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

Iqbal, Zohaib; Ho, Jan Hoong; Adam, Safwaan; France, Michael; Syed, Akheel; Neely, Dermot; Rees, Alan; Khatib, Rani; Cegla, Jaimini; Byrne, Christopher; Qureshi, Nadeem; Capps, Nigel; Ferns, Gordon; Payne, Jules; Schofield, Jonathan; Nicholson, Kirsty; Datta, Dev; Pottle, Alison; Halcox, Julian; Krentz, Andrew; Durrington, Paul; Soran, Handrean

Abstract

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 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. 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 sequestrants, nutraceuticals, red yeast rice, Omega-3-Fatty acids, Lomitapide, hypercholesterolaemia, dyslipidaemia and Volanesorsen. 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.

• Journal Article Type: Article
• Acceptance Date: Sep 8, 2020
• Online Publication Date: Sep 14, 2020
• Publication Date: 2020-11
• Deposit Date: Dec 4, 2020
• Publicly Available Date: Sep 15, 2021
• Journal: Atherosclerosis
• Print ISSN: 0021-9150
• Electronic ISSN: 1879-1484
• Peer Reviewed: Peer Reviewed
• Volume: 313
• Pages: 126-136
• DOI: https://doi.org/10.1016/j.atherosclerosis.2020.09.008
• Keywords: Covid-19; Hyperlipideamia; Statins; Fibrates; Lipid lowering therapy; PCSK9 monoclonal antibodies; Ezetimibe; Bile acid sequestrants; Omega-3-fatty acids; Volanesorsen; Lomitapide
• Public URL: https://nottingham-repository.worktribe.com/output/5100643
• Publisher URL: https://www.atherosclerosis-journal.com/article/S0021-9150(20)30504-9/fulltext
• Related Public URLs: https://www.sciencedirect.com/science/article/pii/S0021915020305049
• Additional Information: This article is maintained by: Elsevier; Article Title: Managing hyperlipidaemia in patients with COVID-19 and during its pandemic: An expert panel position statement from HEART UK; Journal Title: Atherosclerosis; CrossRef DOI link to publisher maintained version: https://doi.org/10.1016/j.atherosclerosis.2020.09.008; Content Type: article; Copyright: © 2020 Published by Elsevier B.V.