Follow-up study on serum cholesterol profiles and potential sequelae in recovered COVID-19 patients

Abstract

Background COVID-19 patients develop hypolipidemia. However, it is unknown whether lipid levels have improved and there are potential sequlae in recovered patients. Objective In this follow-up study, we evaluated serum lipidemia and various physiopathological laboratory values in recovered patients. Methods A 3–6 month follow-up study was performed between June 15 and September 3, 2020, to examine serum levels of laboratory values in 107 discharged COVID-19 patients (mild = 59; severe/critical = 48; diagnoses on admission). Sixty-one patients had a revisit chest CT scan. A Wilcoxon signed-rank test was used to analyze changes in laboratory values at admission and follow-up. Results LDL-c and HDL-c levels were significantly higher at follow-up than at admission in severe/critical cases (p < 0.05). LDL-c levels were significantly higher at follow-up than at admission in mild cases (p < 0.05). Coagulation and liver functional values were significantly improved at follow-up than at admission for patients (p < 0.05). Increases in HDL-c significantly correlated with increases in numbers of white blood cells (p < 0.001) during patients’ recovery. With exclusion of the subjects taking traditional Chinese medicines or cholesterol-lowering drugs, LDL-c and HDL-c levels were significantly increased at follow-up than at admission in severe/critical cases (p < 0.05). Residue lesions were observed in CT images in 72% (44 of 61) of follow-up patients. Conclusions Improvements of LDL-c, HDL-c, liver functions, and incomplete resolution of lung lesions were observed at 3–6 month follow-up for recovered patients, indicating that a long-term recovery process could be required and the development of sequelae such as pulmonary fibrosis could be expected in some patients.

Uneven metabolic and lipidomic profiles in recovered COVID‐19 patients as investigated by plasma NMR metabolomics

“… 23 These differences were observed in TC, phospholipids and their respective particles and sub‐particles, and they were reminiscent of those observed during the acute phase of COVID‐19 disease, which were associated with liver dysfunction. 15 , 24 , 25 …”

“…Statistical differences between cohorts are represented as **** (p < 0.0001) These differences were observed in TC, phospholipids and their respective particles and sub-particles, and they were reminiscent of those observed during the acute phase of COVID-19 disease, which were associated with liver dysfunction. 15,24,25 The RE_II sub-cohort showed specific features, including an upregulation of many lipoprotein subfractions that were found to be depleted in acute COVID-19 patients. Indeed, the profile shown in Figure S3 suggested that the lipoprotein metabolism for the RE_II sub-cohort rebooted from the disease, but still does not show full recovery.…”

Hyperlipidemia in Post-COVID patients; a unique observational follow-up study on lipid levels in post-COVID patients

“…Recent studies have reported that hypolipidemia in hospitalized COVID-19 patients at the admission and the decrease in lipid levels were associated with the severity of the symptoms (6)(7)(8)(9)(10)12,14,15). In one of the first studies early in the pandemic, patients with COVID-19 develop hypolipidemia as early as when they have mild symptoms and a reduction of lipid levels in patients with COVID-19 has an association with the severity of the symptoms (23).…”

“…LDL-C, TC and HDL-C concentrations significantly decreased in COVID-19 patients (6)(7)(8)(9)(10). Although most of the studies were in hospitalized patients, literature on lipid profiles during follow-up in discharged COVID-19 (post-COVID) patients is rare (11)(12).…”

COVID-19 and lipids. The role of lipid disorders and statin use in the prognosis of patients with SARS-CoV-2 infection

“…The anti-fibrotic effect of statins seems to be very interesting from the point of view of complications of SARS-CoV-2 infection (especially in the long-COVID-19 syndrome). In a study by Li et al which included 107 patients with COVID-19, it was shown that after 3–6 months after recovery, some of them may develop pulmonary fibrosis [ 85 ]. In an experimental study using mice and human lung fibroblasts/myofibroblasts, the effect of atorvastatin on the processes of fibrosis was assessed.…”