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Coronary microcirculatory dysfunction in hypercholesterolemic patients with COVID-19: potential benefit from

Alpo Vuorio1,2, Petri T Kovanen3, Frederick J Raal4

  • 1Forensic Medicine, Mehiläinen Airport Health Centre, Vantaa, Finland.

Annals of Medicine
|April 17, 2023
PubMed

Insights

Coronary microvascular dysfunction (CMD) is common in COVID-19 patients. Effective cholesterol-lowering treatments, like statins, may improve or reverse CMD, particularly in those with hypercholesterolemia.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Pharmacology

Background:

  • Coronary microvascular dysfunction (CMD) is frequently observed in patients with hypercholesterolemia.
  • Viral infections, including SARS-CoV-2, can precipitate or exacerbate CMD.
  • Endothelial dysfunction is a primary contributor to CMD.

Purpose of the Study:

  • To explore the role of cholesterol-lowering medications in managing CMD, especially in the context of SARS-CoV-2 infection.
  • To highlight the potential benefits of statins, lipoprotein apheresis, and PCSK9 inhibitors for CMD.
  • To emphasize the significance of timely cholesterol management during and after COVID-19.

Main Methods:

  • Review of non-randomized studies on statin effects in non-infected patients with CMD.
  • Analysis of potential mechanisms of statin action in SARS-CoV-2-infected patients.
  • Consideration of other lipid-lowering therapies for CMD.

Main Results:

  • Three non-randomized studies indicate beneficial effects of statins on CMD in non-infected individuals.
  • Statins may ameliorate endothelial dysfunction, a key factor in CMD, in SARS-CoV-2 patients.
  • Lipoprotein apheresis and PCSK9 inhibitors show potential in improving or reversing CMD.

Conclusions:

  • CMD is prevalent in hospitalized SARS-CoV-2 patients.
  • Statins demonstrate positive effects on CMD, with potential benefits in COVID-19 patients.
  • Effective cholesterol management during and post-COVID-19 is crucial, especially for hypercholesterolemic individuals.

Keywords:
COVID-19Coronary microcirculatory dysfunctionPCSK9 inhibitorsendothelial dysfunctionlipid-lowering drugsstatins

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