Familial hypercholesterolemia and statins in the COVID-19 era: Mitigating the risk of ischemic stroke

• Main Authors: Alpo Vuorio, Markku Kaste, Petri T. Kovanen
• Format: Article
• Language: English
• Published: Elsevier 2021-06-01
• Series: eNeurologicalSci
• Subjects: COVID-19; endothelial dysfunction; familial hypercholesterolemia; LDL cholesterol; stroke; statins
• Online Access: http://www.sciencedirect.com/science/article/pii/S2405650221000368

There is a continuing need for research about the underlying mechanisms behind ischemic strokes in COVID-19 patients. Pre-existing endothelial dysfunction, especially if it is accompanied by a viral infection of the endothelial cells may present an important mechanism behind the immunothrombotic/thromboembolic complications of the COVID-19 illness. Here we emphasize that pharmacotherapy with statins could partly counteract such pathophysiological scenarios. Accordingly, using familial hypercholesterolemia (FH) as a pertinent example of a lifelong endothelial dysfunction, we aim to make the clinicians and consulting neurologists aware of statins as a possible adjuvant therapy in the context of an increased risk of ischemic stroke in patients with COVID-19. Based on recent clinical evidence, there is a need to encourage clinicians and consulting neurologists to continue or initiate effective statin treatment to prevent an ischemic stroke, particularly when they encounter a hypercholesterolemic COVID-19 patient with FH.