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Updated: Oct 28, 2025

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

Zhe Zhu1,2, Yayun Yang2,3, Lingyan Fan2,4

  • 1Department of Blood Transfusion, HwaMei Hospital, University of Chinese Academy of Sciences, Ningbo, China.

Journal of Clinical Laboratory Analysis
|July 14, 2021
PubMed

Insights

COVID-19 patients exhibit abnormal blood lipid profiles, particularly severe cases. Serum apolipoprotein A1 (ApoA1) levels can effectively predict COVID-19 severity, offering a valuable diagnostic marker.

Area of Science:

  • Biochemistry
  • Clinical Medicine
  • Infectious Diseases

Background:

  • Dyslipidemia is a known comorbidity in patients diagnosed with coronavirus disease 2019 (COVID-19).
  • Understanding lipid profile alterations is crucial for managing COVID-19 patients.

Purpose of the Study:

  • To investigate the blood lipid profiles of COVID-19 patients.
  • To determine the predictive value of lipid profiles for COVID-19 severity.

Main Methods:

  • Retrospective analysis of 142 COVID-19 patients and 77 healthy controls.
  • Comparison of blood lipid profiles (Total Cholesterol, HDL-C, LDL-C, ApoA1) between groups.
  • Multivariable logistic regression and ROC curve analysis to assess predictive values.

Main Results:

  • COVID-19 patients, especially severe cases, showed significantly lower levels of Total Cholesterol, HDL-C, LDL-C, and ApoA1 compared to healthy controls.
  • Apolipoprotein A1 (ApoA1) was identified as an independent risk factor for COVID-19 severity (aOR: 0.865, p < 0.001).
  • A combined model of ApoA1 and Interleukin-6 (IL-6) demonstrated high prediction efficiency for COVID-19 severity (AUC: 0.977).

Conclusions:

  • Blood lipid profiles are significantly altered in COVID-19 patients, with more pronounced abnormalities in severe cases.
  • Serum ApoA1 is a promising biomarker for predicting the severity of COVID-19.
  • Further research into lipid-modulating therapies for COVID-19 may be warranted.
Abstract

Keywords:
ApoA1COVID-19SARS-CoV-2blood lipiddisease severity

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