Cholesterol: A new game player accelerating vasculopathy caused by SARS-CoV-2?

Area of Science:

• Cardiovascular Medicine
• Infectious Diseases
• Metabolic Disorders

Background:

• COVID-19 causes multi-organ dysfunction, including vascular damage.
• Metabolic conditions like obesity and diabetes increase COVID-19 severity.
• Coagulation disorders and vasculopathy are linked to COVID-19 mortality.

Purpose of the Study:

• To review metabolic and vascular manifestations of COVID-19.
• To emphasize the link between low-density lipoprotein cholesterol (LDL-c) levels and COVID-19 severity.
• To explore pathophysiologic mechanisms of LDL-c and SARS-CoV-2 on endothelial cells (ECs).

Main Methods:

• Literature review of metabolic and vascular aspects of COVID-19.
• Analysis of existing evidence on LDL-c levels in COVID-19 patients.
• Exploration of pathophysiologic mechanisms involving ECs, LDL-c, and SARS-CoV-2.

Main Results:

• Decreased LDL-c levels correlate with increased COVID-19 disease severity.
• Metabolic conditions may predispose ECs to SARS-CoV-2 attack.
• Synergistic effects of LDL-c and SARS-CoV-2 contribute to EC injury and vasculopathy.

Conclusions:

• Dyslipidemia, particularly altered LDL-c, is a significant factor in COVID-19 vasculopathy.
• Endothelial cell dysfunction is a key mechanism linking metabolic issues to severe COVID-19.
• Further research is needed to understand and address the metabolic and vascular complications of COVID-19.