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. Highlights • Statins have well-established anti-inflammatory, anti-thrombotic and immuno-modulatory effects. • They may also influence SARS-CoV-2 entry into human cells, but the net effect is unclear. • Retrospective studies have shown lower risk of severe illness and mortality with COVID-19 among statin users. • Randomized studies are required to confirm these initial observations.
【저자키워드】 SARS-CoV-2, Coronavirus disease 2019, cardiovascular disease, angiotensin-converting enzyme 2, Toll-like receptors, statins, myeloid differentiation factor 88, Nuclear factor kappa light chain enhancer of activated B cells,