Brief recommendations on the management of adult patients with familial hypercholesterolemia during the COVID-19 pandemic

Banach, Maciej; Penson, Peter E.; Fras, Zlatko; Vráblík, Michal; Pella, Daniel; Reiner, Željko; Nabavi, Seyed Mohammad; Sahebkar, Amirhossein; Kayıkçıoğlu, Meral; Daccord, Magdalena; Europe, FH

doi:10.1016/j.phrs.2020.104891

Cited by 64 publications

(84 citation statements)

References 20 publications

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“…Also, treatment of pediatric patients with HoFH and an adult with hyperLp(a) with advanced cardiovascular disease continued as scheduled, while frequency of treatment in 2 adult patient affected by HeFH and one adult patients with hyperLp(a) was reduced from biweekly to monthly. Our decisions agree with later issued recommendations for FH patients, stating that patients in regular LA treatment, including very high-risk HoFH patients, should be enabled to access this procedure and, where this is not possible, treatment might be postponed safely by as much as 2 months, maintaining maximal lipid lowering therapy and strict monitoring of symptoms [7]. Treatment was also guaranteed in 2 cases of NMOSD not responding to high-dose steroids, in accordance with a recent consensus paper [8], and in a pediatric patient affected by FSGS recurrent after kidney transplant.…”

Section: Discussionsupporting

confidence: 76%

Impact of COVID-19 pandemic in the activity of a Therapeutic Apheresis unit in Italy

Colpo

Astolfi²,

Tison

et al. 2020

Transfusion and Apheresis Science

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The recent Coronavirus Disease 2019 (COVID-19) outbreak has led to profound and rapid changes in the Italian and Veneto Region Healthcare System. This context also includes the quick reorganization which the Apheresis Unit (AU) of the Padova University Hospital, i.e. the Regional Reference Center for Therapeutic Apheresis (TA), had to face. Material and Methods: The study retrospectively evaluated the TA activity (procedures performed, patients treated and consultations) during the COVID-19 pandemic, from March to April 2020, comparing the activity in the same time period in 2018 and 2019. Results: In the period analyzed, a significant reduction in both the total number of procedures performed and of patients treated, respectively by 17 % and 16 % for the procedures and by 19 % and 20 % for patients treated compared to the same period of 2018 and 2019, respectively, was observed. A concomitant reduction in requests for TA consultation for new patients (both outpatients and inpatients) was observed, equal to 32 % and 21 % compared to 2018 and 2019, respectively. Conclusion: Many reasons determined the observed reduction in the TA activity during the recent COVID-19 outbreak. The AU itself was quickly reorganized in terms of location and supplies to allow for the appropriate COVID-19 patients care. Many non urgent cases, after multidisciplinary discussion between Clinicians and Apheresis Specialists, were deferred, maintaining close phone and e-mail contact with patients.

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Section: Discussionsupporting

confidence: 76%

Impact of COVID-19 pandemic in the activity of a Therapeutic Apheresis unit in Italy

Colpo

Astolfi²,

Tison

et al. 2020

Transfusion and Apheresis Science

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show abstract

“…Another issue is represented by the risk of statin-related myotoxicity and hepatotoxity, which may be increased by drug-to-drug interactions between statins and antiviral, antiretroviral, antiparasitic, and antirheumatic drugs as well as antibiotics (mainly macrolides) that may be concomitantly administered to COVID-19 patients [ 49 ]. In some cases, either discontinuation of statin therapy or continuation with caution and at lower doses is possible options [ 49 ]. Nonetheless, when statin discontinuation is required, other lipid-lowering therapies could be considered, especially in patients at high CVD risk, which are more prone to undergo COVID-19 complications [ 49 , 50 ].…”

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confidence: 99%

“…In some cases, either discontinuation of statin therapy or continuation with caution and at lower doses is possible options [ 49 ]. Nonetheless, when statin discontinuation is required, other lipid-lowering therapies could be considered, especially in patients at high CVD risk, which are more prone to undergo COVID-19 complications [ 49 , 50 ].…”

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confidence: 99%

“…To this regard, although no clinical studies are currently available clearly showing that statins can reduce the incidence of cardiovascular events in COVID-19 patients, evidence is emerging showing a possible benefit from statin therapy in reduction of COVID-19 severity and mortality. Therefore, the continuation of statin therapy in COVID-19 patients should be considered [ 49 , 57 ]. Further, despite a current lack of direct information in COVID-19 subjects, observational and interventional studies appear warranted to establish both the efficacy and safety of de novo initiation of statin therapy as add-on treatment for the management of COVID-19.…”

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confidence: 99%

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Commentary: Statins, COVID-19, and coronary artery disease: killing two birds with one stone

et al. 2020

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“…In patients with CVD their usage should not be discontinued. However, it remains unclear whether starting these medications prophylactically or during COVID-19 has any clinical benefit ( Banach et al, 2020 ; Katsiki et al, 2020 ; Reiner et al, 2020 ).…”

Section: Perspective and Future Directionsmentioning

confidence: 99%

Pathophysiology of Cardiovascular Complications in COVID-19

Petrović

Radenković

et al. 2020

Front. Physiol.

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Numerous recent studies have shown that patients with underlying cardiovascular disease (CVD) are at increased risk of more severe clinical course as well as mortality of COVID-19. Also, the available data suggests that COVID-19 is related to numerous de novo cardiovascular complications especially in the older population and those with pre-existing chronic cardiometabolic conditions. SARS-CoV-2 virus can cause acute cardiovascular injury, as well as increase the risk of chronic cardiovascular damage. As CVD seem to be the major comorbidity in critically unwell patients with COVID-19 and patients often die of cardiovascular complications, we review the literature and discuss the possible pathophysiology and molecular pathways driving these disease processes: cytokine release syndrome, RAAS system dysregulation, plaque destabilization and coagulation disorders with the aim to identify novel treatment targets. In addition, we review the pediatric population, the major cause of the cardiovascular complications is pediatric inflammatory multisystem syndrome that is believed to be associated with COVID-19 infection. Due to the increasingly recognized CVD damage in COVID-19, there is a need to establish clear clinical and follow-up protocols and to identify and treat possible comorbidities that may be risk factors for the development of cardiovascular complications.

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Brief recommendations on the management of adult patients with familial hypercholesterolemia during the COVID-19 pandemic

Cited by 64 publications

References 20 publications

Impact of COVID-19 pandemic in the activity of a Therapeutic Apheresis unit in Italy

Impact of COVID-19 pandemic in the activity of a Therapeutic Apheresis unit in Italy

Commentary: Statins, COVID-19, and coronary artery disease: killing two birds with one stone

Pathophysiology of Cardiovascular Complications in COVID-19

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