Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Mar 30;11(1):7217.
doi: 10.1038/s41598-021-86747-5.

Low HDL and high triglycerides predict COVID-19 severity

Lluís Masana  1 , Eudald Correig  2 , Daiana Ibarretxe  3 , Eva Anoro  4 , Juan Antonio Arroyo  5 , Carlos Jericó  6 , Carolina Guerrero  7 , Marcel la Miret  8 , Silvia Näf  9 , Anna Pardo  10 , Verónica Perea  11 , Rosa Pérez-Bernalte  12 , Núria Plana  3 , Rafael Ramírez-Montesinos  13 , Meritxell Royuela  14 , Cristina Soler  15 , Maria Urquizu-Padilla  16 , Alberto Zamora  17 , Juan Pedro-Botet  18 ; STACOV-XULA research group
Collaborators, Affiliations

Low HDL and high triglycerides predict COVID-19 severity

Lluís Masana et al. Sci Rep. .

Abstract

Lipids are indispensable in the SARS-CoV-2 infection process. The clinical significance of plasma lipid profile during COVID-19 has not been rigorously evaluated. We aim to ascertain the association of the plasma lipid profile with SARS-CoV-2 infection clinical evolution. Observational cross-sectional study including 1411 hospitalized patients with COVID-19 and an available standard lipid profile prior (n: 1305) or during hospitalization (n: 297). The usefulness of serum total, LDL, non-HDL and HDL cholesterol to predict the COVID-19 prognosis (severe vs mild) was analysed. Patients with severe COVID-19 evolution had lower HDL cholesterol and higher triglyceride levels before the infection. The lipid profile measured during hospitalization also showed that a severe outcome was associated with lower HDL cholesterol levels and higher triglycerides. HDL cholesterol and triglyceride concentrations were correlated with ferritin and D-dimer levels but not with CRP levels. The presence of atherogenic dyslipidaemia during the infection was strongly and independently associated with a worse COVID-19 infection prognosis. The low HDL cholesterol and high triglyceride concentrations measured before or during hospitalization are strong predictors of a severe course of the disease. The lipid profile should be considered as a sensitive marker of inflammation and should be measured in patients with COVID-19.

PubMed Disclaimer

Conflict of interest statement

L. Masana: Has received personal fees for lectures and/or advisory work from Amgen, Sanofi, Mylan, Servier, MSD, Novartis, and Daiichi-Sankyo.N. Plana: Personal fees for lectures from Amgen, Mylan, and Sanofi. J. Pedro-Botet: Personal fees for lectures and/or advisory work from Amgen, Astra-Zeneca, Esteve, Ferrer, MSD, Mylan, Sanofi, Servier, and Rovi. C. Soler: Personal fees for lectures from Almirall, MSD, VISO farmacèutica, Mylan, and Esteve. M. Miret: Personal fees for lectures and/or advisory work from Sanofi, Novartis, Novonordisk, Astra-Zeneca, Esteve, Lilly, MSD, Ferrer, and Janssen, C. Jericó: Personal fees for lectures and/or advisory work from Sanofi, Amgen, MSD, Ferrer, Astra-Zeneca, Boehringer-Ingelheim, Lilly, Esteve, Novo-Nordisk, and Rovi. D. Ibarretxe: Personal fees for lectures from Sanofi, Rubió.E. Anoro, E. Correig, A. Pardo, C. Guerrero, S. Naf, JA. Arroyo, M. Urquizu-Padilla, V. Perea, R. Pérez-Berbalte, R. Ramirez-Montesinos, M. Royuela, and A. Zamora: Declare no conflicts of interest.

Figures

Figure 1
Figure 1
Distribution of patients included in the study according lipid profile availability.
Figure 2
Figure 2
Box plot depicting lipid values obtained during COVID 19 hospitalization sorted according clinical severity.
Figure 3
Figure 3
Percentage variation of mean (SD) lipid values in the group with data before and during hospitalization sorted by COVID-19 severity. TC total cholesterol, TG triglycerides; *p < 0.001.
Figure 4
Figure 4
Distribution of patients according HDL-C and TG concentrations and COVID-19 severity. The upper left square shows that only severe patients were in the low HDL-C, high triglyceride area.
Figure 5
Figure 5
(a) Plot depicting the out of bag importance of each analysed variable on COVID-19 random forest model. P values of the variables of interest according a variable permutation analysis: Ferritin: 0.017; CRP: 0.009; D-Dimer: < 0.001; triglycerides: 0.006; HDL-C: 0.019; LDL-C: 0.026; Body mass index: 0.008; age: < 0.001; total cholesterol:  < 0.001; non-HDL-C: < 0.001. (b) Coefficients for regularized classification model of severity applicable to (a) data indicating the direction of the effect.
See this image and copyright information in PMC

References

    1. Grasselli G, et al. Baseline characteristics and outcomes of 1591 patients infected with SARS-CoV-2 admitted to ICUs of the Lombardy region Italy. JAMA. 2020;323:1574–1581. doi: 10.1001/jama.2020.5394. - DOI - PMC - PubMed
    1. Ji W, et al. Effect of underlying comorbidities on the infection and severity of covid-19 in Korea: a nationwide case-control study. J. Korean Med. Sci. 2020;35:1–15. doi: 10.3904/kjim.2019.317. - DOI - PMC - PubMed
    1. Richardson S, et al. Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with covid-19 in the New York city area. JAMA. 2020;323:2052–2059. doi: 10.1001/jama.2020.6775. - DOI - PMC - PubMed
    1. Choi GJ, Kim HM. The potential role of dyslipidemia in COVID-19 severity: An umbrella review of systematic reviews. J. Lipid Atheroscler. 2020;9:435–442. doi: 10.12997/jla.2020.9.3.435. - DOI - PMC - PubMed
    1. Wiersinga WJ, Rhodes A, Cheng AC, Peacock SJ, Prescott HC. Pathophysiology, transmission, diagnosis, and treatment of coronavirus disease 2019 (COVID-19): A review. JAMA. 2020;324:782–793. doi: 10.1001/jama.2020.12839. - DOI - PubMed

Publication types