Section of Clinical Biochemistry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy.
Cardiac Intensive Care Unit, The Heart Institute, Cincinnati Children's Hospital Medical Center, Ohio.
Semin Thromb Hemost. 2021 Jun;47(4):392-399. doi: 10.1055/s-0040-1722307. Epub 2021 Jan 22.
Severe acute respiratory syndrome coronavirus 2 has spread rapidly throughout the world, becoming an overwhelming global health emergency. The array of injuries caused by this virus is broad and not limited to the respiratory system, but encompassing also extensive endothelial and systemic tissue damage. Since statins effectively improve endothelial function, these drugs may have beneficial effects in patients with coronavirus disease 2019 (COVID-19). Therefore, this investigation aimed to provide an updated overview on the interplay between statins and COVID-19, with particular focus on their potentially protective role against progression toward severe or critical illness and death. A systematic electronic search was performed in Scopus and PubMed up to present time. Data on statins use and COVID-19 outcomes especially in studies performed in Europe and North America were extracted and pooled. A total of seven studies met our inclusion criteria, totaling 2,398 patients (1,075 taking statins, i.e., 44.8%). Overall, statin usage in Western patients hospitalized with COVID-19 was associated with nearly 40% lower odds of progressing toward severe illness or death (odds ratio: 0.59; 95% confidence interval: 0.35-0.99). After excluding studies in which statin therapy was started during hospital admission, the beneficial effect of these drugs was magnified (odds ratio: 0.51; 95% confidence interval: 0.41-0.64). In conclusion, although randomized trials would be necessary to confirm these preliminary findings, current evidence would support a favorable effect of statins as adjuvant therapy in patients with COVID-19. Irrespective of these considerations, suspension of statin therapy seems highly unadvisable in COVID-19 patients.
严重急性呼吸综合征冠状病毒 2 在全球迅速传播,成为一场压倒性的全球卫生紧急事件。这种病毒引起的损伤范围广泛,不仅限于呼吸系统,还包括广泛的内皮和全身组织损伤。由于他汀类药物能有效改善内皮功能,因此这些药物可能对 2019 年冠状病毒病(COVID-19)患者有益。因此,本研究旨在提供他汀类药物与 COVID-19 之间相互作用的最新概述,特别关注它们在预防疾病向严重或危重症进展以及死亡方面的潜在保护作用。在 Scopus 和 PubMed 上进行了系统的电子搜索,截至目前。提取并汇总了关于他汀类药物使用和 COVID-19 结局的数据,特别是在欧洲和北美进行的研究。共有 7 项研究符合我们的纳入标准,共纳入 2398 例患者(1075 例服用他汀类药物,即 44.8%)。总体而言,COVID-19 住院患者使用他汀类药物与严重疾病或死亡进展的几率降低近 40%(比值比:0.59;95%置信区间:0.35-0.99)。在排除他汀类药物治疗在住院期间开始的研究后,这些药物的有益作用更加显著(比值比:0.51;95%置信区间:0.41-0.64)。总之,尽管需要随机试验来证实这些初步发现,但目前的证据支持将他汀类药物作为 COVID-19 患者的辅助治疗。尽管存在这些考虑因素,但在 COVID-19 患者中暂停他汀类药物治疗似乎极不明智。