Abstract
Patients with familial hypercholesterolemia (FH) are likely at increased risk for COVID-19 complications in the acute phase of the infection, and for a long time thereafter. Because in FH patients the level of low density lipoprotein cholesterol (LDL-C) is elevated from birth and it correlates with the degree of systemic endothelial dysfunction, both heterozygous FH (HeFH) patients and, in particular, homozygous FH (HoFH) patients have a dysfunctional endothelium prone to further damage by the direct viral attack and the hyper-inflammatory reaction typical of severe COVID-19. Evidence to date shows the benefit of statin use in patients with COVID-19. In FH patients, the focus should therefore be on the effective lowering of LDL-C levels, the root cause of the expected excess vulnerability to COVID-19 infection in these patients. Moreover, the ongoing use of statins and other lipid-lowering therapies should be encouraged during the COVID pandemic to mitigate the risk of cardiovascular complications from COVID-19. For the reduction of the excess risk in FH patients with COVID-19, we advocate stringent adherence to the guideline determined LDL-C levels for FH patients, or maybe even to lower levels. Unfortunately, epidemiologic data are lacking on the severity of COVID-19 infections, as well as the number of acute cardiac events that have occurred in FH subjects during the COVID-19 pandemic. Such data need to be urgently gathered to learn how much the risk for, and the severity of COVID-19 in FH are increased.
【저자키워드】 COVID-19, Endothelial dysfunction, statins, Familial hypercholesterolemia, PCSK9 inhibitors, 【초록키워드】 pandemic, therapy, severe COVID-19, COVID-19 pandemic, Infection, risk, Endothelium, COVID, infections, COVID-19 infection, severity of COVID-19, Patient, LDL-C, patients, cardiac event, reduction, cardiovascular complication, increased risk, subject, acute phase, lipoprotein cholesterol, homozygous, heterozygous, mitigate, effective, benefit, occurred, elevated, expected, COVID-19 complication, patients with COVID-19, 【제목키워드】 Treatment, Familial hypercholesterolaemia,