J Am Coll Cardiol . Investigating Lipid-Modulating Agents for Prevention or Treatment of COVID-19: JACC State-of-the-Art Review

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J Am Coll Cardiol


. 2021 Oct 19;78(16):1635-1654.
doi: 10.1016/j.jacc.2021.08.021.
Investigating Lipid-Modulating Agents for Prevention or Treatment of COVID-19: JACC State-of-the-Art Review


Azita H Talasaz ¹ , Parham Sadeghipour ² , Maryam Aghakouchakzadeh ³ , Isaac Dreyfus ⁴ , Hessam Kakavand ³ , Hamid Ariannejad ⁵ , Aakriti Gupta ⁶ , Mahesh V Madhavan ⁷ , Benjamin W Van Tassell ⁸ , David Jimenez ⁹ , Manuel Monreal ¹⁰ , Muthiah Vaduganathan ¹¹ , John Fanikos ¹² , Dave L Dixon ⁸ , Gregory Piazza ¹¹ , Sahil A Parikh ⁷ , Deepak L Bhatt ¹¹ , Gregory Y H Lip ¹³ , Gregg W Stone ¹⁴ , Harlan M Krumholz ¹⁵ , Peter Libby ¹¹ , Samuel Z Goldhaber ¹¹ , Behnood Bikdeli ¹⁶



Affiliations

• PMID: 34649702
• DOI: 10.1016/j.jacc.2021.08.021

Abstract

Coronavirus disease-2019 (COVID-19) is associated with systemic inflammation, endothelial activation, and multiorgan manifestations. Lipid-modulating agents may be useful in treating patients with COVID-19. These agents may inhibit viral entry by lipid raft disruption or ameliorate the inflammatory response and endothelial activation. In addition, dyslipidemia with lower high-density lipoprotein cholesterol and higher triglyceride levels portend worse outcomes in patients with COVID-19. Upon a systematic search, 40 randomized controlled trials (RCTs) with lipid-modulating agents were identified, including 17 statin trials, 14 omega-3 fatty acids RCTs, 3 fibrate RCTs, 5 niacin RCTs, and 1 dalcetrapib RCT for the management or prevention of COVID-19. From these 40 RCTs, only 2 have reported preliminary results, and most others are ongoing. This paper summarizes the ongoing or completed RCTs of lipid-modulating agents in COVID-19 and the implications of these trials for patient management.

Keywords: COVID-19; fibrate; lipid-modulating agent; niacin; omega-3; statin.