Long-Term Cardiovascular and Cerebrovascular Challenges Posed by COVID-19 in Patients With Familial Hypercholesterolemia

TLDR: Concerns related to the long-term effects of SARS-CoV-2 infections and the increases in the risk for complications and potentially a poor outcome in this group of patients are highlighted.

Abstract: Follow-up studies have revealed that during the severe acute respiratory syndrome (SARS) caused by coronavirus SARS-CoV epidemic between 2002 and 2003, a significant proportion of those infected had a deterioration in the general health and exercise capacity, especially during the 24 months postinfection (Ngai et al., 2010; Zhang et al., 2020a). Although the emphasis of the follow-up by Ngai and coworkers (2010) was on monitoring alterations in the lung function, a significant impairment in quality of life, as assessed by the SF-36 quality-of-life measures, was reported (Ngai et al., 2010). The long-term effects of SARS-CoV infection have been found to also affect lipid and glucose metabolism in recovered SARS patients (Wu et al., 2017). Thus, the impaired metabolic pathologies were observed 12 years after the infection, and they were considered to be long-term effects of the initial lung damages, and to be potentially also related to the one-month-long high-dose prednisolone treatment given during the acute phase of the disease. Long-term symptoms, usually lasting for about 24 months, have also been reported in survivors of the epidemic influenza A (H7N9) (Chen et al., 2017) and Dengue (Garcia et al., 2011). As could have been envisaged, numerous COVID-19 patients also suffer from long-term impairment of health after an acute SARS-CoV-2 infection, particularly if the symptoms of the disease have been severe and the patients had to be hospitalized (Nalbandian et al., 2021). In an earlier commentary, we have discussed the acute phase of COVID-19 in patients with familial hypercholesterolemia (FH) (Vuorio et al., 2021a). We now wish to highlight concerns related to the long-term effects of SARS-CoV-2 infections and the increases in the risk for complications and potentially a poor outcome in this group of patients.