀类药物随机对照试验的基本原理。