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.

Scientific Reports
|October 20, 2022
PubMed

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.

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