key: cord-1004131-rvfd4lsr
authors: Katsiki, Niki; Banach, Maciej; Mikhailidis, Dimitri P
title: More Good News on Statins and COVID-19
date: 2020-10-23
journal: Am J Cardiol
DOI: 10.1016/j.amjcard.2020.10.026
sha: 9d949ce0f4a81e8e084a3aec84329fbf388e5b69
doc_id: 1004131
cord_uid: rvfd4lsr

nan

95% confidence intervals 0.53-0.94) compared with non-use. This finding strongly supports the clinical importance of continuing or initiating (according to current guidelines 2 ) statin treatment in the COVID-19 era. The authors mention some pathophysiological mechanisms that could explain this beneficial impact of statins, including anti-inflammatory actions and upregulation of angiotensin-converting enzyme (ACE) 2 expression. There are also other mechanisms that have been described, including the degradation of lipid rafts, directly affecting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) S-protein, and reducing the cholesterol important for viral entry into host cells 3, 4 .

Another mechanism could involve acute kidney injury (AKI) and acute cardiac injury, both of which are predictors of COVID-19 mortality 5, 6 . Statins have been shown to prevent contrast-induced AKI 7, 8 and stabilize atherosclerotic plaques 9 , thus protecting from acute adverse events from the cardiac and renal system. Drug-drug interactions should also be considered when treating COVID-19 patients on statins with antibiotics (e.g. macrolides) and antiviral drugs, due to an increased risk of statin-associated muscle symptoms (SAMS) 12, 13 . Furthermore, the use of lovastatin and simvastatin is contraindicated in patients on ritonavir/lopinavir therapy since they might increase the risk of rhabdomyolysis 14 Overall, statins can exert beneficial effects on the heart, vascular and lung function, as well as inflammation 15 , thus strongly supporting their continuation or initiation, based on recommendations 2 , during the COVID-19 pandemic.

Niki Katsiki 1 , Maciej Banach 2,3 , Dimitri P Mikhailidis 4

Conflict of interest NK has given talks, attended conferences and participated in trials sponsored by Astra Zeneca, Bausch Health

Grants from Sanofi and Valeant. DPM has given talks and attended conferences sponsored by Amgen, Novo Nordisk, and Libytec

Meta-analysis of Effect of Statins in Patients with COVID-19

Authors/Task Force Members; ESC Committee for Practice Guidelines (CPG)

ESC/EAS guidelines for the management of dyslipidaemias: Lipid modification to reduce cardiovascular risk

Cholesterol in Relation to COVID-19: Should We Care about It?

Statins and the COVID-19 main protease: in silico evidence on direct interaction

Acute kidney injury in critically ill patients with COVID-19

Cardiac injuries in patients with coronavirus disease 2019: Not to be ignored

Contrast-Induced Nephropathy: An "All or None" Phenomenon?

Contrast-induced acute kidney injury in diabetes mellitus: Clinical relevance and predisposing factors. Could statins be of benefit?

High-intensity statin therapy and regression of coronary atherosclerosis in patients with diabetes mellitus

Pros and cons for use of statins in people with coronavirus disease-19 (COVID-19)

Treating the host response to emerging virus diseases: lessons learned from sepsis, pneumonia, influenza and Ebola

Statin intolerance-an attempt at a unified definition. Position paper from an International Lipid Expert Panel

Brief recommendations on the management of adult patients with familial hypercholesterolemia during the COVID-19 pandemic

Cardiovascular Considerations for Patients, Health Care Workers, and Health Systems During the COVID-19 Pandemic

Lipid-lowering therapy and reninangiotensin-aldosterone system inhibitors in the era of the COVID-19 pandemic