SARS-CoV-2 infection-related deregulation of blood lipids in a patient with-/-LDLR familial homozygous hypercholesterolemia: A case report

Background: The effect of SARS-CoV-2 infection in blood lipids of homozygous familial hyperc-holesterolemia (HoFH) has not been explored.Case summary: We report a case of a 43-year-old male patient with -/-LDLR HoFH with previous history of premature coronary artery disease, coronary artery bypass graft (CABG) and surgical repair of aortic valve stenosis. He presented with an abrupt decrease of his blood lipid levels during acute infection with SARS-CoV2 and subsequently a rebound increase above pre-infection levels, refractory to treatment including LDL-apheresis, statin, ezetimibe and lomitapide up-titration to maximum tolerated doses. Markers of liver stiffness were closely monitored, increased at 9 months and decreased at 18 months after the infection. Potential interactions of hypolipidemic treatment with the viral replication process during the acute phase, as well as therapeutic dilemmas occurring in the post infection period are discussed.(c) 2023 National Lipid Association. Published by Elsevier Inc. All rights reserved.

Automated summary

This article reports a case of a HoFH patient who experienced a sudden decrease in blood lipid levels during SARS-CoV-2 infection, followed by a rebound increase refractory to treatment. Marker of liver stiffness increased at 9 months and decreased at 18 months after the infection. The potential interactions of hypolipidemic treatment with the viral replication process and the therapeutic dilemmas in the post-infection period are discussed.