Investigating Lipid-Modulating Agents for Prevention or Treatment of COVID-19: JACC State-of-the-Art Review

• Published in: Journal of the American College of Cardiology 2021-10, Vol.78 (16), p.1635
• Main Authors: Talasaz, Azita H, Sadeghipour, Parham, Aghakouchakzadeh, Maryam, Dreyfus, Isaac, Kakavand, Hessam, Ariannejad, Hamid, Gupta, Aakriti, Madhavan, Mahesh V, Van Tassell, Benjamin W, Jimenez, David, Monreal, Manuel, Vaduganathan, Muthiah, Fanikos, John, Dixon, Dave L, Piazza, Gregory, Parikh, Sahil A, Bhatt, Deepak L, Lip, Gregory Y H, Stone, Gregg W, Krumholz, Harlan M, Libby, Peter, Goldhaber, Samuel Z, Bikdeli, Behnood
• Format: Article
• Language: English
• Subjects: Amides - pharmacology; Amides - therapeutic use; COVID-19 - prevention & control; COVID-19 Drug Treatment; Esters - pharmacology; Esters - therapeutic use; Fatty Acids, Omega-3 - pharmacology; Fatty Acids, Omega-3 - therapeutic use; Fibric Acids - pharmacology; Fibric Acids - therapeutic use; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - pharmacology; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; Lipid Regulating Agents - pharmacology; Lipid Regulating Agents - therapeutic use; Niacin - pharmacology; Niacin - therapeutic use; Randomized Controlled Trials as Topic; Sulfhydryl Compounds - pharmacology; Sulfhydryl Compounds - therapeutic use
• ISSN: 1558-3597; 1558-3597
• DOI: 10.1016/j.jacc.2021.08.021

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.