Finding answers in lipid profile in COVID-19 patients

Abstract

Introduction A small percentage of patients will develop a severe form of COVID-19 caused by SARS-CoV-2 infection. Thus, it is important to predict the potential outcomes identifying early markers of poor prognosis. In this context, we evaluated the association of SARS-CoV-2 infection with lipid abnormalities and their role in prognosis. Methods Single-center, retrospective, observational study of COVID-19 patients admitted from March to October 2020. Clinical and laboratory data, comorbidities, and treatments for COVID-19 were evaluated. Main outcomes including intensive care unit (ICU) admission and mortality were analyzed with a multivariable Cox proportional hazards regression model. Results We selected 1489 from a total of 2038 consecutive patients with confirmed COVID-19, who had a complete lipid profile before ICU admission. During the follow-up performed in 1109 patients, we observed a decrease in T-c, HDL-c, and LDL-c in 28.6%, 42.9%, and 30.4% of patients, respectively, and an increase in TG in 76.8%. The decrease of both T-c and HDL- c was correlated with a decrease in albumin levels (r = 0.39 and r = 0.37, respectively). Kaplan–Meier survival curves found an increased ICU admission in patients with lower T-c (HR 0.55, CI 0.36–0.86), HDL-c (HR 0.61, CI 0.45–0.84), and LDL-c (HR 0.85, CI 0.74–0.97). Higher values of T-c (HR 0.45, CI 0.36–0.57), HDL-c (HR 0.66, CI 0.54–0.81), and LDL-c (HR 0.86, CI 0.78–0.94) showed a protective effect on mortality. Conclusions Abnormalities in lipid profile are a frequent complication of SARS-CoV-2 infection and might be related to morbidity and mortality. Funding Proyectos de Investigación en Salud (FIS) and cofinanced by FEDER.

The predictive values of dynamic blood lipid profile for mortality in COVID-19 patients

“…This suggests that a more pronounced dyslipidemia may result from a stronger in ammatory response. Our study found that non-surviving COVID-19 patients exhibited a robust in ammatory response, as indicated by higher levels of WBC, neutrophil count, and CRP, which is consistent with previous studies (7,13,15,(17)(18)(19). In sepsis patients, TC and HDL decreased during the acute phase and slowly increased within 28 days (20).…”

“…For example, in one study of 424 COVID-19 patients, non-survivors showed a dramatic decrease in HDL-C levels (7). Consistently, another study manifested that higher levels of HDL-C, TC, and LDL-C were found to offer protection to mortality (13).…”

Myocardial Infarction in Patients with and without COVID-19: Comparisons of Characteristics, Clinical Courses, and Outcomes

“…This elevation could be secondary to cytokine storms and cause the activation of iatrogenic mechanisms. 22 …”

Valor Prognóstico do Colesterol não HDL na Pneumonia por COVID-19

“… 2 , 3 Ainda que os lipídios desempenhem um papel importante na penetração e disseminação da SARS- A infecção por CoV-2 em células, estudos e meta-análises geralmente investigaram as alterações lipídicas que ocorrem durante a infecção grave e o impacto dessas alterações no prognóstico da doença e na mortalidade. 4 , 5 …”

“… 2 , 3 Although lipids play an important role in the penetration and spread of SARS-CoV-2 infection into cells, studies, and meta-analyses have generally investigated the lipid changes that occur during severe infection and the impact of these changes on disease prognosis and mortality. 4 , 5 …”