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

Managing hyperlipidaemia in patients with COVID-19 and during its pandemic: an expert panel position statement from HEART UK
Managing hyperlipidaemia in patients with COVID-19 and during its pandemic: an expert panel position statement from HEART UK
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.
Bile acid sequestrants, Covid-19, Ezetimibe, Fibrates, Hyperlipidaemia, Lipid lowering therapy, Lomitapide, Omega-3-fatty acids, PCSK9 monoclonal antibodies, Statins, Volanesorsen
0021-9150
126-136
Iqbal, Zohaib
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Ho, Jan Hoong
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Adam, Safwaan
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France, Michael
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Syed, Akheel
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Neely, Dermot
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Rees, Alan
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Khatib, Rani
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Cegla, Jaimini
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Byrne, Christopher
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Qureshi, Nadeem
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Capps, Nigel
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Ferns, Gordon
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Payne, Jules
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Schofield, Jonathan
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Nicholson, Kirsty
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Datta, Dev
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Pottle, Alison
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Halcox, Julian
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Krentz, Andrew
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Durrington, Paul
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Soran, Handrean
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on behalf of Heart UK’s Medical Scientific and Research Committee
Iqbal, Zohaib
375696d7-57c2-4684-b224-b2d5c50129af
Ho, Jan Hoong
83b34169-5267-4a96-a1cf-4cc17381911e
Adam, Safwaan
159a3f13-36f6-4b7c-979b-b8b4684d96a2
France, Michael
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Syed, Akheel
df1c6c4f-9cde-4fbc-babb-2cec381707e9
Neely, Dermot
96b0077f-3c7e-4f02-95e0-040489d5ab85
Rees, Alan
265903fa-1c44-4e26-9574-6b67dddec527
Khatib, Rani
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Cegla, Jaimini
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Byrne, Christopher
1370b997-cead-4229-83a7-53301ed2a43c
Qureshi, Nadeem
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Capps, Nigel
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Ferns, Gordon
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Payne, Jules
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Schofield, Jonathan
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Nicholson, Kirsty
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Datta, Dev
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Pottle, Alison
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Halcox, Julian
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Krentz, Andrew
bbbb016f-e038-4e7a-99cf-2a17a3f83b78
Durrington, Paul
3baebc78-55ab-4dd3-8f73-8e024bd89812
Soran, Handrean
a5807c6a-ac90-4fda-bcaf-881637b54255

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 and Soran, Handrean , on behalf of Heart UK’s Medical Scientific and Research Committee (2020) Managing hyperlipidaemia in patients with COVID-19 and during its pandemic: an expert panel position statement from HEART UK. Atherosclerosis, 313, 126-136. (doi:10.1016/j.atherosclerosis.2020.09.008).

Record type: Review

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.

Text
Managing hyperlipidaemia in patients with COVID-19_Atherosclerosis 2020 - Version of Record
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More information

Accepted/In Press date: 8 September 2020
e-pub ahead of print date: 15 September 2020
Published date: November 2020
Additional Information: open access paper
Keywords: Bile acid sequestrants, Covid-19, Ezetimibe, Fibrates, Hyperlipidaemia, Lipid lowering therapy, Lomitapide, Omega-3-fatty acids, PCSK9 monoclonal antibodies, Statins, Volanesorsen

Identifiers

Local EPrints ID: 445242
URI: http://eprints.soton.ac.uk/id/eprint/445242
ISSN: 0021-9150
PURE UUID: bf4155e8-12ec-4f05-b7ee-72fe71c87134
ORCID for Christopher Byrne: ORCID iD orcid.org/0000-0001-6322-7753

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Date deposited: 26 Nov 2020 17:30
Last modified: 28 Apr 2022 01:45

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Contributors

Author: Zohaib Iqbal
Author: Jan Hoong Ho
Author: Safwaan Adam
Author: Michael France
Author: Akheel Syed
Author: Dermot Neely
Author: Alan Rees
Author: Rani Khatib
Author: Jaimini Cegla
Author: Nadeem Qureshi
Author: Nigel Capps
Author: Gordon Ferns
Author: Jules Payne
Author: Jonathan Schofield
Author: Kirsty Nicholson
Author: Dev Datta
Author: Alison Pottle
Author: Julian Halcox
Author: Andrew Krentz
Author: Paul Durrington
Author: Handrean Soran
Corporate Author: on behalf of Heart UK’s Medical Scientific and Research Committee

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