Dyslipidemia & COVID-19 – How are the two related?

Saptaparna Dasgupta, Bennett University

Determination of the risk factors of COVID-19 has turned out to be crucial in analyzing the constant increase in the number of cases and the following deaths that occurred. Coping up with this disastrous pandemic, dyslipidemia (abnormal fat and lipid levels in blood) has turned out to be a common complication in patients with COVID-19. However, the coherence of dyslipidemia associated with severity and mortality of COVID-19 still remains to be unclear. In such a present condition where conclusions remain unclear, a recent study was carried out by Liu et al. that aimed to study the association of dyslipidemia with severity and mortality of COVID-19.

COVID-19 patients with dyslipidemia:

SARS-CoV-2 is reported to be the third-highest pathogenic virus, from the coronavirus family after SARS and MERS. Patients suffering from SARS-CoV-2 show various symptoms such as fever, bilateral interstitial pneumonia, terminal organs failure, etc. Dyslipidemia is observed as a common complication amongst patients suffering from COVID-19. It is associated with a reduction in the level of cholesterol and low-density lipoprotein cholesterol (LDL-C) amongst the patients suffering from COVID-19. It indicates the pathophysiological interaction between the metabolism of lipids and vascular diseases in COVID-19 patients. As the relation between dyslipidemia and COVID-19 has not yet been established, a meta-analysis was conducted for the establishment of a better understanding of features of COVID-19 patients with dyslipidemia.

The Study:

Using several search terms (keywords) related to COVID-19 and dyslipidemia, high-quality evidence was collected from various databases namely PubMed, Embassy, MEDLINE, etc. were collected. Considering several parameters, the collected sample swab from patients tested positive for COVID-19. The selection criteria was based on either of the following listed parameters:

• Arterial oxygen partial pressure ≤ 300 mmHg
• Level of oxygen saturation ≤ 93% when indoor air at rest
• Respiratory rates ≥ 30 breaths per minute
• Patients requiring intensive care unit
• Critical condition of patients/death

Two separate meta-analyses were conducted, wherein, the primary study was based on the relationship between dyslipidemia and severity of COVID-19. On the other hand, the secondary study was based on the association between dyslipidemia and mortality of COVID-19. The extraction and analysis of data were done by three researchers individually. The analysis was based on scoring the observations on a scoring method on the scale of 0-9, known as the Newcastle Ottawa scale. On this scale, 0 is of the lowest and 9 is of the highest quality, respectively. The analysis was conducted using Stata 13.1 software, wherein, forest plot was used in the determination of the severity and mortality of COVID-19 with and without dyslipidemia. Statistical significance was used for the quantitative estimation of the data based on the association of dyslipidemia with severity and mortality of COVID-19.

Results:

The results obtained were based on the study records collected from 12,995 patients with COVID-19 were included for meta-analysis for the assessment of mortality and severity (Table 1). Comparing the patients without dyslipidemia, it was observed that the patients with dyslipidemia were at a higher risk in terms of death. Results reveal that dyslipidemia was associated with mortality of COVID-19 as well.

Discussion and Conclusion:

COVID-19 is more severe and has a higher death rate due to dyslipidemia. Endothelial cell pyroptosis and apoptosis were found to be the source of lung damage in COVID-19 patients. Lowering cholesterol levels reduces the severity of vascular disease, maintaining endothelial cell integrity. Low lipid levels are most likely the consequence of SARS-CoV-2 infection’s complicated biological and clinical processes. The typical alterations in the acute phase response found in many other inflammatory diseases, such as acute coronary syndromes, might stand as an explanation for this characteristic. The severity and mortality of COVID-19 are linked to dyslipidemia.

The primary drawback is the absence of large-scale randomized controlled studies. The number of studies considered was few, which may have influenced the accuracy of the analysis. All of the research that was included, however, followed national or international standards. Finally, the meta-analysis revealed that dyslipidemia may be used as a predictor of COVID-19 severity and mortality. COVID-19 individuals may benefit from active blood lipid control and lipid level monitoring.

Also read: A Non-invasive MRI technique for children

Reference:

1. Liu, Y., Pan, Y., Yin, Y., Chen, W., & Li, X. (2021). Association of dyslipidemia with the severity and mortality of coronavirus disease 2019 (COVID-19): A meta-analysis. Virology Journal, 18(1), 157. https://doi.org/10.1186/s12985-021-01604-1

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Author info:

Saptaparna Dasgupta, currently a B. Tech 3^rd year student, pursuing Biotechnology, is a diligent student and determined in terms of her career goals. Being a budding biotechnologist, she is open to all research fields of her course and passionate about knowledge. She is focused and constantly tries to improve her writing skills, also a project enthusiast and is fond of gaining hands-on experience in laboratories. She believes that all hard work and efforts pays off eventually and follows this as the motto of her life.