期刊
CURRENT OPINION IN LIPIDOLOGY
卷 34, 期 3, 页码 119-125出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MOL.0000000000000876
关键词
COVID-19; endothelial dysfunction; heterozygous familial hypercholesterolemia; LDL-cholesterol; lipid metabolism; lipid-lowering therapy
Patients with heterozygous familial hypercholesterolemia (HeFH) are at increased risk for COVID-19 cardiovascular complications due to elevated levels of LDL-C and lipoprotein(a), which lead to endothelial dysfunction and are aggravated by viral attack and exposure to proinflammatory and prothrombotic mediators during the hyperinflammatory reaction of COVID-19.
Purpose of reviewPatients with heterozygous familial hypercholesterolemia (HeFH) are at increased risk for COVID-19 cardiovascular complications in the acute phase of the infection. Elevated levels of LDL-C and often lipoprotein(a) are present from birth and lead to endothelial dysfunction, which is aggravated by a direct viral attack of the endothelial cells and their exposure to the toxic levels of circulating proinflammatory and prothrombotic mediators during the hyperinflammatory reaction typical of COVID-19.Recent findingsEvidence to date shows the benefit of lipid-lowering therapy in patients with COVID-19. In HeFH patients who are at much higher cardiovascular risk, the focus should, therefore, be on the effective lowering of LDL-C levels, the root cause of the greater cardiovascular vulnerability to COVID-19 infection in these patients. The ongoing use of statins and other lipid-lowering therapies should be encouraged during the ongoing COVID pandemic to mitigate the risk of cardiovascular complications from COVID-19, particularly in HeFH patients.Epidemiologic registry data show that the incidence of myocardial infarction is increased in SARS-CoV-2-infected HeFH patients. There is a need to study whether the risk for acute cardiovascular events is increased in the long-term and if there are changes in lipid metabolism after SARS-CoV infection(s) in patients with HeFH.
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