Statins as Adjuvant Therapy for COVID-19 to Calm the Stormy Immunothrombosis and Beyond

Vuorio, Alpo; Kovanen, Petri T.

doi:10.3389/fphar.2020.579548

Cited by 23 publications

(15 citation statements)

References 61 publications

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“…There is rapidly growing evidence supporting the potential benefit of treating COVID-19 patients with statins [2,9,[12][13][14][15][16][17]. Importantly, the use of statins correlates significantly with lower mortality in patients with COVID-19, consistent with the findings in patients with pneumonia (Figure 1).…”

supporting

confidence: 67%

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Adjunctive Use of Statins for COVID-19

Sathekge

Byttebier²,

Spiegeleer

et al. 2021

JCM

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supporting

confidence: 67%

“…Cholesterol and lipid metabolism are essential for several steps in the life cycle of many viruses, including virus fusion to cell membranes and cell entry, virus replication and particle assembly, and virus release from host cells. Host lipid metabolic pathways are known to promote the replication and infectivity of several viruses [9].…”

mentioning

confidence: 99%

Adjunctive Use of Statins for COVID-19

Sathekge

Byttebier²,

Spiegeleer

et al. 2021

JCM

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“…Due to the expected presence of subclinical ASCVD and the associated increased mortality risks among adult FH patients with COVID-19, treatment of hypercholesterolemia must be continued and probably even intensified, not only acutely, but also for an extended period after COVID-19 infection. The need for effective treatment applies especially to statins, which have been associated with a more favorable prognosis in most studies among hospitalized COVID-19 patients [ 40 ]. Indeed, most retrospective analyses about mortality in hospitalized patients with COVID-19 suggest that ongoing statin therapy improves the prognosis of hospitalized COVID-19 patients [ 41 ].…”

Section: Impact Of Lipid-lowering Medications On Sustained Metabolic Alterations In Fh Patients With Covid-19mentioning

confidence: 99%

Familial hypercholesterolemia and COVID-19: A menacing but treatable vasculopathic condition

Vuorio¹,

Strandberg

Raal

et al. 2021

Atherosclerosis Plus

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SARS-CoV-2 infection continues to cause increased morbidity and mortality, and due to the slow pace of vaccination COVID-19 will probably remain a global burden to health systems for a long time. Unfortunately, the necessary prevention and treatment strategies of COVID-19 have led to restriction measures that are hampering the routine care of common chronic metabolic conditions like hypercholesterolemia. It is of particular concern that during the acute phase of COVID-19, the control of pre-existing metabolic diseases tends to get worse which again increases the risk for complications and a poor outcome in these patients. A significant contributor to these complications is endothelial dysfunction which is associated with COVID-19. This Commentary will discuss the impact of COVID-19 on endothelial function particularly in patients with familial hypercholesterolemia (FH), a metabolic inherited disease known to in itself adversely affect endothelial function. There should be no hesitation to continue with statin therapy in severe hypercholesterolemic patients with COVID-19. We argue that in FH patients with COVID-19 the clinicians need even consider intensifying statin therapy as well as the addition of other lipid-lowering agents, such as proprotein convertase subtilisin/kexin type 9(PCSK9) inhibitors. In contrast to statins, the PCSK9 inhibitors lower lipoprotein(a) [Lp(a)] level, and, accordingly, these latter drugs need to be considered particularly in FH patients with an elevated level of Lp(a). This call applies to the in-hospital stay and also beyond. When considering that the vasculopathic effects of COVID-19 may persist, a long-term follow-up of individualized therapies in FH patients is warranted.

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“…Ever-increasing numbers of evidence-based data derived from individual studies and meta-analyses show that statins are beneficial for the prognosis of COVID-19 patients and, accordingly, a consensus expert statement calls for a continuation of statin treatment in COVID-19 patients also after the illness (20)(21)(22)(23)(24). The amenable effect of statins especially applies to patients with HeFH because of both the magnitude and duration of the elevation of serum LDL-C, which often combines with an elevated Lp(a) level and then jointly correlates with the severity of systemic endothelial dysfunction and coagulation propensity (25).…”

Section: Statins and Covid-19mentioning

confidence: 99%