COVID-19, dislipidemia e hipercolesterolemia familiar: uma atualização
DOI:
https://doi.org/10.33448/rsd-v11i9.31975Palavras-chave:
Dislipidemia; Hipercolesterolemia Familiar; COVID-19; SARS-CoV-2; Hipolipemiante.Resumo
A COVID-19 (doença do coronavírus 2019) é uma infecção causada pelo coronavírus SARS-CoV-2, que pode evoluir para um quadro respiratório grave, afetando a população mundial de forma pandêmica. Neste estudo, objetivamos atualizar os achados dos mecanismos que associam a dislipidemia à infecção por COVID-19, a evolução da forma grave e a influência do tratamento hipolipemiante nos desfechos. A busca foi realizada nas bases PubMed e Embase, e a seleção foi baseada em estudos de dislipidemia e COVID-19, que resultaram em 31 artigos. Os resultados evidenciaram que alterações no metabolismo do colesterol foram encontradas na infecção pelo vírus SARS-CoV-2 com variações nos níveis de lipoproteína de alta densidade (HDL). Além disso, a infecção proporcionou aumento de triglicerídeos (TG) e colesterol da lipoproteína de muito baixa densidade (VLDLc). Pacientes com hipercolesterolemia familiar (HF) com COVID-19 representam um grupo de indivíduos que desenvolvem doença aterosclerótica precoce com maior risco de evento cardiovascular, o que deve intensificar o tratamento hipolipemiante devido ao risco potencial de disfunção endotelial coronariana causada por infecção viral. Os medicamentos modificadores do colesterol têm potencial para alterar o ciclo do vírus, resultando em uma série de efeitos pleiotrópicos na infectividade, imunidade e inflamação, como estatinas, fibratos, ezetimiba, inibidores da pró-proteína convertase-subtilisina/kexina tipo 9 (iPCSK9), ácidos graxos ômega 3, sequestrantes de ácidos biliares e ácido nicotínico. Como a dislipidemia é um dos principais fatores de risco para a forma grave de COVID-19, causando a disfunção endotelial previamente instalada em pacientes dislipidêmicos, o uso de hipolipemiantes pode reduzir o risco de fatores para o desfecho desfavorável nesses pacientes.
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