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