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Biological Actions, Implications, and Cautions of Statins Therapy in COVID-19

The Coronavirus Disease 2019 (COVID-19) showed worse prognosis and higher mortality in individuals with obesity. Dyslipidemia is a major link between obesity and COVID-19 severity. Statins as the most common lipid regulating drugs have shown favorable effects in various pathophysiological states. Im...

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Autores principales: Liu, Chengyu, Yan, Wanyao, Shi, Jiajian, Wang, Shun, Peng, Anlin, Chen, Yuchen, Huang, Kun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9257176/
https://www.ncbi.nlm.nih.gov/pubmed/35811982
http://dx.doi.org/10.3389/fnut.2022.927092
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author Liu, Chengyu
Yan, Wanyao
Shi, Jiajian
Wang, Shun
Peng, Anlin
Chen, Yuchen
Huang, Kun
author_facet Liu, Chengyu
Yan, Wanyao
Shi, Jiajian
Wang, Shun
Peng, Anlin
Chen, Yuchen
Huang, Kun
author_sort Liu, Chengyu
collection PubMed
description The Coronavirus Disease 2019 (COVID-19) showed worse prognosis and higher mortality in individuals with obesity. Dyslipidemia is a major link between obesity and COVID-19 severity. Statins as the most common lipid regulating drugs have shown favorable effects in various pathophysiological states. Importantly, accumulating observational studies have suggested that statin use is associated with reduced risk of progressing to severe illness and in-hospital death in COVID-19 patients. Possible explanations underlie these protective impacts include their abilities of reducing cholesterol, suppressing viral entry and replication, anti-inflammation and immunomodulatory effects, as well as anti-thrombosis and anti-oxidative properties. Despite these benefits, statin therapies have side effects that should be considered, such as elevated creatinine kinase, liver enzyme and serum glucose levels, which are already elevated in severe COVID-19. Concerns are also raised whether statins interfere with the efficacy of COVID-19 vaccines. Randomized controlled trials are being conducted worldwide to confirm the values of statin use for COVID-19 treatment. Generally, the results suggest no necessity to discontinue statin use, and no evidence suggesting interference between statins and COVID-19 vaccines. However, concomitant administration of statins and COVID-19 antiviral drug Paxlovid may increase statin exposure and the risk of adverse effects, because most statins are metabolized mainly through CYP3A4 which is potently inhibited by ritonavir, a major component of Paxlovid. Therefore, more clinical/preclinical studies are still warranted to understand the benefits, harms and mechanisms of statin use in the context of COVID-19.
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spelling pubmed-92571762022-07-07 Biological Actions, Implications, and Cautions of Statins Therapy in COVID-19 Liu, Chengyu Yan, Wanyao Shi, Jiajian Wang, Shun Peng, Anlin Chen, Yuchen Huang, Kun Front Nutr Nutrition The Coronavirus Disease 2019 (COVID-19) showed worse prognosis and higher mortality in individuals with obesity. Dyslipidemia is a major link between obesity and COVID-19 severity. Statins as the most common lipid regulating drugs have shown favorable effects in various pathophysiological states. Importantly, accumulating observational studies have suggested that statin use is associated with reduced risk of progressing to severe illness and in-hospital death in COVID-19 patients. Possible explanations underlie these protective impacts include their abilities of reducing cholesterol, suppressing viral entry and replication, anti-inflammation and immunomodulatory effects, as well as anti-thrombosis and anti-oxidative properties. Despite these benefits, statin therapies have side effects that should be considered, such as elevated creatinine kinase, liver enzyme and serum glucose levels, which are already elevated in severe COVID-19. Concerns are also raised whether statins interfere with the efficacy of COVID-19 vaccines. Randomized controlled trials are being conducted worldwide to confirm the values of statin use for COVID-19 treatment. Generally, the results suggest no necessity to discontinue statin use, and no evidence suggesting interference between statins and COVID-19 vaccines. However, concomitant administration of statins and COVID-19 antiviral drug Paxlovid may increase statin exposure and the risk of adverse effects, because most statins are metabolized mainly through CYP3A4 which is potently inhibited by ritonavir, a major component of Paxlovid. Therefore, more clinical/preclinical studies are still warranted to understand the benefits, harms and mechanisms of statin use in the context of COVID-19. Frontiers Media S.A. 2022-06-22 /pmc/articles/PMC9257176/ /pubmed/35811982 http://dx.doi.org/10.3389/fnut.2022.927092 Text en Copyright © 2022 Liu, Yan, Shi, Wang, Peng, Chen and Huang. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Nutrition
Liu, Chengyu
Yan, Wanyao
Shi, Jiajian
Wang, Shun
Peng, Anlin
Chen, Yuchen
Huang, Kun
Biological Actions, Implications, and Cautions of Statins Therapy in COVID-19
title Biological Actions, Implications, and Cautions of Statins Therapy in COVID-19
title_full Biological Actions, Implications, and Cautions of Statins Therapy in COVID-19
title_fullStr Biological Actions, Implications, and Cautions of Statins Therapy in COVID-19
title_full_unstemmed Biological Actions, Implications, and Cautions of Statins Therapy in COVID-19
title_short Biological Actions, Implications, and Cautions of Statins Therapy in COVID-19
title_sort biological actions, implications, and cautions of statins therapy in covid-19
topic Nutrition
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9257176/
https://www.ncbi.nlm.nih.gov/pubmed/35811982
http://dx.doi.org/10.3389/fnut.2022.927092
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