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. 2021 Mar 24:14:1179551421990675.
doi: 10.1177/1179551421990675. eCollection 2021.

Dyslipidemia Increases the Risk of Severe COVID-19: A Systematic Review, Meta-analysis, and Meta-regression

Indriwanto Sakidjan Atmosudigdo  1 , Michael Anthonius Lim  2 , Basuni Radi  1 , Joshua Henrina  3 , Emir Yonas  4 , Rachel Vania  2   5 , Raymond Pranata  2
Affiliations

Dyslipidemia Increases the Risk of Severe COVID-19: A Systematic Review, Meta-analysis, and Meta-regression

Indriwanto Sakidjan Atmosudigdo et al. Clin Med Insights Endocrinol Diabetes. .

Abstract

Objective: This systematic review and meta-analysis aimed to evaluate whether dyslipidemia affects the mortality and severity of COVID-19, we also aimed to evaluate whether other comorbidities influence the association.

Methods: A systematic literature search using PubMed, Embase, and EuropePMC was performed on 8 October 2020. This study's main outcome is a poor composite outcome, comprising of mortality and severe COVID-19.

Results: There were 9 studies with 3663 patients. The prevalence of dyslipidemia in this pooled analysis was 18% (4%-32%). Dyslipidemia was associated with increased composite poor outcome (RR 1.39 [1.02, 1.88], P = .010; I 2: 56.7%, P = .018). Subgroup analysis showed that dyslipidemia was associated with severe COVID-19 (RR 1.39 [1.03, 1.87], P = .008; I 2: 57.4%, P = .029). Meta-regression showed that the association between dyslipidemia and poor outcome varies by age (coefficient: -0.04, P = .033), male gender (coefficient: -0.03, P = .042), and hypertension (coefficient: -0.02, P = .033), but not diabetes (coefficient: -0.24, P = .135) and cardiovascular diseases (coefficient: -0.01, P = .506). Inverted funnel-plot was relatively symmetrical. Egger's test indicates that the pooled analysis was not statistically significant for small-study effects (P = .206).

Conclusion: Dyslipidemia potentially increases mortality and severity of COVID-19. The association was stronger in patients with older age, male, and hypertension.PROSPERO Registration Number: CRD42020213491.

Keywords: COVID-19; coronavirus; dyslipidemia; hyperlipidemia; prognosis.

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Conflict of interest statement

Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
PRISMA flowchart.
Figure 2.
Figure 2.
Dyslipidemia and poor outcome.
Figure 3.
Figure 3.
Dyslipidemia and severe COVID-19.
Figure 4.
Figure 4.
Meta-regression analysis. Covariates: age (a), male gender (b), and hypertension (c).
Figure 5.
Figure 5.
Inverted funnel plot analysis.
See this image and copyright information in PMC

References

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