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Changes in HDL cholesterol, particles, and function associate with pediatric COVID-19 severity.

Michele Mietus-Snyder1,2,3,4, William Suslovic1, Meghan Delaney1,4,5

  • 1Children's National Hospital, Washington, DC, United States.

Frontiers in Cardiovascular Medicine
|October 31, 2022
PubMed
Summary

High-density lipoprotein (HDL) levels and function are linked to COVID-19 severity in youth. Lower HDL cholesterol and impaired cholesterol efflux capacity correlate with more severe symptoms, aiding risk identification.

Keywords:
HDL functionHDL subspeciesHDL-cholesterolNMR lipoprotein analysislipoprotein Zpediatric COVID-19 severity

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Area of Science:

  • Immunology
  • Cardiovascular Science
  • Pediatric Infectious Diseases

Background:

  • High-density lipoprotein (HDL) has roles beyond cardiovascular protection, including immune functions.
  • These immune functions may influence the severity of coronavirus disease-2019 (COVID-19) in adults.

Purpose of the Study:

  • To investigate the association between HDL parameters and COVID-19 severity in pediatric patients.
  • To determine if HDL function can predict severe outcomes in youth with COVID-19.

Main Methods:

  • A cohort of 102 pediatric COVID-19 patients with varying disease severity was studied.
  • HDL cholesterol, apolipoprotein AI, particle size/number, and cholesterol efflux capacity (CEC) were measured.
  • Findings were compared between COVID-19 severity groups and with 30 uninfected children.

Main Results:

  • Decreased HDL cholesterol, apolipoprotein AI, HDL particles, and HDL CEC showed a dose-response relationship with increasing COVID-19 severity.
  • Lipoprotein Z (LP-Z), associated with hepatic inflammation, was more frequent in severe cases.
  • HDL CEC remained a significant predictor of severity, even after adjusting for other factors.

Conclusions:

  • HDL parameters, particularly HDL function, may serve as biomarkers for identifying youth at risk of severe COVID-19.
  • These findings suggest HDL's role in modulating infectious disease outcomes in children.
  • Further research could explore HDL's utility in predicting severe consequences from novel infectious pathogens.