Low serum level of apolipoprotein A1 may predict the severity of COVID‐19: A retrospective study

Abstract

Background Dyslipidemia has been observed in patients with coronavirus disease 2019 (COVID‐19). This study aimed to investigate blood lipid profiles in patients with COVID‐19 and to explore their predictive values for COVID‐19 severity. Methods A total of 142 consecutive patients with COVID‐19 were included in this single‐center retrospective study. Blood lipid profile characteristics were investigated in patients with COVID‐19 in comparison with 77 age‐ and gender‐matched healthy subjects, their predictive values for COVID‐19 severity were analyzed by using multivariable logistic regression analysis, and their prediction efficiencies were evaluated by using receiver operator characteristic (ROC) curves. Results There were 125 and 17 cases in the non‐severe and severe groups, respectively. Total cholesterol (TC), high‐density lipoprotein cholesterol (HDL‐C), low‐density lipoprotein cholesterol (LDL‐C), and apolipoprotein A1 (ApoA1) gradually decreased across the groups in the following order: healthy controls, non‐severe group, and severe group. ApoA1 was identified as an independent risk factor for COVID‐19 severity (adjusted odds ratio [OR]: 0.865, 95% confidence interval [CI]: 0.800–0.935, p < 0.001), along with interleukin‐6 (IL‐6) (adjusted OR: 1.097, 95% CI: 1.034–1.165, p = 0.002). ApoA1 exhibited the highest area under the ROC curve (AUC) among all single markers (AUC: 0.896, 95% CI: 0.834–0.941); moreover, the risk model established using ApoA1 and IL‐6 enhanced prediction efficiency (AUC: 0.977, 95% CI: 0.932–0.995). Conclusion Blood lipid profiles in patients with COVID‐19 are quite abnormal compared with those in healthy subjects, especially in severe cases. Serum ApoA1 may represent a good indicator for predicting the severity of COVID‐19.

Prognostic value of apolipoproteins in COVID-19 patients: A systematic review and meta-analysis

“…The screening process by titles and abstracts left 32 studies for full-text review (see Excluded articles by full-text in Supplemental Table S1 ). In turn, screening by full-text left 12 studies respecting all eligibility criteria [ [13] , [14] , [15] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] ]. This process is summarised in a flow chart ( Fig.…”

“…Although there are studies that suggest its prognostic value in sepsis and bacterial diseases, to our knowledge, the evidence of its prognostic value in patients hospitalized for COVID-19 was not systematized. Recently, these biological markers have been evaluated as prognosis indicators of severity in COVID-19 patients [ [13] , [14] , [15] ]. In order to keep increasing knowledge about COVID-19 and supporting clinical practise, we conducted a meta-analysis of available evidence to assess the prognosis value of apolipoproteins and ApoB/ApoA1 ratio for COVID-19 severity and mortality.…”

Clinical value of blood markers to assess the severity of coronavirus disease 2019

“…Currently, researchers are reporting some new indicators for severe COVID-19, which might be the next step for our research group. For example, Yang et al [ 27 ] showed that serum apolipoprotein A 1 served as an indicator to reflect the severity of COVID-19. Gómez-Pastora et al [ 28 ] examined the level of ferritin in COVID-19 patients, and confirmed hyperferritinemia in the critically ill, but failed to reveal whether it was the product of inflammation or a pathogenic mediator.…”

New insights into Covid‐19 disease. Apo‐A1 antibodies are generated after mRNA Covid‐19 vaccination and after Covid‐19 infection

“…Apo‐A1 is therefore recognized as an important player in the prevention of athero‐thrombotic disease; the higher the Apo‐A1 levels, the more cholesterol could be locally cleared. In a recent study, it was found that the severity of (acute) Covid‐19 infections was associated with significantly lower ApoA1 levels 2 and a significant dyslipidaemia with a predominantly pronounced increase in plasma triglyceride levels (and, in reverse, a low HDL) was found in patients with severe Covid‐19 infections 3 …”