Managing hyperlipidaemia in patients with COVID-19 and during its pandemic: An expert panel position statement from HEART UK

Autor: Zohaib Iqbal, Jan Hoong Ho, Safwaan Adam, Michael France, Akheel Syed, Dermot Neely, Alan Rees, Rani Khatib, Jaimini Cegla, Christopher Byrne, Nadeem Qureshi, Nigel Capps, Gordon Ferns, Jules Payne, Jonathan Schofield, Kirsty Nicholson, Dev Datta, Alison Pottle, Julian Halcox, Andrew Krentz, Paul Durrington, Handrean Soran
Rok vydání: 2020
Předmět:
0301 basic medicine
medicine.medical_specialty
Statin
medicine.drug_class
Pneumonia
Viral
Hyperlipidemias
Review Article
030204 cardiovascular system & hematology
medicine.disease_cause
Bile Acid sequestrants
03 medical and health sciences
chemistry.chemical_compound
Betacoronavirus
0302 clinical medicine
Ezetimibe
Diabetes mellitus
Case fatality rate
Medicine
Humans
Intensive care medicine
Pandemics
Coronavirus
Hypolipidemic Agents
medicine.diagnostic_test
business.industry
SARS-CoV-2
Statins
COVID-19
Evidence-based medicine
medicine.disease
Volanesorsen
Lomitapide
United Kingdom
Omega-3-fatty acids
030104 developmental biology
chemistry
Hyperlipidaemia
PCSK9 monoclonal antibodies
business
Liver function tests
Cardiology and Cardiovascular Medicine
Coronavirus Infections
Fibrates
medicine.drug
Lipid lowering therapy
Zdroj: Atherosclerosis
Iqbal, Z, Ho, J H, Adam, S, France, M, Syed, A, Neely, D, Rees, A, Khatib, R, Cegla, J, Byrne, C, Qureshi, N, Capps, N, Ferns, G, Payne, J, Schofield, J, Nicholson, K, Datta, D, Pottle, A, Halcox, J, Krentz, A, Durrington, P & Soran, H 2020, ' Managing hyperlipidaemia in patients with COVID-19 and during its pandemic: An expert panel position statement from HEART UK ', Atherosclerosis, vol. 313, pp. 126 . https://doi.org/10.1016/j.atherosclerosis.2020.09.008
ISSN: 1879-1484
0021-9150
DOI: 10.1016/j.atherosclerosis.2020.09.008
Popis: Background & aims The emergence of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) which causes Coronavirus Disease 2019 (COVID-19) has resulted in a worldwide pandemic. SARS-CoV-2 is highly contagious and its severity highly variable. The fatality rate is unpredictable but is amplified by several factors including advancing age, atherosclerotic cardiovascular disease, diabetes mellitus, hypertension and obesity. A large proportion of patients with these conditions are treated with lipid lowering medication and questions regarding the safety of continuing lipid-lowering medication in patients infected with COVID-19 have arisen. Some have suggested they may exacerbate their condition. It is important to consider known interactions with lipid-lowering agents and with specific therapies for COVID-19. This statement aims to collate current evidence surrounding the safety of lipid-lowering medications in patients, who have COVID-19. We offer a consensus view based on current knowledge and we rated the strength and level of evidence for these recommendations. Methods Pubmed, Google scholar and Web of Science were searched extensively for articles using search terms: SARS-CoV-2, COVID-19, coronavirus, Lipids, Statin, Fibrates, Ezetimibe, PCSK9 monoclonal antibodies, nicotinic acid, bile acid sequestrate, nutraceuticals, red yeast rice, Omega-3-Fatty acids, Lomitapide, hypercholesterolaemia, dyslipidaemia and Volanesorsen. Results & Conclusions: There is no evidence currently that lipid lowering therapy is unsafe in patients with COVID-19 infection. Lipid-lowering therapy should not be interrupted because of the pandemic or in patients at increased risk of COVID-19 infection. In patients with confirmed COVID-19, care should be taken to avoid drug interactions, between lipid-lowering medications and drugs that may be used to treat COVID-19, especially in patients with abnormalities in liver function tests.
Graphical abstract Image 1
Highlights • Patients with known atherosclerotic cardiovascular disease and related comorbidities are at increased risk of severe illness and mortality if infected with COVID-19. • There is no convincing evidence to suggest harm from lipid lowering therapy or on-treatment low LDL cholesterol if patients develop acute illnesses or SARS-CoV-2. In fact, available evidence suggests that statin therapy is associated with benefits. • Patients treated for hyperlipidaemia should not interrupt their treatment because of COVID-19 pandemic. • Continue lipid lowering therapy in patients with confirmed diagnosis of COVID-19 unless possible risks outweigh benefits. • In patient treated for COVID-19 with pharmacologic agents, drug interactions with lipid lowering therapies should be investigated and assessed.
Databáze: OpenAIRE
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