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Published on: November 10, 2017
Remnant cholesterol levels are associated with severity and death in COVID-19 patients
Bibiana Fabre1,2, Nahuel Fernandez Machulsky1,2, Carolina Olano1,2
1Departamento de Bioquímica Clínica, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Cátedra de Bioquímica Clínica I, Junín 956 (C1113AAD), Buenos Aires, Argentina.
Insights
High remnant lipoprotein (RLP)-cholesterol levels are linked to severe COVID-19 outcomes and death. These findings highlight lipid metabolic disorders in patients with coronavirus disease-19 (COVID-19).
Area of Science:
- Cardiovascular Research
- Metabolic Disorders
- Infectious Diseases
Background:
- Patients with severe Coronavirus disease-19 (COVID-19) often have comorbidities like cardiovascular disease, hypertension, and type-2 diabetes mellitus.
- These conditions share metabolic alterations, including insulin resistance (IR) and dyslipidemia.
- Lipid-lipoprotein profiles are crucial in understanding disease severity and outcomes.
Purpose of the Study:
- To evaluate the association between lipid-lipoprotein profile components, specifically remnant lipoprotein (RLP)-cholesterol, and COVID-19 severity.
- To analyze the relationship between these lipid markers and mortality in hospitalized COVID-19 patients.
- To identify lipid profiles indicative of metabolic disorders and insulin resistance in COVID-19.
Main Methods:
- Studied 193 hospitalized COVID-19 patients and 200 controls.
- Assessed lipoprotein profile, glucose, and procalcitonin levels.
- Utilized binary logistic regression to identify predictors of death.
Main Results:
- COVID-19 patients exhibited higher glucose, triglyceride (TG), TG/HDL-cholesterol, and RLP-cholesterol levels, alongside lower total, LDL, HDL, and non-HDL-cholesterol.
- Age, non-HDL-cholesterol, and RLP-cholesterol were associated with mortality.
- Worsening COVID-19 severity correlated with decreased cholesterol fractions but increased RLP-cholesterol and TG/HDL-cholesterol.
Conclusions:
- Lower cholesterol fractions, except RLP-cholesterol and TG/HDL-cholesterol index, are linked to COVID-19 presence and severity.
- Altered lipid profiles suggest metabolic disorders and insulin resistance in COVID-19 patients.
- RLP-cholesterol levels are a significant predictor of COVID-19 severity and mortality.
Abstract:
Coronavirus disease-19 (COVID-19) patients with severe complications present comorbidities like cardiovascular-disease, hypertension and type-2 diabetes mellitus (DM), sharing metabolic alterations like insulin resistance (IR) and dyslipidemia. Our objective was to evaluate the association among different components of the lipid-lipoprotein profile, such as remnant lipoprotein (RLP)-cholesterol, in patients with COVID-19, and to analyze their associations with the severity of the disease and death. We studied 193 patients (68 (29-96) years; 49.7% male) hospitalized for COVID-19 and 200 controls (46 (18-79) years; 52.5% male). Lipoprotein profile, glucose and procalcitonin were assessed. Patients presented higher glucose, TG, TG/HDL-cholesterol and RLP-cholesterol levels, but lower total, LDL, HDL and no-HDL-cholesterol levels (p < 0.001). When a binary logistic regression was performed, age, non-HDL-cholesterol, and RLP-cholesterol were associated with death (p = 0.005). As the COVID-19 condition worsened, according to procalcitonin tertiles, a decrease in all the cholesterol fractions (p < 0.03) was observed with no differences in TG, while levels of RLP-cholesterol and TG/HDL-cholesterol increased (p < 0.001). Lower levels of all the cholesterol fractions were related with the presence and severity of COVID-19, except for RLP-cholesterol levels and TG/HDL-cholesterol index. These alterations indicate a lipid metabolic disorder, characteristic of IR states in COVID-19 patients. RLP-cholesterol levels predicted severity and death in these patients.
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