Hypolipidemia is associated with the severity of COVID-19

Wei, Xiuqi; Zeng, Wenjuan; Su, Jingyu; Wan, Huimin; Yu, Xinqin; Cao, Xiaoling; Tan, Wenbin; Wang, Hui

Abstract Background Many patients with coronavirus disease 2019 (COVID-19) suffer multiple organ dysfunctions. However, whether patients develop dyslipidemia is unknown. Objective In this study, we aimed to investigate the pathological alterations of low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c), and total cholesterol (TC) in COVID-19 patients and their relationships with the disease severity. Methods A retrospective study was performed to examine serum levels of LDL-c, HDL-c, and TC on 597 COVID-19 patients (mild: 394; severe, 171; critical: 32) who were hospitalized in our center between February 1 and March 3, 2020. Age and gender-matched normal subjects (n=50) who had routine laboratory lipid tests between October 1 and November 1, 2019 in our center were included as the control group. Results LDL-c and TC levels were significantly lower in COVID-19 patients as compared with normal subjects (p<0.001). There were significant and gradual decreases in levels of LDL-c (median (IQR) in mg/dL, mild: 91 (76, 104); severe 86 (69, 102); critical: 69 (48, 81); p<0.02) and TC (mild: 173 (148, 203); severe 167 (138, 197); critical: 125 (95, 162); p<0.05) across all three groups. HDL-c levels only decreased significantly in critical cases as compared to levels in mild and severe cases. LDL-c and TC levels inversely correlated with C-reactive protein and IL-6, and positively correlated with the number of lymphocytes in patients. Conclusions Development of hypolipidemia starts in patients with mild symptoms. It progressively becomes worse in an association with the disease severity.