HDL particles may act to buffer host cells from excessive inflammatory mediators. The aim of this study is to investigate if the lipid profile provides a prognostic biomarker for COVID-19 outcomes.
This was a prospective study of the characteristics of 125 adult COVID-19 patients with a lipid profile performed on the day of admission analyzed with regard to clinical outcomes.
Seventy-seven patients (61.2%) were men, with a mean age of 66.3 (15.6) years. 54.1% had bilateral pneumonia. The all-cause mortality rate during hospitalization was 20.8%. We found a direct association between more severe disease assessed by the WHO classification, admission to the ICU and death with more pronounced lymphopenia, higher levels of CRP, ferritin ( p < 0.001), D-dímer and lactate dehydrogenase (LDH) all statistically significant. Lower leves of HDL-c and LDL-c were also associated with a worse WHO classification, ICU admission, and death,. HDL-c levels were inversely correlated with inflammatory markers CRP ( r = −0.333; p < 0.001), ferritin ( r = −0.354; p < 0.001), D-dímer ( r = −0.214; p < 0.001), LDH ( r = −0.209; p < 0.001. LDL-c levels were significantly associated with CRP ( r = −0.320; p < 0.001) and LDH ( r = −0.269; p < 0.001). ROC curves showed that HDL [AUC = 0.737(0.586–0.887), p = 0.005] and lymphocytes [AUC = 0.672(0.497–0.847], p < 0.043] had the best prognostic accuracy to predict death. In a multivariate analysis, HDL-c (β = −0.146(0.770–0.971), p = 0.014) and urea (β = 0.029(1.003–1.057), p = 0.027) predicted mortality.
125 patients with a lipid profile at admission were included from the first wave of COVID disease.
Need of ICU admission and mortality was associated to lower levels of HDL-c and LDL-c.
HDL-c levels were inversely correlated with the inflammatory markers associated with the “cytokine storm”.
HDL-c at admission identifes patients with a higher risk of death and a worse prognostic course.