ABSTRACT
The emergence of the novel severe acute respiratory syndrome coronavirus 2 (SARS- CoV-2) which causes Coronavirus Disease 2019 (COVID-19) has resulted in a pandemic. A large proportion of patients are treated with lipid lowering medication and questions regarding the safety of continuing this therapy have arisen. Proprotein convertase subtilisin/kexin type 9 (PCSK9) monoclonal antibodies are novel drugs that reduce low-density lipoprotein cholesterol (LDL-C) to previously unprecedented levels. The PCSK9 protein is often upregulated during sepsis and inflammation and is postulated to have a detrimental effect on host response and survival. This has led to argue for a possible role of PCSK9 monoclonal antibodies in treating the dysregulated immune response during SARS-CoV-2 infection. In order to effectively reduce overcrowding and block the spread of the virus through person-to-person transmission during the coronavirus epidemic, in the ASL ROMA 1 a local health unit of the Lazio Region based in the city of Rome and providing health services to more than 1.100.000 residents, a PCSK9 monoclonal antibodies medication delivery service has been instituted, providing multiple benefits to our patients treated with PCSK9 monoclonal antibodies (N=168) during home quarantine. The mean value of LDL-C at the end of the first lockdown period was on target according to current secondary prevention guidelines in all patients (<55 mg/dL). Therefore, our main suggestions are that counteracting therapy discontinuation could represents a crucial issue during pandemics and that this novel function of PCSK9 should have important implications in optimizing their clinical use in the context of infectious/inflammatory disease.