High-density lipoprotein cholesterol as a factor affecting virus clearance in covid-19 patients

Ding, Xinmin; Zhang, Jie; Liu, Lifei; Yuan, Xiaodong; Zang, Xuefeng; Lu, Feiping; He, Ping; Wang, Qian; Zhang, Xiaomeng; Xu, Yimin; Li, Xiang; Liu, Ying; Li, Qun; Tan, Xuebing; Zheng, Yunhui; Lin, Xue; Liu, Yuhang

OBJECTIVE: There were COVID-19 patients with SARS-COV-2 nucleic acid long-term positive. This article aims to understand the relevant factors that affect SARS-COV-2 clearance time. METHODS: The clinical data of 115 COVID-19 patients with SARS-COV-2 nucleic acid positive time exceeding 14 days were collected retrospectively, and the relationship between clinical characteristics, chest CT scans, blood cells, biochemical indicators, and the time of viral nucleic acid turning negative were analyzed. RESULTS: The time from symptom onsets to nucleic acid turning negative was (32.5 ± 8.7) days in this group of patients. The time of nucleic acid turning negative: no fever group was longer than fever group, diabetes group was longer than no comorbidity group, elevated levels of ALT (alanine aminotransferase), or GLU (fasting blood glucose) group, decreased levels of ALB (albumin) group or HDLC (high-density lipoprotein cholesterol) group was longer than it's normal group separately (P < 0.05). Cox multivariate regression analysis showed that ALT [odds ratio (OR): 2.164 (95% CI: 1.276–3.670), P = 0.004], GLU [OR: 2.064 (95% CI: 1.195–3.566), P = 0.009] and HDLC [OR: 0.527 (95% CI: 0.307–0.907), P = 0.021] were independent factors which affected the time of nucleic acid turning negative. CONCLUSIONS: ALT, GLU and HDLC were independent factors that influenced the time of nucleic acid turning negative. Although diabetes or hyperglycemia is a known risk factor, HDLC is the first to be identified, clinicians should be aware of dyslipidemia in covid-19 patients.