Hypolipidemia is associated with the severity of COVID-19

Wei, Xin; Zeng, Wenjuan; Su, Jingyu; Wan, Huihui; Yu, Xinqin; Cao, Xiaoling; Tan, Wenbin; Wang, Hui

doi:10.1016/j.jacl.2020.04.008

Cited by 311 publications

(437 citation statements)

References 28 publications

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“…Previous studies have reported that lipid metabolism impairment may be involved in the pathogenesis of sepsis secondary to pneumonia and in uenza [8][9][10]. Similarly, recent studies observed dyslipidemia in patients infected with SARS-CoV-2, using MS analysis [6,7] and routine laboratory lipid tests [11], indicating that blood lipid might involve in the pathogenesis of COVID-19. In the study of Wei et al [11], a serum hypolipidemia was found in the COVID-19 patients, which showed that the serum level of TC, HDL-C and LDL-C in the patients with COVID-19 were signi cantly lower than healthy subjects, especially in the severe and critical cases.…”

Section: Discussionmentioning

confidence: 86%

A Preliminary Study on Blood Lipid Profile in Patients with COVID-19

Zhu

Yang

Fan

et al. 2020

Preprint

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Background: Recently, dyslipidemia was observed in the patients with coronavirus disease 2019 (COVID-19). This study aimed to investigate the blood lipid profile in the patients with COVID-19, and explore their predictive value for COVID-19 severity.Methods: 142 consecutive patients with COVID-19 admitted to HwaMei Hospital, University of Chinese Academy of Sciences, from January 23 to April 20, 2020, and 77 age- and gender-matched healthy subjects were included in this retrospective study. The blood lipid profile in the patients with COVID-19 were investigated, and their predictive values for COVID-19 severity were analysed.Results: There were 125 and 17 cases in the non-severe and severe group, respectively. Total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and apolipoprotein A1 (ApoA1) gradually decreased across healthy controls, non-severe group, and severe group. ApoA1 was recognized as an independent risk factor for COVID-19 severity，and had the highest area under the receiver operator characteristic curve (AUC) among all the single markers (AUC: 0.896, 95% CI: 0.834-0.941). Moreover, the risk model established using ApoA1 and IL-6 enhanced the prediction efficiency (AUC: 0.977, 95% CI: 0.932-0.995). Conclusion: The blood lipid profile in the patients with COVID-19 is quite abnormal from healthy subjects, especially in the severe cases. Serum ApoA1 might serve as a good indictor to reflect the severity of COVID-19.

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Section: Discussionmentioning

confidence: 86%

A Preliminary Study on Blood Lipid Profile in Patients with COVID-19

Zhu

Yang

Fan

et al. 2020

Preprint

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“…Recently, studies have found that levels of LDL-C and TC in COVID-19 patients are decreased [20,21]. Nevertheless, these studies largely focused on the levels of total cholesterol(TC), triglycerides (TG), HDL cholesterol(HDL-C) and LDL cholesterol(LDL-C).…”

Section: Introductionmentioning

confidence: 99%

Changes in lipid metabolism in patients with severe COVID-19

Li¹,

Zhang²,

Dai³

et al. 2020

Preprint

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Background: Dyslipidemia plays an important role in the pathogenesis and evolution of critical illness, but limited information exists regarding the lipid metabolism of severe coronavirus disease 2019 (COVID-19) patients. The aim of this study was to investigate role of dyslipidemia in patients with severe COVID-19Methods: We retrospectively reviewed 216 severe COVID-19 patients with clarified outcomes (discharged or deceased), admitted to the West Court of Union Hospital in Wuhan, China, between February 1 and March 31, 2020. The dynamic changes of lipid profiles and their relationships with disease severity and clinical outcomes were analyzed.Results: A total of 216 severe COVID-19 patients, including 24 non-survivors and 192 survivors, were included in the final analyses. The levels of high-density lipoprotein cholesterol (HDL-C) and apolipoprotein AI (Apo-AI) on admission were significantly lower in non-survivors compared to survivors. During hospitalization, low-density lipoprotein cholesterol (LDL-C), total cholesterol(TC), HDL-C and Apo-AI were shown an increasing trend in survivors, but maintained lower levels or shown downward trend in non-survivors. The serum levels of HDL-C and Apo-AI were inversely correlated with C-reactive protein (CRP), length of hospital stay of survivors and disease severity. The receiver operating characteristic (ROC) curve analysis identified a CRP/ HDL-C ratio cut-off value of 62.54 as the predictor for in-hospital mortality (AUC=0.823, Sensitivity=83.3%, Specificity=70.8%). Logistic regression analysis demonstrated that hypertension, neutrophils-to-lymphocytes ratio(NLR), platelet count and high CRP/ HDL-C ratio (>62.54) were independent factors to predict in-hospital mortality.Conclusions: The results demonstrated that dyslipidemia was associated with the inflammatory response, disease severity and poor prognosis of COVID-19. High CRP/ HDL-C ratio may serve as an independently potential predictor for hospital mortality among patients with severe COVID-19.

