Low-Density Lipoprotein Cholesterol Levels and Disease Severity in COVID-19 Pneumonia

Abstract

Objective: Pneumonia and acute respiratory distress syndrome are observed as major complications in Coronavirus disease-2019 (COVID-19). Cholesterol is a principal lipid component of the cell membranes. Lipoproteins have a fundamental role as the first line of defense against microbes. Lipoprotein levels are altered during viral infections. This study aimed to investigate the association between low-density lipoprotein cholesterol (LDL-C) levels and disease severity of patients hospitalized with COVID-19 pneumonia. Methods: This is a retrospective and observational study of 817 patients with Severe Acute Respiratory syndrome-Coronavirus-2 (SARS-CoV-2), who are diagnosed with COVID-19 using the real-time polymerase chain reaction and are hospitalized due to moderate and severe COVID-19 pneumonia. Results: Among 817 patients with COVID-19 pneumonia, 347 (42.5%) were moderate and 470 (57.5%) were severe. Total cholesterol (TC) and LDL-C levels reduced in patients who have severe condition than those with moderate condition (p=0.02, p=0.03, respectively). TC and LDL-C were negatively correlated with the hospitalization duration (r=-0.163, p=0.02, r=-0.154, p=0.03, respectively). Conclusion: Our results suggest a decreased LDL-C levels in patients with COVID-19 in relation to disease severity. Therefore, a strong link was found between lipid metabolism and SARS-CoV-2, which allow us to suggest LDL as a marker indicating COVID-19 severity in the near future.