Estatinas y efectos pleiotrópicos en COVID-19: una revisión exploratoria

Juan Coronado-Sarmiento, Eduardo Tuta-Quintero, Alejandra Lozano, Diego Rojas-Pardo

Resumen


Introducción: La infección por SARS-COV-2 representa una grave emergencia de salud pública a nivel mundial; los adultos mayores comórbidos tienen una mayor riesgo de infección severa y mortalidad. Las enfermedades metabólicas y cardiovasculares se benefician de los tratamiento hipolipemiantes con estatinas, debido a sus efectos anti-inflamatorios, antioxidantes e incluso antivirales. Objetivo: Explorar la evidencia médica acerca de la eficacia y seguridad de las estatinas en el tratamiento de pacientes con COVID-19.  Materiales y métodos: Revisión sistemática exploratoria en PubMed y Scopus, incluyendo publicaciones con datos empíricos (estudios observacionales y experimentales) en inglés y español. Además, se buscaron ensayos clínicos registrados en 17 registros primarios de la Red de Registros de la organización mundial de la salud. Resultados: Se incluyeron documentos (n=12) y registros de ensayos clínicos (n=10). Estudios de cohorte retrospectivos (n= 11) e in silico (n= 1). El país de origen de los autores en su mayoría fue Estados Unidos (n= 6). El 60% de los registros de ensayos clínicos se encuentran reclutando, la suma total de los participantes en los registros es de 14,204 pacientes. Conclusión: La evidencia presentada en esta revisión exploratoria sugiere que las estatinas, dados sus efectos pleiotrópicos, podrían tener un beneficio en el manejo de la COVID-19. Sin embargo, no es suficiente para generar una recomendación como parte del manejo estandarizado, requiriendo conocer los resultados de los ensayos clínicos aleatorizados en marcha. 


Palabras clave


SARS-COV-2, COVID-19, estatinas, revisión sistemática.

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Referencias


Arksey H, O’Malley L: Scoping studies: Towards a Methodological Framework. Int J Soc Res Methodol 2005, 8:19-32. https://doi.org/10.1080/1364557032000119616

Barkas, F., Milionis, H., Anastasiou, G., & Liberopoulos, E. (2021). Statins and PCSK9 inhibitors: What is their role in coronavirus disease 2019?. Medical hypotheses, 146:110452. https://doi.org/10.1016/j.mehy.2020.110452

Bikdeli, B., Madhavan, M. V., Jimenez, D., Chuich, T., Dreyfus, I., Driggin, E., Nigoghossian, C., Ageno, W., Madjid, M., Guo, Y., Tang, L. V., Hu, Y., Giri, J., Cushman, M., Quéré, I., Dimakakos, E. P., Gibson, C. M., Lippi, G., Favaloro, E. J., Fareed, J., Caprini , J. A., Tafur, A. J., Burton, J. R., Francese, D. P., Wang. E. Y., Falanga. A., McLintock, C., Hunt, B., Spyropoulos, A. C., Barnes, G. D., Eikelboom, J. W., Weinberg, I., Schulman, S., Carrier. M., Piazza, G., Beckman, J. A., Steg, G., Stone, G. W., Rosenkranz, S., Goldhaber, S. Z., Parikh, S. A., Monreal, M., Krumholz, H. M., Konstantinides, S. V., Weitz, J. & Lip, G. YH. (2020). COVID-19 and Thrombotic or Thromboembolic Disease: Implications for Prevention, Antithrombotic Therapy, and Follow-Up: JACC State-of-the-Art Review. Journal of the American College of Cardiology, 75(23), 2950–2973. https://doi.org/10.1016/j.jacc.2020.04.031

Bikdelia, B., Talasazd, A. H., Rashidie, F., Sharif-Kashanif, B., Farrokhpourh, M., Bakhshandehi, H., Sezavarj, H., Dabbaghk, A., Taghi Beigmohammadil, M., Payandemehrm, P., Yadollahzadehh, M., Riahij, T., Khalilin, H., Jamalkhanio, S., Rezaeifare, P., Abedinip, A., Lookzadehp, S., Shahmirzaeim, S., Tahamtane, O., Matine, S., Amini, A., Parhizgari, S. E., Jimenezq, D., Gupta, A., Madhavan, M.V.,.. Parikh, S. A. , Monrealu, M., Hadavandi, N., Hajighasemid, A., Malekii, M., Saeed S. , Bahram Mohebbii , Gregory Piazzaa , Ajay J. Kirtanec,t , Gregory Y.H. Lipv,w, Harlan M. Krumholzb, S. Z., Goldhabera, A. & Sadeghipourz, P.(2020). Intermediate versus standard-dose prophylactic anticoagulation and statin therapy versus placebo in critically-ill patients with COVID-19: Rationale and design of the INSPIRATION/INSPIRATION-S studies. Thromb Res, 96:113. https://doi.org/10.1016/j.thromres.2020.09.027

