Hyperlipidemia in Post-COVID patients; a unique observational follow-up study on lipid levels in post-COVID patients

Year 2022, Volume: 5 Issue: 1, 220 - 226, 17.01.2022

Oğuz Abdullah Uyaroğlu , Murat Özdede , Nursel Çalık Başaran , Bahadır Köylü Taha Koray Sahin , Lale Özışık , Mine Durusu Tanrıöver , Gülay Sain Güven

https://doi.org/10.32322/jhsm.1027661

Cited By: 4

Abstract

Aim: Alterations in plasma lipid levels have been shown to be correlated with the severity of infections due to various pathogens such as bacteria, viruses. In this study, we aimed to evaluate the lipid metabolism changes associated with disease severity and prognosis in hospitalized COVID-19 patients during and after (post-COVID) the disease.
Material and Method: Patients who were hospitalized in the COVID-19 wards between April 02, 2020, and November 20, 2020 and were then evaluated in the follow-up outpatient clinic were retrospectively searched.
Results:  Lipid levels were present at the admission and follow-up for 95 patients. The mean (S.D) age was 48.49 (16.4), and 49(51.6%) were male. The mean (S.D) day between the admission and the first visit in the COVID-19 follow-up outpatient clinic was 27.8 (12.8). LDL-C (p=0.044), and HDL-C (p=0.004) levels were significantly lower in the severely ill group at the admission. Total cholesterol, LDL-C, HDL-C, and triglyceride levels on follow-up were significantly higher than those levels on the admission day (p<0.001). Delta (Follow up-Admission) levels LDL-C, total cholesterol and triglyceride levels were significantly high in patients who have received steroid therapy. Only delta LDL-C was significantly high in patients who require Intensive Care Unit.
Conclusions: Dyslipidemia is observed in COVID-19 patients both during the disease and in the post-COVID period. Our findings also support the evidence demonstrating that low LDL-C and/or HDL-C levels can increase the risk of developing severe infections, also in COVID-19. The dynamics of lipid profiles before/during and after the entire disease course should be monitorized.

Keywords

COVID-19, dyslipidemia, hyperlipidemia, post-COVID, Long-COVID

References

• Feingold KR, Grunfeld C. The Effect of Inflammation and Infection on Lipids and Lipoproteins. In: Feingold KR, Anawalt B, Boyce A, Chrousos G, et al. (eds). 2019 Jan 8. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-.
• Qin C, Minghan H, Ziwen Z, Yukun L. Alteration of lipid profile and value of lipids in the prediction of the length of hospital stay in COVID-19 pneumonia patients. Food Sci Nutr 2020; 8: 6144-52.
• Alvarez C, Ramos A. Lipids, lipoproteins, and apoproteins in serum during infection. Clin Chem 1986; 32: 142–5.
• Filippas-Ntekouan S, Liberopoulos E, Elisaf M. Lipid testing in infectious diseases: possible role in diagnosis and prognosis. Infection 2017; 45: 575-588.
• Grion CM, Cardoso LT, Perazolo TF, et al. Lipoproteins and CETP levels as risk factors for severe sepsis in hospitalized patients. Eur J Clin Invest 2010; 40: 330-8.
• Li Y, Zhang Y, Lu R, et al. Lipid metabolism changes in patients with severe COVID-19. Clin Chim Acta 2021; 517: 66-73.
• Henry BM, Szergyuk I, de Oliveira MHS, et al. Alterations in the lipid profile associate with a dysregulated inflammatory, prothrombotic, anti-fibrinolytic state and development of severe acute kidney injury in coronavirus disease 2019 (COVID-19): A study from Cincinnati, USA. Diabetes Metab Syndr 2021; 15: 863-8.
• Hu X, Chen D, Wu L, He G, Ye W. Declined serum high density lipoprotein cholesterol is associated with the severity of COVID-19 infection. Clin Chim Acta 2020; 510: 105-10.
• Wang G, Zhang Q, Zhao X, et al. Low high-density lipoprotein level is correlated with the severity of COVID-19 patients: an observational study. Lipids Health Dis 2020; 19: 204.
• Masana L, Correig E, Ibarretxe D, et al; STACOV-XULA research group. Low HDL and high triglycerides predict COVID-19 severity. Sci Rep 2021; 11: 7217.
• Bai Y, Huang W, Li Y, et al. Lipidomic alteration of plasma in cured COVID-19 patients using ultra high-performance liquid chromatography with high-resolution mass spectrometry. Biosci Rep 2021; 41: BSR20204305.
• Li G, Du L, Cao X, et al. Follow-up study on serum cholesterol profiles and potential sequelae in recovered COVID-19 patients. BMC Infect Dis 2021; 21: 299.
• World Health Organization. Clinical management of severe acute respiratory infection (SARI) when COVID-19 disease is suspected: interim guidance, 13 March 2020. World Health Organization. [Accessed 14 April 2020]. URL: https://apps.who.int/iris/handle/10665/331446.
• Fessler MB, Summer RS. Surfactant lipids at the host-environment interface. metabolic sensors, suppressors, and effectors of inflammatory lung disease. Am J Respir Cell Mol Biol 2016; 54: 624-35.
• Gowdy KM, Fessler MB. Emerging roles for cholesterol and lipoproteins in lung disease. Pulm Pharmacol Ther 2013; 26: 430-7.
• Apostolou F, Gazi IF, Lagos K, et al. Acute infection with Epstein-Barr virus is associated with atherogenic lipid changes. Atherosclerosis 2010; 212: 607-13.
• Fleck-Derderian S, McClellan W, Wojcicki JM. The association between cytomegalovirus infection, obesity, and metabolic syndrome in U.S. adult females. Obesity (Silver Spring) 2017; 25: 626-33.
• Biswas HH, Gordon A, Nuñez A, Perez MA, Balmaseda A, Harris E. Lower low-density lipoprotein cholesterol levels are associated with severe dengue outcome. PLoS Negl Trop Dis 2015; 9: e0003904.
• Wan J, Sun W, Li X, et al. Inflammation inhibitors were remarkably up-regulated in plasma of severe acute respiratory syndrome patients at progressive phase. Proteomics 2006; 6: 2886-94.
• Wu Q, Zhou L, Sun X, et al. Altered lipid metabolism in recovered SARS patients twelve years after infection. Sci Rep 2017; 7: 9110.
• Wang H, Yuan Z, Pavel MA, et al. Cholesterol and COVID19 lethality in elderly. bioRxiv 2020; 086249.
• Cao X, Yin R, Albrecht H, Fan D, Tan W. Cholesterol: a new game player accelerating vasculopathy caused by SARS-CoV-2? Am J Physiol Endocrinol Metab 2020; 319: E197-E202.
• Wei X, Zeng W, Su J, et al. Hypolipidemia is associated with the severity of COVID-19. J Clin Lipidol 2020; 14: 297-304.
• McGurnaghan SJ, Weir A, Bishop J, et al. Risks of and risk factors for COVID-19 disease in people with diabetes: a cohort study of the total population of Scotland. Lancet Diabetes Endocrinol 2021; 9: 82-93.
• Fan J, Wang H, Ye G, et al. Letter to the Editor: Low-density lipoprotein is a potential predictor of poor prognosis in patients with coronavirus disease 2019. Metabolism 2020; 107: 154243.