COVID-19-associated dyslipidemia: the role of lipid and fatty acids in the pathogenesis of SARS-CoV-2 infection

Abstract

Introduction. The COVID-19 pandemic is a global public health problem. In COVID-19, systemic inflammation is accompanied by a “cytokine storm”, hypercoagulability, and generalized vasculitis, and new evidence suggests that lipid transportation disorders may exacerbate the course of the disease. Aim. Discussion of the role of lipids, fatty acids, and various cascade molecular pathways in the pathogenesis of COVID-19-associated dyslipidemia. Results. When conducting a systematic analysis of the scientific literature in the PubMed database, we concluded the following: lipoproteins, oxidized forms of phospholipids and fatty acids can lead to organ damage due to hyperactivation of scavenger of the innate immune response. Thus, restoring lipoprotein function with agents that increase apolipoprotein A-I levels or blocking the relevant scavenger receptors with neutralizing antibodies may be effective in the treatment of COVID-19. The key role of lipoprotein-transported omega-3 fatty acids in the production of specialized proreactive mediators has been demonstrated, and activation of the leukotriene pathway has been shown to be associated with the severity of COVID-19. Conclusion. A growing number of scientific studies indicates that lipid and fatty acids have both positive and negative effects in SARS-CoV-2 infection. Additional studies or preclinical models evaluating the eicosanoid profile in patients with COVID-19 will provide new insights into the interaction of the coronavirus with “the host” and the regulation of the inflammatory response.