Bonten MJM. (2015). Randomized, Embedded, Multifactorial Adaptive Platform Trial for Community- Acquired Pneumonia ClinicalTrials.gov. Disponible en: https://clinicaltrials.gov/show/NCT02735707 (Acceso marzo 2021)

Cariou, B., Goronflot, T., Rimbert, A., Boullu, S., Le May, C., Moulin, P., Pichelin, M., Potier, L., Smati, S., Sultan, A., Tramunt, B., Wargny, M., Gourdy, P., Hadjadj, S., & CORONADO investigators (2021). Routine use of statins and increased COVID-19 related mortality in inpatients with type 2 diabetes: Results from the CORONADO study. Diabetes & metabolism, 47(2):101202. https://doi.org/10.1016/j.diabet.2020.10.001

Cereto-Massagué, A., Ojeda, M. J., Valls, C., Mulero, M., Pujadas, G., & Garcia-Vallve, S. (2015). Tools for in silico target fishing. Methods (San Diego, Calif.), 71:98–103. https://doi.org/10.1016/j.ymeth.2014.09.006

Collins, R., Reith, C., Emberson, J., Armitage, J., Baigent, C., Blackwell, L., Blumenthal, R., Danesh, J., Smith, G. D., DeMets, D., Evans, S., Law, M., MacMahon, S., Martin, S., Neal, B., Poulter, N., Preiss, D., Ridker, P., Roberts, I., Rodgers, A., Danesh, J., Smith, G. D., DeMets, D., Evans, E., MacMahon, S., Neal, B., Poulter, N., Preiss, D., Ridker, P., Roberts, I.,. Sandercock. P., Schulz, K., Sever, P., Simes, J., Smeeth, L., Wald, N., Yusuf, S. & Peto, R. (2016). Interpretation of the evidence for the efficacy and safety of statin therapy. Lancet (London, England), 388(10059):2532–2561. https://doi.org/10.1016/S0140-6736(16)31357-5

Garnacho-Montero, J., Barrero-García, I., Gómez-Prieto, M. G., & Martín-Loeches, I. (2018). Severe community-acquired pneumonia: current management and future therapeutic alternatives. Expert review of anti-infective therapy, 16(9):667–677. https://doi.org/10.1080/14787210.2018.1512403

Glynn, R.J., Danielson, E., Fonseca, F.A., Genest, J., Gotto, A.M., Jr., Kastelein, J.J., Koenig, W., Libby, P., Lorenzatti, A.J., MacFadyen, J.G., Nordestgaard, B.G., Shepherd, J., Willerson, J.T. & Ridker, P.M. (2009). Un ensayo aleatorio de rosuvastatina en la prevención del tromboembolismo venoso. The New England Journal of Medicine, 360 (18): 1851–1861. https://doi.org/10.1056/NEJMoa0900241

Huang, C., Wang, Y., Li, X., Ren, L., Zhao, J., Hu, Y., Zhang, L., Fan, G., Xu, J., Gu, X., Cheng, Z., Yu, T., Xia, J., Wei, Y., Wu, W., Xie, X., Yin, W., Li, H., Liu, M., Xiao, Y., Gao, H., Guo, L., Xie, J., Wang, G., Jiang, R., Gao, Z., Jin, Q., Wang, J. & Cao, B. (2020). Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet (London, England), 395(10223), 497–506. https://doi.org/10.1016/S0140-6736(20)30183-5

Hussain, A., Bhowmik, B., & do Vale Moreira, N. C. (2020). COVID-19 and diabetes: Knowledge in progress. Diabetes research and clinical practice, 162:108142. https://doi.org/10.1016/j.diabres.2020.108142

Ilyas, R., Wallis, R., Soilleux, E. J., Townsend, P., Zehnder, D., Tan, B. K., Sim, R. B., Lehnert, H., Randeva, H. S., & Mitchell, D. A. (2011). High glucose disrupts oligosaccharide recognition function via competitive inhibition: a potential mechanism for immune dysregulation in diabetes mellitus. Immunobiology, 216(1-2):126–131. https://doi.org/10.1016/j.imbio.2010.06.002

Knapp S. (2013). Diabetes and infection: is there a link?--A mini-review. Gerontology, 59(2):99–104. https://doi.org/10.1159/000345107

