Direct and Indirect Effects of SARS-CoV-2 Pandemic in Subjects with Familial Hypercholesterolemia: A Single Lipid-Center Real-World Evaluation

Abstract

We evaluated the impact of direct and indirect effects of SARS-CoV-2 infection in subjects with familial hypercholesterolemia (FH). In this observational, retrospective study, 260 FH subjects participated in a telephone survey concerning lipid profile values, lipidologist and cardiologist consultations and vascular imaging evaluation during the 12 months before and after the Italian lockdown. The direct effect was defined as SARS-CoV-2 infection; the indirect effect was defined as the difference in one of the parameters evaluated by the telephone survey before and after lockdown. Among FH subjects, the percentage of the lipid profile evaluation was lower after lockdown than before lockdown (56.5% vs. 100.0%, p < 0.01), HDL-C was significantly reduced (47.78 ± 10.12 vs. 53.2 ± 10.38 mg/dL, p < 0.05) and a significant increase in non-HDL-C was found (117.24 ± 18.83 vs. 133.09 ± 19.01 mg/dL, p < 0.05). The proportions of lipidologist and/or cardiologist consultations and/or vascular imaging were lower after lockdown than before lockdown (for lipidologist consultation 33.5% vs. 100.0%, p < 0.001; for cardiologist consultation 22.3% vs. 60.8%, p < 0.01; for vascular imaging 19.6% vs. 100.0%, p < 0.001); the main cause of missed lipid profile analysis and/or healthcare consultation was the fear of SARS-CoV-2 contagion. The percentage of FH subjects affected by SARS-CoV-2 was 7.3%. In conclusion, a lower percentage of FH subjects underwent a lipid profile analysis, lipidologist and cardiologist consultations and vascular imaging evaluation after SARS-CoV-2 Italian lockdown.

Impact of high prebiotic and probiotic dietary education in the SARS-CoV-2 era: improved cardio-metabolic profile in schizophrenia spectrum disorders

“…This situation seems to be linked to a modification of lifestyles and defined by hypercaloric dietary patterns and restrictions in physical activity (up to 60% lower) [ 10 , 12 , 32 ]. These conditions can increase body weight and worsen the glycaemic and lipid profile, even in the short term [ 12 , 23 , 34 ]. In this sense, Solé et al (2021) and Rishi et al (2020) support the need to develop new strategies for home-based care and monitoring in states of confinement, promoting appropriate lifestyles and optimal health outcomes [ 9 , 23 ].…”

Barriers and shortcomings in access to cardiovascular management and prevention for familial hypercholesterolemia during the COVID‐19 pandemic

“…The resources allotted to cardiology, after the reorganization of the healthcare system, were drastically reduced and were largely limited to managing cardiac emergencies, especially, critical cardiac presentations in patients with COVID‐19 55 . The number of lipidologist consultations were reportedly lower than before the lockdown (33.5% vs. 100.0%, p < .001), with a decline in lipid profile evaluations (56.5% vs. 100.0%, p < .01) 11 . This decline can be attributed to the widely observed pause in active screening and diagnosing of FP patients.…”

“…Moreover, 48% of patients who did visit the hospital did so after the ideal window for urgent care had passed. An untreated heart attack due to patient reluctance will further life‐threatening complications and this outweighs the mortality associated with COVID‐19 11 …”

“…This inevitably increases the need to employ continuous and long‐term pharmacological intervention, with frequent follow‐ups and screening for ASCVD risk. However, this paradigm became obsolete during the COVID‐19 pandemic due to its direct and indirect effects on FH care 10,11 . The COVID‐19 pandemic has generated significant burdens in health management worldwide, with systems struggling to meet the needs of most individuals with comorbidities 12 .…”

Impact of the COVID-19 Pandemic on Global Diseases and Human Well-Being

“…Moreover, this study evidenced that the percentage of lipids, through lipid profile evaluation, was lower after lockdown than before (56.5% vs. 100.0%, p < 0.01), with a reduction in HDL-C (47.78 ± 10.12 vs. 53.2 ± 10.38 mg/dL, p < 0.05), and a relevant increase in non-HDL-C (117.24 ± 18.83 vs. 133.09 ± 19.01 mg/dL, p < 0.05). This finding may be explained by the unregulated and sedentary lifestyle that characterized the pandemic period [ 7 ]. Moreover, in the pandemic scenario, there has been great interest in the association between SARS-CoV-2 and kidney function; in fact, since the very beginning of the pandemic, several studies analyzed the impact of COVID-19 from different points of view.…”