Baseline Cardiometabolic Profiles and SARS-CoV-2 Risk in the UK Biobank

Abstract

Background SARS-CoV-2 is a rapidly spreading coronavirus with a high incidence of severe upper respiratory infection that first presented in Wuhan, China in December 2019. Many factors have been identified as risk factors for SARS-CoV-2, with much attention being paid to body mass index (BMI), but little investigation has been done to investigate dysregulation of lipid profiles and diabetes, which are often comorbid in high BMI patients. Objective This study seeks to describe the impact of BMI, HDL, LDL, ApoA, ApoB, triglycerides, hemoglobin A1c (HbA1c), diabetes, alcohol and red wine intake on SARS-CoV-2 risk in UK Biobank (UKB) study participants. Methods We examined the effect of BMI, lipid profiles, diabetes and alcohol intake on the risk of testing positive for SARS-Cov-2 among 9,005 UKB participants tested for SARS-CoV-2 from March 16 through June 29, 2020. Logistic regression was performed on the target variables controlling for age, sex and ancestry. Results BMI, Type II diabetes and HbA1c were associated with increased SARS-CoV-2 risk (p < 0.05) while HDL and ApoA were associated with decreased risk (p < 0.001). Additionally, red wine intake was associated with reduced SARS-CoV-2 risk (p < 0.05). LDL, ApoB and triglyceride levels were not found to be significantly associated with increased risk. Conclusion Elevated HDL and ApoA levels and alcohol intake, specifically red wine intake, were associated with reduced risk of testing positive for SARS-CoV-2, while type II diabetes and HbA1c were associated with increased risk. The effects of alcohol, type II diabetes and HbA1c levels may be indirect, mediated in part through regulation of HDL levels. In summary, our study corroborates the emerging picture that high HDL levels may confer protection against SARS-CoV-2.

Diabetes, obesity, metabolism, and SARS-CoV-2 infection: the end of the beginning

“…Moreover, an inverse correlation between measured levels of HDL and LDL cholesterol and hospitalizations for infectious disease was detected in 407,558 British individuals in the UK Biobank, whereas genetically determined levels of HDL were also inversely associated with hospitalizations for infections and rates of sepsis-related mortality ( Trinder et al., 2020 ). In agreement with these findings, higher levels of HDL were associated with a reduced risk of COVID-19 infection in the UK Biobank population ( Scalsky et al., 2020 ), whereas low levels of HDL on admission have been associated with greater severity of COVID-19 illness in retrospective observational analyses ( Wang et al., 2020a ).…”

Coronavirus Disease 2019 and Cardiometabolic Disease

“…Finally, a study of cardiometabolic profiles in 9005 COVID-19 patients in the UK Biobank showed that T2DM and obesity were associated with significantly increased odds of SARS-CoV-2 infection, while elevated levels of HDL and apolipoprotein A were associated with significantly decreased odds of infection. 27 Interestingly, in this final study, after controlling for HDL, the effects of BMI, T2DM, and hemoglobin A1c lost significance, suggesting that HDL may be a major mediator providing protection against COVID-19. The exact mechanism by which obesity predisposes patients to SARS-CoV-2 infection remains unclear; however, there are some key parameters to consider.…”

Coronavirus Infection and Cholesterol Metabolism

“…Thus, serum cholesterol and lipoprotein marker monitoring may have an important clinical value for COVID-19 risk prediction ( 115 ). Increased triglyceride/HDL-C ratios may be useful for the early identification of patients with high risk and poor outcomes ( 245 , 246 ). Moreover, in patients with severe disease, significantly elevated serum HDL levels are associated with favorable outcomes ( 112 ).…”