Laidler, M. R., Thomas, A., Baumbach, J., Kirley, P. D., Meek, J., Aragon, D., Morin, C., Ryan, P. A., Schaffner, W., Zansky, S. M., & Chaves, S. S. (2015). Statin treatment and mortality: propensity score-matched analyses of 2007-2008 and 2009-2010 laboratory-confirmed influenza hospitalizations. Open forum infectious diseases, 2(1):ofv028. https://doi.org/10.1093/ofid/ofv028

Lee, K., Sewa, D.W. & Phua, G.C. (2020). Papel potencial de las estatinas en COVID-19. Revista internacional de enfermedades infecciosas: IJID: publicación oficial de la Sociedad Internacional de Enfermedades Infecciosas, 96: 615–617. https://doi.org/10.1016/j.ijid.2020.05.115

Lima Martínez, M. M., Contreras, M. A., Marín, W., & D'Marco, L. (2020). Statins in COVID-19: is there any foundation?. Estatinas en COVID-19: ¿existe algún fundamento?. Clinica e investigacion en arteriosclerosis : publicacion oficial de la Sociedad Espanola de Arteriosclerosis, 32(6):278–281. https://doi.org/10.1016/j.arteri.2020.06.003

Madjid, M., Safavi-Naeini, P., Solomon, S.D. & Vardeny, O. (2020). Potential Effects of Coronaviruses on the Cardiovascular System: A Review. JAMA Cardiol. 2020 Jul 1;5(7):831-840. https://doi.org/10.1001/jamacardio.2020.1286

Marić, I., Oskotsky, T., Kosti, I., Le, B., Wong, R. J., Shaw, G. M., Sirota, M., & Stevenson, D. K. (2021). Decreased Mortality Rate Among COVID-19 Patients Prescribed Statins: Data From Electronic Health Records in the US. Frontiers in medicine, 8:639804. https://doi.org/10.3389/fmed.2021.639804

Mitacchione, G., Schiavone, M., Curnis, A., Arca, M., Antinori, S., Gasperetti, A., Mascioli, G., Severino, P., Sabato, F., Caracciolo, M. M., Arabia, G., D'Erasmo, L., Viecca, M., Mancone, M., Galli, M., & Forleo, G. B. (2021). Impact of prior statin use on clinical outcomes in COVID-19 patients: data from tertiary referral hospitals during COVID-19 pandemic in Italy. Journal of clinical lipidology, 15(1): 68–78. https://doi.org/10.1016/j.jacl.2020.12.008

Nägele, M., Haubner, B., Tanner, F.C., Ruschitzka, F., Flammer, A.J. & Matthias, P,N. (2020). Endothelial dysfunction in COVID-19: Current findings and therapeutic implications. Atherosclerosis. 314:58–62. https://doi.org/10.1016/j.atherosclerosis.2020.10.014

O'Brien, K.K., Colquhoun, H., Levac, D., Baxter, L., Tricco, A.C., Straus, S., Wickerson, L., Nayar, A., Moher, D. & O'Malley, L. (2016). Avanzando en la metodología del estudio de alcance: una encuesta y consulta en línea de percepciones sobre terminología, definición y pasos metodológicos. Investigación de servicios de salud de BMC , 16 :305. https://doi.org/10.1186/s12913-016-1579-z

Onorato, D., Pucci, M., Carpene, G., Henry, B. M., Sanchis-Gomar, F., & Lippi, G. (2021). Protective Effects of Statins Administration in European and North American Patients Infected with COVID-19: A Meta-Analysis. Seminars in thrombosis and hemostasis, 47(4): 392–399. https://doi.org/10.1055/s-0040-1722307

Pal, R., Banerjee, M., Yadav, U., & Bhattacharjee, S. (2021). Statin use and clinical outcomes in patients with COVID-19: An updated systematic review and meta-analysis. Postgraduate medical journal, postgradmedj-2020-139172. Advance online publication. https://doi.org/10.1136/postgradmedj-2020-139172

Parihar, S. P., Guler, R., & Brombacher, F. (2019). Statins: a viable candidate for host-directed therapy against infectious diseases. Nature reviews. Immunology, 19(2):104–117. https://doi.org/10.1038/s41577-018-0094-3

Qin, C., Zhou, L., Hu, Z., Zhang, S., Yang, S, & Tao, Y. (2020). Dysregulation of Immune Response in Patients With Coronavirus 2019 (COVID-19) in Wuhan, China. Clin Infect Dis. 28;71(15):762-768. https://doi.org/10.1093/cid/ciaa248

Radenkovic, D., Chawla, S., Pirro, M., Sahebkar, A., & Banach, M. (2020). Cholesterol in Relation to COVID-19: Should We Care about It?. Journal of clinical medicine, 9(6): 1909. https://doi.org/10.3390/jcm9061909

