Effect of COVID-19 on Lipid Profile and its Correlation with Acute Phase Reactants

Abstract

Background and Objective Coronavirus disease 2019 (COVID-19) manifests as multiple clinical and pathological organ dysfunctions. It also disrupts metabolic profile due to the release of pro-inflammatory cytokines causing a systemic inflammation reaction. However, the development and correlation of dyslipidemia with acute phase reactants is unknown. This investigation was performed to assess the pathological alterations of low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein (HDL), triglycerides, and total cholesterol levels in COVID-19 patients. Methods This was a prospective study performed on real-world patients to assess serum levels of LDL-C, HDL, TG, TC on COVID-19 patients (mild: 319; moderate: 391; critical: 357) hospitalized at our center between April 2020 through January 2021. Age- and gender-matched controls who had their lipid profiles in the same period were included as the control group. Results LDL-C, HDL, TG, and TC levels were significantly lower in COVID-19 patients when compared with the control group (P < 0.001, 0.047, 0.045, < 0.001, respectively). All parameters decreased gradually with COVID-19 disease severity (LDL-C: median (IQR), mild: 98 (91,134); moderate: 97 (81,113); critical: 68 (68,83); HDL: mild: 45 (37,50); moderate: 46 (41,50); critical: 40 (37,46); TG: mild: 186 (150,245); moderate: 156 (109,198); critical: 111 (98,154); TC: mild: 224 (212,238); moderate: 212 (203,213); critical: 154 (125,187)). LDL-C, TC, and TG were inversely correlated with acute phase reactants (interleukin-6 (IL-6), Procalcitonin, C-reactive protein (CRP), and D-dimers). Logistic regression demonstrated lipid profile, thyroid profile, and acute phase reactants as predictors of severity of COVID-19 disease. Conclusion Hypolipidemia develops in increasing frequency with severe COVID-19 disease. It inversely correlates with levels of acute-phase reactants, indicating SARS-COV-2 as the causative agent for alteration in lipid and thyroid levels.

Laboratory Findings in Different Disease Status of COVID-19 Admitted Patients at Dilla University Referral Hospital Treatment Center, South Ethiopia

“…Most of the severe and moderate, and total cases shown increased level of HDL and total cholesterol level, while most of the severe, and 50% of the moderate cases shown increased level of LDL and Triglycerides. These findings were different from the study in Pakistan that stated all parameters decreased gradually with COVID-19 disease severity (LDL, HDL, Triglycerides and total cholesterol), 46 and meta-analysis findings that stated significantly decreased levels of total cholesterol, high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) in the severe group when compared with the non-severe group, 52 which may be due to the sample size and socio-demographic factors difference. There was no statistically significant mean concentration difference between severe and moderate cases for HDL, LDL, triglycerides and total cholesterol level (p=0.21, P=0.10, p=0.96 and p=0.17 respectively).…”

“…42 Which was also true for other study in China that stated the prevalence of elevated BUN and elevated serum creatinine at admission was 6.29% and 5.22%, respectively, 47 study in Pakistan that showed creatinine was significantly increased in severe COVID-19 cases. 46 However, our study was in line with other study in China that showed serum creatinine was not abnormally elevated in all the patients, and BUN was abnormally elevated in only few (25.0%) of the patients, and other study that showed the abnormally elevated rates of serum creatinine and BUN are quite low. 6 Though it was different from the study that stated kidney function tests findings were significantly elevated in patients with both severe and fatal COVID-19, 39 we found a statistically significant mean Cr concentration difference between severe and mild cases (p=0.00).…”

“…44 Which was also similar with study in Pakistan that showed AST and ALT were all significantly increased in severe COVID-19 cases. 46 In our study we found no statistically significant mean AST concentration differences between severe and moderate (p=0.94), severe and mild (P= 0.86), and moderate and mild cases (P= 0.89). Similarly, there was no statistically significant mean ALT concentration difference between severe and moderate, severe and mild, and moderate and mild cases (P= 0.61, P= 0.91, P= 0.98 respectively).…”

Association of ABO blood group with COVID-19 severity, acute phase reactants and mortality

“…In our previous study and a preprint, we demonstrated altered lipid profiles and thyroid function tests in association with COVID-19 disease and its severity along with acute phase reactants [ 17 , 18 ]. Acute phase reactants were severely deranged in both study cohorts and there was a positive correlation with the higher classification of severity of COVID-19.…”

Altered Lipid Profile in COVID-19 Patients and Metabolic Reprogramming

“…However, the concentration of lipid profiles in patients with COVID-19 was reported with variable values ( Gao et al, 2020 ; Hu et al, 2020 ; Lei et al, 2020 ; Malik et al, 2021 ). A likely explanation is that the genetic phenotypes and underlying diseases are significantly different among patients with COVID-19.…”