Low serum apolipoprotein A 1 is an indicator of severity in patients with coronavirus disease 2019

Abstract

Background: Recently, dyslipidaemia was observed in patients with coronavirus disease 2019 (COVID-19), especially in severe cases. This study aimed to explore the predictive value of blood lipid levels for COVID-19 severity.Methods: All patients with COVID-19 admitted to HwaMei Hospital, University of Chinese Academy of Sciences, from January 23 to April 20, 2020, were included in this retrospective study. General clinical characteristics and laboratory data (including blood lipid parameters) were obtained, and their predictive values for the severity were analysed.Results: In total, 142 consecutive patients with COVID-19 were included. The non-severe group included 125 cases, and 17 cases were included in the severe group. Total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and apolipoprotein A1 (ApoA1) at baseline were significantly lower in the severe group. ApoA1 and interleukin-6 (IL-6) were recognized as independent risk factors for COVID-19 severity. ApoA1 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 predictive value (AUC: 0.977, 95% CI: 0.932-0.995). On the other hand, ApoA1 levels were elevated in the severe group during treatment, and there was no significant difference between the severe and non-severe groups during the recovery stage of the disease.Conclusion: The blood lipid profile in severe COVID-19 patients is quite different from that in non-severe cases. Serum ApoA1 could severe as a good indictor to reflect the severity of COVID-19.

Apolipoprotein A1 level in plasma of patients with diabetes and diabetic patients with COVID-19 as a possible marker of disease

“…The obtained data indicate that upregulation of C3 and downregulation of ApoA1 in urine affect respiratory rigidity and, thus, the severity of COVID-19. Moreover, dysregulation of APP and ApoA1 may contribute to the possible side effects of COVID-19 on the nervous system [9,10].…”