Reiner, Ž., Hatamipour, M., Banach, M., Pirro, M., Al-Rasadi, K., Jamialahmadi, T., Radenkovic, D., Montecucco, F., & Sahebkar, A. (2020). Statins and the COVID-19 main protease: in silico evidence on direct interaction. Archives of medical science : AMS, 16(3): 490–496. https://doi.org/10.5114/aoms.2020.94655

Rodriguez-Nava, G., Trelles-Garcia, D. P., Yanez-Bello, M. A., Chung, C. W., Trelles-Garcia, V. P., & Friedman, H. J. (2020). Atorvastatin associated with decreased hazard for death in COVID-19 patients admitted to an ICU: A retrospective cohort study. Critical Care, 24(1). https://doi.org/10.1186/s13054-020-03154-4

Saeed, O., Castagna, F., Agalliu, I., Xue, X., Patel, S. R., Rochlani, Y., Kataria, R., Vukelic, S., Sims, D. B., Alvarez, C., Rivas-Lasarte, M., Garcia, M. J., & Jorde, U. P. (2020). Statin Use and In-Hospital Mortality in Patients With Diabetes Mellitus and COVID-19. Journal of the American Heart Association, 9(24):, e018475. https://doi.org/10.1161/JAHA.120.018475

Sultana, J., Crisafulli, S., Gabbay, F., Lynn, E., Shakir, S., & Trifirò, G. (2020). Challenges for Drug Repurposing in the COVID-19 Pandemic Era. Frontiers in pharmacology, 11: 588654. https://doi.org/10.3389/fphar.2020.588654

Tricco, A,C,, Lillie, E,, Zarin, W., O’Brien, K.K., Colquhoun, H, & Levac, D. (2018). PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Ann Intern Med. 169:467. https://doi.org/10.7326/M18-0850

Tuta-Quintero, E., Vega-Corredor, M. C., Perdomo-Rodríguez, L. S., & Pimentel, J. (2021). Colchicina, perspectivas de un viejo amigo para la reumatología en la COVID-19: una revisión exploratoria. Revista Colombiana de Reumatología, Advance online publication. https://doi.org/10.1016/j.rcreu.2021.02.002

Vuorio, A., & Kovanen, P. T. (2021). Statins as Adjuvant Therapy for COVID-19 to Calm the Stormy Immunothrombosis and Beyond. Frontiers in pharmacology, 11: 579548. https://doi.org/10.3389/fphar.2020.579548

Vuorio, A., Raal, F., Kaste, M. y Kovanen, PT (2021). Hipercolesterolemia familiar y COVID-19: un escenario de dos efectos para la disfunción endotelial susceptible de tratamiento. Aterosclerosis , 320 : 53–60. https://doi.org/10.1016/j.atherosclerosis.2021.01.021

World Health Organization. (2020). WHO Registry Network. Disponible en: https://www.who.int/ictrp/network/primary/en/ (Acceso m,arzo 2021)

Yang, W., Cao, Q., Qin, L., Wang, X., Cheng, Z., Pan, A., Dai, J., Sun, Q., Zhao, F., Qu, J., & Yan, F. (2020). Clinical characteristics and imaging manifestations of the 2019 novel coronavirus disease (COVID-19):A multi-center study in Wenzhou city, Zhejiang, China. The Journal of infection, 80(4): 388–393. https://doi.org/10.1016/j.jinf.2020.02.016

Zeiser R. (2018). Immune modulatory effects of statins. Immunology, 154(1), 69–75. https://doi.org/10.1111/imm.12902

Zhang, X. J., Qin, J. J., Cheng, X., Shen, L., Zhao, Y. C., Yuan, Y., Lei, F., Chen, M. M., Yang, H., Bai, L., Song, X., Lin, L., Xia, M., Zhou, F., Zhou, J., She, Z. G., Zhu, L., Ma, X., Xu, Q., Ye, P. & Li, H. (2020 a). In-Hospital Use of Statins Is Associated with a Reduced Risk of Mortality among Individuals with COVID-19. Cell metabolism, 32(2): 176–187.e4. https://doi.org/10.1016/j.cmet.2020.06.015

Zhang, Y., Xiao, M., Zhang, S., Xia, P., Cao, W., Jiang, W., Chen, H., Ding, X., Zhao, H., Zhang, H., Wang, C., Zhao, J., Sun, X., Tian, R., Wu, W., Wu, D., Ma, J., Chen, Y., Zhang, D., Xie, J., … Zhang, S. (2020). Coagulopathy and Antiphospholipid Antibodies in Patients with Covid-19. The New England journal of medicine, 382(17): e38. https://doi.org/10.1056/NEJMc2007575


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