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Elevated Lp(a) and course of COVID-19: Is there a relationship?
Agnieszka Pawlos1, Paulina Gorzelak-Pabiś1, Mateusz Staciwa1
1Department of Internal Diseases and Clinical Pharmacology, Laboratory of Tissue Immunopharmacology, Medical University of Lodz, Lodz, Poland.
Insights
Elevated Lipoprotein (a) (Lp(a)) in COVID-19 patients is linked to more severe disease, including longer hospital stays and increased risk of complications. Further research is needed to confirm Lp(a) as a significant factor in COVID-19 severity.
Area of Science:
- Cardiology
- Infectious Diseases
- Clinical Pharmacology
Background:
- Lipoprotein (a) (Lp(a)) possesses proinflammatory, prothrombotic, and proatherogenic properties.
- Lp(a) may theoretically influence the clinical course of COVID-19.
Purpose of the Study:
- To investigate if COVID-19 patients with elevated Lp(a) (≥30mg/dl) experience a worse disease course.
- To assess the association between elevated Lp(a) and increased incidence of thromboembolic complications, intubation, ICU admission, and mortality.
Main Methods:
- Retrospective analysis of 124 hospitalized COVID-19 patients (age <80 years).
- Patients were stratified into two groups: Lp(a) <30mg/dl (n=80) and Lp(a) ≥30mg/dl (n=44).
Main Results:
- Elevated Lp(a) correlated with significantly longer hospitalization (11 vs. 9.5 days).
- Patients with elevated Lp(a) showed more extensive CT radiological changes (35% vs. 30%) and higher oxygen demand on admission (8 vs. 5L/min).
- Elevated Lp(a) was associated with increased odds for High Flow Nasal Oxygen Therapy (HFNOT), intubation/ICU admission, and death.
Conclusions:
- Elevated Lp(a) may be a contributing factor to severe COVID-19.
- Further studies with larger patient cohorts are required to validate these findings.
Background:
Lipoprotein (a)-Lp(a) has proinflammatory, prothrombotic and proatherogenic properties and may theoretically influence the course of COVID-19.
Objectives:
The aim of the study was to explore whether patients hospitalized due to COVID-19 with Lp(a) ≥30mg/dl may develop a worse course of the disease, increased incidence of thromboembolic complications, intubation and ICU hospitalization or death.
Patients And Methods:
A retrospective analysis was performed of 124 patients hospitalized due to COVID-19 in the Department of Internal Diseases and Clinical Pharmacology between 29 November 2020 and 15 April 2021. The only exclusion criterion was age≥80 years. Patients were divided into two groups: 1. COVID-19 patients with Lp(a) <30mg/dl regarded as not elevated n = 80; 2. COVID-19 patients with Lp(a) ≥30 regarded as elevated n = 44.
Results:
A total of 124 COVID-19 patients were included in the study (66 men and 58 women) with a mean age of 62.8±11 years. COVID-19 patients with elevated Lp(a) level had significantly longer hospitalization time (11 vs. 9.5 days; p = 0.0362), more extensive radiological changes in CT scan (35 vs. 30%; p = 0.0301) and higher oxygen demand on admission (8 vs. 5L/min; p = 0.0428). Elevated Lp(a) was also associated with significantly higher OR for High Flow Nasal Oxygen Therapy (HFNOT) OR = 3.5 95%CI(1.2;8.9), p = 0.0140, Intubation and ICU OR = 4.1 95%CI(1.1;15.2) p = 0.0423, Death OR = 2.8 95%CI(0.9;8.5), p = 0.0409.
Conclusions:
Elevated Lp(a) might be one of the factors which contribute to a more severe course of COVID-19; however, further studies including larger groups of patients are needed.
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