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Review
. 2020 Nov:313:126-136.
doi: 10.1016/j.atherosclerosis.2020.09.008. Epub 2020 Sep 15.

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

Zohaib Iqbal  1 , Jan Hoong Ho  1 , Safwaan Adam  2 , Michael France  3 , Akheel Syed  4 , Dermot Neely  5 , Alan Rees  6 , Rani Khatib  7 , Jaimini Cegla  8 , Christopher Byrne  9 , Nadeem Qureshi  10 , Nigel Capps  11 , Gordon Ferns  12 , Jules Payne  6 , Jonathan Schofield  1 , Kirsty Nicholson  3 , Dev Datta  13 , Alison Pottle  14 , Julian Halcox  15 , Andrew Krentz  16 , Paul Durrington  17 , Handrean Soran  18 ; Heart UK's Medical Scientific and Research Committee
Affiliations
Review

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

Zohaib Iqbal et al. Atherosclerosis. 2020 Nov.

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.

Keywords: Bile acid sequestrants; Covid-19; Ezetimibe; Fibrates; Hyperlipidaemia; Lipid lowering therapy; Lomitapide; Omega-3-fatty acids; PCSK9 monoclonal antibodies; Statins; Volanesorsen.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. HS received research and education grants from AMGEN, AKCEA, AMRYT and SANOFI. There are no other conflicts of interest related to this article to declare.

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