Altered Lipid Profile is a Risk Factor for the Progression Andrecurrenceof COVID-19: From Two Retrospective Cohorts

Abstract Background The COVID-19 pandemic has spread worldwide. However, the impact of lipid profile and lipid-lowering treatment on clinical endpoints in COVID-19 have not previously been investigated. Methods In this retrospective, multicenter cohort study, we consecutively enrolled 430 adult COVID-19 patients from two Chinese hospitals (one each in Chengdu and Wuhan) admitted during February 2020 and followed-up until April 30. Demographic, metabolic profile, laboratory, treatment and clinical endpoint data including in-hospital death and recurrence of COVID-19, were collected. Results In Chengdu patients, univariable and multivariable Cox regression showed that the low-density lipoprotein cholesterol (LDL-C) dyslipidemia on admission was associated with the recurrence of COVID-19 during the follow-up period. In Wuhan cohort, the patients with triglycerides hyperlipemia had an increased risk of in-hospital death. However, in both cohorts, statin therapy during COVID-19 course did not affect these clinical endpoints. Compared to the Chengdu cohort, the Wuhan patients tended to have more severe COVID-19 but, unexpectedly, had lower levels of serum lipid. It is of interesting to notice that the relationship between the observed biomarkers of inflammation and lipid do not match the relationship between the organ function measures and this lipid. Conclusions The baseline dyslipidemia should be considered as a risk factor for poor prognosis and recurrence of COVID-19. The lipid level may be altered during COVID-19 course, since lipidology may be distinctly affected by both inflammation and organic damage for SARS-CoV-2. Further investigation is needed on the role of use of lipid-lowering therapy among patients with COVID-19 infections.