Use of Statins in COVID-19 Treatment: Multiple Pathways but Minimal Evidence

Coronavirus disease-2019(COVID-19) is an emerging viral infection of public importance and it is caused by a beta coronavirus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). So far, it has affected about 15 million individuals and over 600 000 patients have died from it. The virus is novel and there is no approved specific therapy for the infection. This has led to the trial of different drugs to reduce the morbidity and mortality of the infection. Statins are primarily used to lower cholesterol. They also have other pleiotropic effects such as anti-inflammatory, anti-thrombotic, immunomodulatory and antiviral effects. Coincidentally, the processes that statins antagonize are the mechanisms underlying the pathogenesis of COVID-19. Therefore, it has been suggested that statins should be considered as an adjunct in the treatment of COVID-19. In the new era of evidence-based medicine, there is a need to examine the level of evidence available to support the clinically beneficial effect of statins in COVID-19 treatment. This literature review explores the strength and volume of evidence for the usage of statins in COVID-19. However, as at the time of writing this review, the evidence base is very scanty. The most quoted evidence available is a retrospective study which is a low level of evidence. Therefore, it can be concluded that there are various mechanisms identified by which statins could be useful in the treatment of COVID-19. However, the evidence for their recommendation as adjuncts for COVID-19 treatment is very weak.