COVID-19 AND CARDIOVASCULAR DISEASES: EFFECT OF STATINS AND METFORMIN (review of literature and own data)

Authors

  • Sokolova A. M. SI “V.P. Komisarenko Institute of Endocrinology and Metabolism of the National Academy of Medical Sciences of Ukraine”, Kyiv, Ukraine, Bogomolets National Medical University, Kyiv, Ukraine https://orcid.org/0009-0006-5334-7333
  • Pushkarev V. V. SI “V.P. Komisarenko Institute of Endocrinology and Metabolism of the National Academy of Medical Sciences of Ukraine”, Kyiv, Ukraine https://orcid.org/0000-0001-5940-5510
  • Sokolova L. K. SI “V.P. Komisarenko Institute of Endocrinology and Metabolism of the National Academy of Medical Sciences of Ukraine”, Kyiv, Ukraine https://orcid.org/0000-0003-0011-0106
  • Pushkarev V. M. SI “V.P. Komisarenko Institute of Endocrinology and Metabolism of the National Academy of Medical Sciences of Ukraine”, Kyiv, Ukraine https://orcid.org/0000-0003-0347-7771
  • Kobrynska N. Ya. SI “V.P. Komisarenko Institute of Endocrinology and Metabolism of the National Academy of Medical Sciences of Ukraine”, Kyiv, Ukraine https://orcid.org/0000-0001-8698-9793
  • Tronko M. D. SI “V.P. Komisarenko Institute of Endocrinology and Metabolism of the National Academy of Medical Sciences of Ukraine”, Kyiv, Ukraine https://orcid.org/0000-0001-7421-0981

DOI:

https://doi.org/10.21856/j-PEP.2024.3.10

Keywords:

COVID-19, cardiovascular system, diabetes, obesity, statins, metformin, review

Abstract

With COVID-19 (corona virus disease 2019), there is an excessive activation of inflammatory processes, which involve: endoplasmic reticulum stress, nuclear factor-κB signaling pathway, inflammasomes, interleukin-6 (IL-6), signal transducer and activator of transcription 3 (STAT-3), T-helper-17 and other pro-inflammatory factors. The consequence of COVID-19 is a violation of the functioning of the cardiovascular system - heart damage, endothelial dysfunction, hyper coagulation. Diabetes, insulin resistance, and obesity are major risk factors for cardiovascular complications in COVID-19.

Statins, as the most common lipid-regulating drugs, have shown beneficial effects in various pathophysiological conditions. Accumulated research findings suggest that statin use is associated with a reduced risk of disease progression and death in patients with COVID-19. Statins can limit the penetration and replication of SARS-CoV-2 (Severe acute respiratory syndrome coronavirus 2) in cells. They lower the cytokine storm by reducing the level of IL-6 in blood serum and modulating the activity of macrophages. Statins may also affect complications of COVID-19, such as thrombosis and pulmonary fibrosis, and improve endothelial function.

Outpatient use of metformin was associated with lower mortality and a trend toward fewer hospitalizations for COVID-19. The fact that such similar results were obtained in different populations from different countries suggests that the observed reduction in mortality risk associated with metformin use in patients with T2DM and COVID-19 may be generalizable. Metformin inhibits the entry of SARS-CoV-2 into cells through the activation of AMP-activated kinase.

Given metformin's low cost, well-established safety profile, wide availability, and existing evidence for reduction in severity of COVID-19 disease, metformin should be tested for outpatient treatment of COVID-19.

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Published

2024-09-15

How to Cite

Sokolova, A., Pushkarev, V., Sokolova, L., Pushkarev, V., Kobrynska, N., & Tronko, M. (2024). COVID-19 AND CARDIOVASCULAR DISEASES: EFFECT OF STATINS AND METFORMIN (review of literature and own data). Problems of Endocrine Pathology, 81(3), 76–91. https://doi.org/10.21856/j-PEP.2024.3.10

Issue

Vol. 81 No. 3 (2024): Problems of Endocrine Pathology

Section

REVIEWS