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Low HDL-C and the Risk of Hospitalisation in Children with COVID-19
Nurhan Kasap1, Onur Incealtin2, Velat Celik3
1Department of Paediatric Allergy-Immunology, Istanbul Medeniyet University, Istanbul, Turkiye.
Insights
Low high-density lipoprotein cholesterol (HDL-C) levels are common in children diagnosed with COVID-19. These children were more likely to be hospitalized and showed increased inflammatory markers compared to those with normal HDL-C.
Area of Science:
- Pediatric Medicine
- Infectious Diseases
- Cardiovascular Health
Background:
- High-density lipoprotein cholesterol (HDL-C) plays a role in cardiovascular health.
- COVID-19 can impact various physiological systems in children.
- Understanding lipid profiles in pediatric COVID-19 is crucial for assessing disease severity.
Purpose of the Study:
- To investigate high-density lipoprotein cholesterol (HDL-C) levels in pediatric patients diagnosed with COVID-19.
- To analyze the association between HDL-C levels and clinical outcomes, including hospitalization and inflammatory markers.
Main Methods:
- A descriptive study was conducted using hospital records from 2020-2022.
- Data from 1,056 children with COVID-19 were reviewed, with lipid levels analyzed in 193 patients.
- Associations between HDL-C, inflammatory biomarkers (e.g., CRP, LDH, ferritin), and hospitalization were examined.
Main Results:
- 65.5% of pediatric COVID-19 patients exhibited low HDL-C levels.
- Low HDL-C was significantly associated with higher rates of hospitalization (p=0.012).
- Patients with low HDL-C showed elevated levels of triglycerides, glucose, LDH, CRP, D-dimer, ferritin, and uric acid.
Conclusions:
- Low HDL-C is a prevalent finding in children with COVID-19.
- Reduced HDL-C levels in children with COVID-19 correlate with increased disease severity and higher inflammatory burden.
- These findings highlight the importance of monitoring HDL-C in pediatric COVID-19 cases.
Objective:
To investigate high-density lipoprotein cholesterol (HDL-C) levels in children with COVID-19.
Study Design:
Descriptive study. Place and Duration of the Study: Goztepe Professor Suleyman Yalcin City Hospital, Istanbul, Turkiye, between 2020 and 2022.
Methodology:
The hospital data were examined to find children (<18 years) who presented with COVID-19. The associations between HDL-C, inflammatory biomarkers, hospital admission requirements, and prolonged hospital stays in children with COVID-19 were analysed.
Results:
During the study period, 1,056 children were diagnosed with COVID-19. Lipid levels were measured in 193 patients during outpatient clinic visits from the same hospital records. One hundred and twenty-seven (65.5%) patients displayed low HDL-C levels. One hundred and nine (86.5%) of the patients with low HDL-C and 33 (50.0%) of the patients with normal HDL-C were hospitalised (p=0.012). Patients with lower HDL-C exhibited higher triglyceride (median 124 vs. 81 mg/dl, p<0.001), glucose (median 116 vs. 101 mg/dl, p=0.001), lactate dehydrogenase (LDH) (median 343 vs. 251 mg/dl, p<0.001), C-reactive protein (CRP) (median 0.6 vs. 0.5 mg/L, p=0.009), D-dimer (median 1.3 vs. 0.3 mcg/mL, p<0.001), ferritin (median 127 vs. 40 µg/L, p<0.001), and uric acid (median 5.5 vs. 4.5 mg/dL, p=0.002) levels compared to children with normal HDL-C. Logistic regression (LR) analysis showed that age (OR = 0.87, CI for OR 0.80-0.94, p < 0.001), ferritin (OR = 1.004, CI for OR 1.001-1.006, p = 0.003), and D-dimer (OR = 2.171, CI for OR 1.183-3.984, p = 0.012) were associated with lower HDL-C level in children with COVID-19.
Conclusion:
Low HDL-C levels were common in children with COVID-19. Children with COVID-19 and low HDL-C were more frequently hospitalised and had higher inflammatory biomarkers of COVID-19 than children with COVID-19 and normal HDL-C levels.
Key Words:
HDL-C, HDL-C levels in children, COVID-19, Children with COVID-19.
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