High-density lipoprotein cholesterol as a factor affecting virus clearance in covid-19 patients

Abstract

Objective There were COVID-19 patients with SARS-COV-2 nucleic acid long-term positive. This article aims to understand the relevant factors that affect SARS-COV-2 clearance time. Methods The clinical data of 115 COVID-19 patients with SARS-COV-2 nucleic acid positive time exceeding 14 days were collected retrospectively, and the relationship between clinical characteristics, chest CT scans, blood cells, biochemical indicators, and the time of viral nucleic acid turning negative were analyzed. Results The time from symptom onsets to nucleic acid turning negative was (32.5 ± 8.7) days in this group of patients. The time of nucleic acid turning negative: no fever group was longer than fever group, diabetes group was longer than no comorbidity group, elevated levels of ALT (alanine aminotransferase), or GLU (fasting blood glucose) group, decreased levels of ALB (albumin) group or HDLC (high-density lipoprotein cholesterol) group was longer than it's normal group separately ( P < 0.05). Cox multivariate regression analysis showed that ALT [odds ratio (OR): 2.164 (95% CI: 1.276–3.670), P = 0.004], GLU [OR: 2.064 (95% CI: 1.195–3.566), P = 0.009] and HDLC [OR: 0.527 (95% CI: 0.307–0.907), P = 0.021] were independent factors which affected the time of nucleic acid turning negative. Conclusions ALT, GLU and HDLC were independent factors that influenced the time of nucleic acid turning negative. Although diabetes or hyperglycemia is a known risk factor, HDLC is the first to be identified, clinicians should be aware of dyslipidemia in covid-19 patients.

A comprehensive guide to the pharmacologic regulation of angiotensin converting enzyme 2 (ACE2), the SARS-CoV-2 entry receptor

“…In this context, high-density and low-density lipoprotein cholesterol and total cholesterol levels were reported to be significantly decreased in COVID-19 patients (Ressaire, Dudoignon, Moreno, Coutrot, & Dépret, 2020; G. Wang et al, 2020 ). Low cholesterol levels were correlated with a higher risk of developing severe events or longer recovery times in some studies ( X. Ding et al, 2020 ; Ressaire, Dudoignon, Moreno, Coutrot, & Dépret, 2020 ; G. Wang et al, 2020 ), but not in another one ( Tanaka et al, 2020 ).…”

The bidirectional link between HDL and COVID-19 infections

“…Increased mortality was observed in patients with low total cholesterol, LDL-C, and/or HDL-C levels at admission to the hospital and in these very ill patient’s lipid levels continued to decline during the hospitalization ( 28 , 36 , 38 , 41 , 43 , 44 , 45 ). A single study reported that the time to develop a negative RT-PCR test for SARs-CoV-2 was increased in patients with low HDL-C levels ( 46 ). Finally, HDL isolated from patients with COVID-19 infections displayed a blunted ability to protect against TNF alpha induced increases in endothelial cell permeability, vascular endothelial-cadherin disorganization, and apoptosis ( 39 ).…”

Native High-Density Lipoproteins (HDL) with Higher Paraoxonase Exerts a Potent Antiviral Effect against SARS-CoV-2 (COVID-19), While Glycated HDL Lost the Antiviral Activity

“…In particular, the HDL-C level decreased according to the severity of the cytokine storm [ 10 ]. HDL-C is an important factor affecting virus clearance in COVID-19 patients [ 11 ]. A lower serum HDL-C level was significantly associated with the longer clearance of SARS-CoV-2, approximately 32.5 days after the onset of COVID-19 [ 11 ].…”

“…HDL-C is an important factor affecting virus clearance in COVID-19 patients [ 11 ]. A lower serum HDL-C level was significantly associated with the longer clearance of SARS-CoV-2, approximately 32.5 days after the onset of COVID-19 [ 11 ]. Other studies showed that the average time from the beginning of symptom onset to the first negative test of a throat swab SARS-CoV-2 was 9.5–11 days [ 12 ].…”