High-density lipoproteins may play a crucial role in COVID-19

Abstract

Background Lipids play a central role in the virus life cycle and are a crucial target to develop antiviral therapeutics. Importantly, among the other lipoproteins, the ‘good cholesterol’ high-density lipoprotein (HDL) has been widely studied for its role in not only cardiovascular but several infectious diseases as well. Studies have suggested a role of serum lipids and lipoproteins including HDL, total cholesterol (TC), triglycerides (TG), and low-density lipoproteins (LDL) in several viral infections including COVID-19. This disease is currently a major public health problem and there is a need to explore the role of these host lipids/lipoproteins in virus pathogenesis. Methodology A total of 75 retrospective COVID-19 positive serum samples and 10 COVID-19 negative controls were studied for their lipid profiles including TC, HDL, LDL, and very-low-density lipoproteins (VLDL), and TG. Results Systematic literature search on dyslipidemia status in India shows that low HDL is the most common dyslipidemia. In this cohort, 65% (49) of COVID-19 patients had severely low HDL levels whereas 35% (26) had moderately low HDL and none had normal HDL levels. On the other hand, ~ 96% of samples had normal TC (72) and LDL (72) levels. VLDL and TG levels were also variable. In the controls, 100% of samples had moderately low HDL but none severely low HDL levels. Conclusion HDL likely plays a crucial role in COVID-19 infection and outcomes. The causal relationships between HDL levels and COVID-19 need to be studied extensively for an understanding of disease pathogenesis and management.

Low High-Density Lipoprotein Level Associated With Enhanced Inflammatory Response and One-Year Persistence of Long Covid in Patients Undergoing Hemodialysis: A Cross-Sectional Cohort Study

“…The observed association between low HDL levels and an augmented inflammatory response in HD patients with long COVID underscores the intricate interplay between dyslipidemia, chronic inflammation, and the lingering effects of SARS-CoV-2 infection. The significant decrease in HDL levels observed in HD patients with long COVID is consistent with prior research in the general population, emphasizing the influence of COVID-19 on lipid metabolism [8][9][10]. Similar results were reported in the HD population evaluating the impact of pre-existing HDL levels and immediate COVID-19 outcomes [11].…”

“…Emerging evidence implicates dyslipidemia, particularly low levels of high-density lipoprotein (HDL), is linked to heightened susceptibility to COVID-19, increased cardiovascular risks, elevated infection severity, and higher mortality rates in the general population [8][9][10]. In addition, our previous report has shown that low HDL levels before the onset of infection are independently associated with COVID-19 morbidity, severity and mortality in patients undergoing HD [11].…”

Management of dyslipidemia in special groups

“…In the controls (10 COVID-19 negative controls), 100% of samples had moderately low HDL but none severely low HDL levels. 48 More studies are needed to establish the cause…”

HDL-Related Parameters and COVID-19 Mortality: The Importance of HDL Function

“…Several studies have investigated the relationship between HDL cholesterol levels and COVID-19 outcomes [22][23][24][25][26][27]. Specifically, low levels of plasma HDL cholesterol and alterations in HDL composition have been associated with increased disease severity and worse clinical outcomes in COVID-19 patients [28,29].…”