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Treatment of Severe Hypertriglyceridemia With Insulin Infusions in Severe COVID-19: A Case Series

Caitlin M Thomas1, Martie Vicent1, Shawn Moore2

  • 1Department of Pharmacy, AdventHealth Orlando, FL, USA.

Journal of Pharmacy Practice
|April 22, 2021
PubMed

Insights

Continuous insulin infusion effectively lowered severe hypertriglyceridemia in critical COVID-19 patients. This method proved safe and rapid, offering a vital treatment option for patients at high risk of pancreatitis.

Area of Science:

  • Critical care medicine
  • Endocrinology
  • Infectious diseases

Background:

  • Severe hypertriglyceridemia is a critical complication in COVID-19 patients.
  • Causes include secondary hemophagocytic lymphohistiocytosis, medications, and liver failure.
  • High triglyceride levels (>1,000 mg/dL) increase pancreatitis risk.

Observation:

  • A case series of 5 mechanically ventilated COVID-19 patients with severe hypertriglyceridemia was reviewed.
  • Patients received continuous insulin infusion therapy alongside standard lipid-lowering treatments.

Findings:

  • Continuous insulin infusion rapidly and successfully reduced triglyceride levels in critically ill COVID-19 patients.
  • No patients experienced pancreatitis or hypoglycemia requiring insulin cessation.

Implications:

  • Continuous insulin infusion is a viable and safe therapeutic option for managing severe hypertriglyceridemia in critical COVID-19.
  • Further research is needed to determine optimal insulin infusion protocols, alone or combined with oral therapies.
Abstract

Keywords:
COVID-19SARS-CoVhypertriglyceridemiainsulinpropofol

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