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Diabetes Metab Syndr
. 2020 Oct 23;14(6):2063-2067.
doi: 10.1016/j.dsx.2020.10.021. Online ahead of print.
Statins and SARS-CoV-2 disease: Current concepts and possible benefits
Madhu Mary Minz 1 , Manish Bansal 2 , Ravi R Kasliwal 1
Affiliations
- PMID: 33120281
- DOI: 10.1016/j.dsx.2020.10.021
Abstract
Background and aims: Inflammation-mediated tissue injury is the major mechanism involved in the pathogenesis of coronavirus disease 2019 (COVID-2019), caused by Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2). Statins have well-established anti-inflammatory, anti-thrombotic and immuno-modulatory effects. They may also influence viral entry into human cells.
Methods: A literature search was done using PubMed and Google search engines to prepare a narrative review on this topic.
Results: Statins interact with several different signaling pathways to exert their anti-inflammatory and vasculoprotective effects. They also variably affect cholesterol content of cell membranes and interfere with certain coronavirus enzymes involved in receptor-binding. Both these actions may influence SARS-CoV-2 entry into human cells. Statins also upregulate expression of angiotensin-converting enzyme 2 receptors on cell surfaces which may promote viral entry into the cells but at the same time, may minimize tissue injury through production of angiotensin [1-7]. The net impact of these different effects on COVID-19 pathogenesis is not clear. However, the retrospective clinical studies have shown that statin use is potentially associated with lower risk of developing severe illness and mortality and a faster time to recovery in patients with COVID-19.
Conclusions: Early observations suggest beneficial effect of statin use on the clinical outcomes in COVID-19. Prospective randomized studies as well as well-designed laboratory studies are required to confirm these observations and to elucidate the mechanisms of such benefits, if proven.
Keywords: Angiotensin-converting enzyme 2; Cardiovascular disease; Coronavirus disease 2019; Myeloid differentiation factor 88; Nuclear factor kappa light chain enhancer of activated B cells; SARS-CoV-2; Statins; Toll-like receptors.