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“…On another hand, a small, retrospective longitudinal study conducted in Wuhan reported a progressive and irreversible decrease in LDL-C levels over the course of the COVID-19 until death [15]. Another cross-sectional study from Wuhan demonstrated that hypolipidemia was correlated with the severity of COVID-19 [14]. Similar to our study, lipid levels were lower in more severe cases of COVID-19, but there was no signi cant linear trend between presence of dyslipidemia and disease severity across subgroups of COVID-19, in either patient cohort.…”

Section: Discussionmentioning

confidence: 99%

“…A retrospective multicenter study conducted in China revealed that patients with these comorbidities (based on self-report) on admission experienced poorer clinical outcomes than those without comorbidities [8]. Only two studies of patients in Wuhan showed that serum lipid levels were unexpectedly lower in COVID-19 patients compared to healthy subjects [14,15].On the other hand, it appears that lipid-lowering pharmacological interventions, in particular statin, might reduce the risk of cardiovascular complications caused by COVID-19 and might potentially have an additional antiviral activity [16]. We need to describe lipid pathological alterations in COVID-19 and what about lipid-lowering therapy and their nal in uence on these nal results.…”

Section: Introductionmentioning

confidence: 99%

Altered Lipid Profile is a Risk Factor for the Progression Andrecurrenceof COVID-19: From Two Retrospective Cohorts

Jin¹,

He²,

Dong³

et al. 2020

Preprint

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Background The COVID-19 pandemic has spread worldwide. However, the impact of lipid profile and lipid-lowering treatment on clinical endpoints in COVID-19 have not previously been investigated. Methods In this retrospective, multicenter cohort study, we consecutively enrolled 430 adult COVID-19 patients from two Chinese hospitals (one each in Chengdu and Wuhan) admitted during February 2020 and followed-up until April 30. Demographic, metabolic profile, laboratory, treatment and clinical endpoint data including in-hospital death and recurrence of COVID-19, were collected. Results In Chengdu patients, univariable and multivariable Cox regression showed that the low-density lipoprotein cholesterol (LDL-C) dyslipidemia on admission was associated with the recurrence of COVID-19 during the follow-up period. In Wuhan cohort, the patients with triglycerides hyperlipemia had an increased risk of in-hospital death. However, in both cohorts, statin therapy during COVID-19 course did not affect these clinical endpoints. Compared to the Chengdu cohort, the Wuhan patients tended to have more severe COVID-19 but, unexpectedly, had lower levels of serum lipid. It is of interesting to notice that the relationship between the observed biomarkers of inflammation and lipid do not match the relationship between the organ function measures and this lipid. Conclusions The baseline dyslipidemia should be considered as a risk factor for poor prognosis and recurrence of COVID-19. The lipid level may be altered during COVID-19 course, since lipidology may be distinctly affected by both inflammation and organic damage for SARS-CoV-2. Further investigation is needed on the role of use of lipid-lowering therapy among patients with COVID-19 infections.

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Hypolipidemia is associated with the severity of COVID-19

Cited by 311 publications

References 28 publications

A Preliminary Study on Blood Lipid Profile in Patients with COVID-19

A Preliminary Study on Blood Lipid Profile in Patients with COVID-19

Changes in lipid metabolism in patients with severe COVID-19

Altered Lipid Profile is a Risk Factor for the Progression Andrecurrenceof COVID-19: From Two Retrospective Cohorts

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