biostudies-literatureUnknownChirinos JNCATS NIH HHSBackground Abnormal cellular lipid metabolism appears to underlie SARS-CoV-2 cytotoxicity and may involve inhibition of peroxisome proliferator activated receptor alpha (PPARα). Fenofibrate, a PPAR-α activator, modulates cellular lipid metabolism. Fenofibric acid has also been shown to affect the dimerization of angiotensin-converting enzyme 2, the cellular receptor for SARS-CoV-2. Fenofibrate and fenofibric acid have been shown to inhibit SARS-CoV-2 replication in cell culture systems <i>in vitro</i> . Methods We randomly assigned 701 participants with COVID-19 within 14 days of symptom onset to 145 mg of fenofibrate (nanocrystal formulation with dose adjustment for renal function or dose-equivalent preparations of micronized fenofibrate or fenofibric acid) vs. placebo for 10 days, in a dResearch squarers.3.rs-1933913https://www.ebi.ac.uk/biostudies/studies/S-EPMC9387540biostudies-literatureA Randomized Trial of Lipid Metabolism Modulation with Fenofibrate for Acute Coronavirus Disease 2019.PMC9387540U01 TR003734Giamarellos-Bourboulis EGomez-Laiton ESanchez GGreczylo CHernandez JRVillavicencio-Carranza MDanos WLPerez-Mayorga MMilionis HKatsaounou PCastro-Callirgos CGreene KSaldarriaga MCChittams JCure-Cure CSharkoski TGiraldo MCRosado-Santander NMoghnieh RPereyra RPoulakou GAyala-Garcia RArbanil HRodriguez-Mori JDimitroulis IGutierrez CPourmussa BAccini-Mendoza JValdivia-Vega RSympardi SPariona MVlachopoulos CSweitzer NGonzalez-Hernandez LChirinos JPutt MLopez-Jaramillo PAngeliki RDavila-Del-Carpio GCohen JSalman OMedina CCarrasco RAAlexiou ZBizri AAndrade-Villanueva JfalseA Randomized Trial of Lipid Metabolism Modulation with Fenofibrate for Acute Coronavirus Disease 2019.Background Abnormal cellular lipid metabolism appears to underlie SARS-CoV-2 cytotoxicity and may involve inhibition of peroxisome proliferator activated receptor alpha (PPARα). Fenofibrate, a PPAR-α activator, modulates cellular lipid metabolism. Fenofibric acid has also been shown to affect the dimerization of angiotensin-converting enzyme 2, the cellular receptor for SARS-CoV-2. Fenofibrate and fenofibric acid have been shown to inhibit SARS-CoV-2 replication in cell culture systems <i>in vitro</i> . Methods We randomly assigned 701 participants with COVID-19 within 14 days of symptom onset to 145 mg of fenofibrate (nanocrystal formulation with dose adjustment for renal function or dose-equivalent preparations of micronized fenofibrate or fenofibric acid) vs. placebo for 10 days, in a d2022-01-01T00:00:00Z2022 Aug2026-04-08T11:10:47.407Z2025-04-19T22:46:06.349ZS-EPMC93875403598267510.21203/rs.3.rs-1933913/v1