The virus responsible for the current
COVID-19 pandemic is severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2): a new virus with high infectivity and moderate mortality. The major clinical manifestation of
COVID-19 is
interstitial pneumonia, which may progress to
acute respiratory distress syndrome (ARDS). However, the disease causes a potent systemic
hyperin-flammatory response, i.e., a
cytokine storm or
macrophage activation syndrome (MAS), which is associated with thrombotic complications. The complexity of the disease requires appropriate intensive treatment. One of promising treatment is
statin administration, these being
3-hydroxy-3-methylglutaryl-CoA reductase inhibitors that exert pleiotropic anti-inflammatory effects. Recent studies indicate that
statin therapy is associated with decreased mortality in
COVID-19, which may be caused by direct and indirect mechanisms. According to literature data,
statins can limit SARS-CoV-2 cell entry and replication by inhibiting the main
protease (Mpro) and
RNA-dependent RNA polymerase (RdRp). The
cytokine storm can be ameliorated by lowering serum
IL-6 levels; this can be achieved by inhibiting
Toll-like receptor 4 (TLR4) and modulating macrophage activity.
Statins can also reduce the complications of
COVID-19, such as
thrombosis and
pulmonary fibrosis, by reducing serum
PAI-1 levels, attenuating TGF-β and
VEGF in lung tissue, and improving endothelial function. Despite these benefits,
statin therapy may have side effects that should be considered, such as elevated
creatinine kinase (CK), liver
enzyme and serum
glucose levels, which are already elevated in severe
COVID-19 infection. The present study analyzes the latest findings regarding the benefits and limitations of
statin therapy in patients with
COVID-19.