Prognostic significance of HDL-C on long-term mortality in patients with COVID-19 pneumonia in the Turkish population: A potential mechanism for population differences

Abstract

Coronavirus disease 2019 (COVID-19) is diagnosed by the evidence of the presence of multiple phenotypes, including thrombosis, inflammation, and alveolar and myocardial damage, which can cause severe illness and mortality. High-density lipoprotein cholesterol (HDL-C) has pleiotropic properties, including anti-inflammatory, anti-infectious, antithrombotic, and endothelial cell protective effects. The aim of this study was to investigate the HDL-C levels and one-year mortality after the first wave of patients with COVID-19 were hospitalized. Data from 101 patients with COVID-19 were collected for this single-center retrospective study. Lipid parameters were collected on the admission. The relationship between lipid parameters and long-term mortality was investigated. The mean age of the non-survivor group (n = 38) was 68.8 ± 14.1 years, and 55% were male. The HDL-C levels were significantly lower in the non-survivors group compared with the survivors (26.9 ± 9.5 vs 36.8 ± 12.8 mg/dl, respectively p < 0.001). Multivariate regression analysis determined that age, C-reactive protein, D-dimer, hypertension, and HDL-C as independent predictors for the development of COVID-19 mortality. HDL-C levels <30.5 mg/dl had 71% sensitivity and 68% specificity to predict one-year mortality after COVID-19. The findings of this study showed that HDL-C is a predictor of one-year mortality in Turkish patients with COVID-19. COVID-19 is associated with decreased lipid levels, and it is an indicator of the inflammatory burden and increased mortality rate. The consequences of long-term metabolic dysregulations in patients that have recovered from COVID-19 still need to be understood.

The predictive values of dynamic blood lipid profile for mortality in COVID-19 patients

“…This suggests that a more pronounced dyslipidemia may result from a stronger in ammatory response. Our study found that non-surviving COVID-19 patients exhibited a robust in ammatory response, as indicated by higher levels of WBC, neutrophil count, and CRP, which is consistent with previous studies (7,13,15,(17)(18)(19). In sepsis patients, TC and HDL decreased during the acute phase and slowly increased within 28 days (20).…”

“…Additionally, HDL has been identi ed as a predictor for one-year mortality after COVID-19 (15). Consequently, it appears that the lipid pro le may play a crucial role in determining the prognosis of patients with COVID-19, both in the long-term and the short-term.…”

COVID-19 Biomarkers Comparison: Children, Adults and Elders

“…Significantly decreased HDL levels in patients with COVID-19 were correlated with both disease severity and mortality [ 11 , 20 , 21 ]. A study from Turkey even considers it a good predictor of one-year mortality in patients with COVID-19 [ 22 ].…”

Association between lipid profile and clinical outcomes in COVID-19 patients

“…Stewart et al 25 associated low HDL-c levels with fatal COVID-19 courses, while Ghoreshi et al 26 suggested that the cytokine milieu in COVID-19 could lead to decreased HDL-c levels. Baycan et al 27 discussed the long-term mortality implications of HDL-c levels in COVID-19 patients, highlighting its prognostic significance.…”