Abstract
Background and aims: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the sole causative agent of coronavirus infectious disease-19 (COVID-19).
Methods and results: We performed a retrospective single-center study of consecutively admitted patients between March 1st and May 15th , 2020, with a definitive diagnosis of SARS-CoV-2 infection. The primary end-point was to evaluate the association of lipid markers with 30-days all-cause mortality in COVID-19. A total of 654 patients were enrolled, with an estimated 30-day mortality of 22.8% (149 patients). Non-survivors had lower total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-c) levels during the entire course of the disease. Both showed a significant inverse correlation with inflammatory markers and a positive correlation with lymphocyte count. In a multivariate analysis, LDL-c ≤ 69 mg/dl (hazard ratio [HR] 1.94; 95% confidence interval [CI] 1.14-3.31), C-reactive protein >88 mg/dl (HR 2.44; 95% CI, 1.41-4.23) and lymphopenia <1000 (HR 2.68; 95% CI, 1.91-3.78) at admission were independently associated with 30-day mortality. This association was maintained 7 days after admission. Survivors presented with complete normalization of their lipid profiles on short-term follow-up.
Conclusion: Hypolipidemia in SARS-CoV-2 infection may be secondary to an immune-inflammatory response, with complete recovery in survivors. Low LDL-c serum levels are independently associated with higher 30-day mortality in COVID-19 patients.
Keywords: COVID-19; Coronavirus; High-density lipoprotein; Inflammation; Low-density lipoprotein; SARS-CoV-2; Total cholesterol; Triglycerides.
【저자키워드】 COVID-19, SARS-CoV-2, Inflammation, coronavirus, High-density lipoprotein, Low-density lipoprotein, Total cholesterol, triglycerides, 【초록키워드】 severe acute respiratory syndrome coronavirus 2, coronavirus, SARS-COV-2 infection, inflammatory markers, C-reactive protein, severe acute respiratory syndrome Coronavirus, lymphopenia, Lymphocyte count, lymphocyte, Survivors, Patient, Inflammatory marker, cholesterol, LDL-C, Follow-up, respiratory, Admission, patients, COVID-19 patients, association, Multivariate analysis, 30-Day mortality, marker, High-density lipoprotein, Low-density lipoprotein, Total cholesterol, retrospective, Analysis, triglycerides, causative agent, secondary to, Admitted Patient, complete recovery, Low-Density Lipoprotein cholesterol, Non-survivors, acute respiratory syndrome, 95% CI, acute respiratory syndrome coronavirus, Serum level, 95% confidence interval, profile, hazard ratio, positive correlation, all-cause mortality, single-center study, inverse correlation, primary end-point, definitive diagnosis, Complete, Course, enrolled, performed, evaluate, the disease, Total, 【제목키워드】 Clinical outcome, Low-density lipoprotein,