Association Analysis of Hyperlipidemia with the 28-Day All-Cause Mortality of COVID-19 in Hospitalized Patients

Abstract

Objective This study aimed to determine the association of hyperlipidemia with clinical endpoints among hospitalized patients with COVID-19, especially those with pre-existing cardiovascular diseases (CVDs) and diabetes. Methods This multicenter retrospective cohort study included all patients who were hospitalized due to COVID-19 from 21 hospitals in Hubei Province, China between December 31, 2019 and April 21, 2020. Patients who were aged < 18 or ≥ 85, in pregnancy, with acute lethal organ injury (e.g., acute myocardial infarction, severe acute pancreatitis, or acute stroke), hypothyroidism, malignant diseases, severe malnutrition, and those with normal lipid profile undertaking lipid-lowering medicines (e.g., statin, niacin, fenofibrate, or gemfibrozil, ezetimibe) were excluded. Propensity score-matching (PSM) analyses at 1:1 ratio were performed to minimize baseline differences between patient groups of hyperlipidemia and non-hyperlipidemia. PSM analysis with the same strategies were further conducted for the parameters of hyperlipidemia in patients with increased triglyceride (TG), increased low-density lipoprotein cholesterol (LDL-C), and decreased high-density lipoprotein cholesterol (HDL-C). Mixed-effect Cox model analysis were used to investigate the associations between the 28-days all cause deaths of COVID-19 patients with hyperlipidemia and the abnormalities of lipid parameters. The results were verified in male, female patients, and in patients with pre-existing CVDs and type 2 diabetes. Results Of 10,945 inpatients confirmed as COVID-19, there were 9822 inpatients included in the study, comprising 3,513 (35.8%) cases without hyperlipidemia and 6,309 (64.2%) cases with hyperlipidemia. Based on a mixed-effect Cox model after PSM at 1:1 ratio, hyperlipidemia was not associated with increased or decreased 28-day all-cause death (adjusted HR, 1.17 [95% CI, 0.95-1.44], P =0.151). We found that the parameters of hyperlipidemia were not associated

Patients with COVID-19 Infection and Stroke have Higher than Expected Mortality, Regardless of the Primary Presentation

“…While previous studies found that hyperlipidemia is not significantly associated with all-cause mortality in COVID-19 patients, it in combination with COVID-19 may specifically predispose patients to hemorrhagic stroke. 21 Second, in contrast with previous studies, we did not find hemorrhagic stroke to be more common in patients with pre-existing hypertension and diabetes mellitus prior to COVID-19 infection. 22 Third, in the COVID-first cohort (N=45), the use of heparin prior to the stroke event showed no significant correlation with mortality (p=1.000) or type of stroke (p=0.321).…”

Hyperlipidemia, COVID-19 and acute pancreatitis: A tale of three entities

“…Thirty-four papers were reviewed after screening, which reported the incidence of hyperlipidemia in COVID-19 patients ( Table 2 ). 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 The incidence of hyperlipidemia ranged from 0.30% to 81.82% in COVID-19 patients among different studies. Potential reasons for the variations could be: 1) Regional factors led to the difference in baseline lipids levels; 2) The definition of hyperlipidemia varied in different studies.…”

COVID-19, dyslipidemia and familial hypercholesterolemia: an up-date

“…However, another study analyzing the association of hyperlipidemia with overall mortality within 28 days of COVID-19 in hospitalized patients did not show evidence that an unbalanced lipid profile would be significantly associated with allcause mortality, even in patients with cardiovascular diseases (CVDs) and previous diabetes mellitus. Therefore, hyperlipidemia would not be the main risk factor for the severity of COVID-19, but a contributing factor for worse outcomes (Wu et al, 2021).…”