Comparative analysis of the course and outcomes of a new coronavirus infection depending on the level of high-density lipoproteins in hospitalized patients with COVID-19

Abstract

Aim of the study was to analyze the course and outcomes of a new coronavirus infection depending on the level of high-density lipoproteins in hospitalized patients with COVID-19.Material and methods. A retrospective analysis of the medical histories of 208 patients hospitalized with a diagnosis of COVID-19 was carried out. Depending on the level of high-density lipoproteins (HDL), patients were divided into 2 groups: group 1 – patients with «low» HDL < 0.83 mmol/l, group 2 – patients with «high» HDL ≥ 0.83 mmol/l. The relationship between HDL levels measured at the beginning of hospitalization and the severity of the course and outcomes of coronavirus infection was evaluated. The primary endpoint was nosocomial death, secondary points: the development of complications of coronavirus infection, the duration of hospitalization, the duration of fever, the duration of stay in the intensive care unit (ICU).Results. In hospitalized patients with COVID-19, lipid profile disorders were observed in the form of a decrease in HDL (<1.0 mmol/l) in 62 % of cases. A «low» HDL level (<0.83 mmol/l) was associated with a more unfavorable course of coronavirus infection in the hospital in the form of a larger volume of lung damage both at admission and at discharge (40 % [32; 54] vs. 32 % [24; 40], p < 0.001 and 40 % [28; 52] vs. 32 % [28; 44] p = 0.018, respectively), the development of complications such as «cytokine storm» (17 % vs. 22 %, p = 0.03), acute kidney injury (10 % vs. 16 %, p = 0.007). When analyzing secondary points, it was found that in patients of group 1 («low» HDL level), in comparison with patients of group 2 («high» level) the fever period was longer (10 [7; 12] days vs. 8.5 [7; 10] days, p = 0.04), the period of stay in the ICU (0 [0; 1] days vs. 0 [0; 0] days, p = 0.03) and the duration of hospitalization was longer (9 [7; 12] days vs. 8,6 [7; 12] days, p < 0.001).The primary endpoint – hospital mortality was statistically significantly higher in patients with initially reduced HDL levels (<0.83 mmol/l) (13 % vs. 8 %, p = 0.013).Conclusions. In hospitalized patients, the level of HDL <0.83 mmol/l at the beginning of hospitalization was associated with a more severe course of coronavirus infection in the subsequent and an increase in hospital mortality.