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Higher HDL Cholesterol Levels Decrease Susceptibility to COVID-19 Infection

33 Pages Posted: 4 Apr 2022

See all articles by Vignesh Chidambaram

Vignesh Chidambaram

Johns Hopkins University - Department of Medicine; University of Arkansas for Medical Sciences - Department of Internal Medicine

Amudha Kumar

University of Arkansas for Medical Sciences; University of Arkansas for Medical Sciences - Department of Internal Medicine

Marie Gilbert Majella

Sri Venkateswara Medical College

Bhavna Seth

Johns Hopkins University - Division of Pulmonary and Critical Care Medicine

Ranjith Kumar Sivakumar

Prince of Wales Hospital - The Chinese University of Hong Kong

Dinesh Voruganti

University of Arkansas for Medical Sciences

Mahesh Bavineni

University of Arkansas for Medical Sciences

Ahmad Baghal

University of Arkansas for Medical Sciences

Kim Gates

University of Arkansas for Medical Sciences

Annu Kumari

University of Arkansas for Medical Sciences

Subhi J. Al'Aref

University of Arkansas for Medical Sciences

Panagis Galiatsatos

Johns Hopkins University - Division of Pulmonary and Critical Care Medicine

Petros Karakousis

Johns Hopkins University - Department of Medicine

JL Mehta

University of Arkansas for Medical Sciences

More...

Abstract

Introduction: Host cell-membrane cholesterol, an important player in viral infections, is in constant interaction with serum high-density lipoprotein-cholesterol (HDL-C) and low-density lipoprotein-cholesterol (LDL-C). Low serum lipid levels during hospital admission are associated with COVID-19 severity. However, the effect of antecedent serum lipid levels on COVID-19 infection risk has not been explored.

Methods: From our retrospective cohort from the Arkansas Clinical Data-Repository, we used log-binomial regression to assess the risk of COVID-19 infection among the trajectories of lipid levels during the 2 years antecedent to COVID-19 testing, identified using group-based-trajectory modeling. We used mixed-effects linear regression to assess the serum lipid level trends followed up to the time of, and 2-months following COVID-19 testing.

Results: Among the 11001 individuals with a median age of 59 years (IQR 46-70), 1340 (12.2%) tested positive for COVID-19. The highest trajectory for antecedent serum HDL-C was associated with the lowest COVID-19 infection risk (RR 0.63, 95%CI 0.46-0.86). Antecedent serum LDL-C, total cholesterol (TC), and triglycerides (TG) were not independently associated with COVID-19 infection risk. In COVID-19 patients, serum HDL-C (-7.7, 95%CI -9.8 to -5.5 mg/dL), and LDL-C (-6.29, 95%CI -12.2 to -0.37 mg/dL), but not TG levels, decreased transiently at the time of testing.

Conclusions: Higher antecedent serum HDL-C, but not LDL-C, TC, or TG, levels were associated with a lower COVID-19 infection risk. Serum HDL-C, and LDL-C levels declined transiently at the time of infection. Further studies are needed to determine the potential role of lipid-modulating therapies in the prevention and management of COVID-19.

Funding: Research reported in this publication was supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under Award Number UL1 TR003107.

Declaration of Interest: We declare no conflicts of interest.

Ethical Approval: This study was classified as non-human subjects research by the IRB at the University of Arkansas for Medical Sciences (UAMS), Little Rock.

Keywords: LDL, Total cholesterol, Triglycerides, Risk, COVID-19

Suggested Citation

Chidambaram, Vignesh and Kumar, Amudha and Majella, Marie Gilbert and Seth, Bhavna and Sivakumar, Ranjith Kumar and Voruganti, Dinesh and Bavineni, Mahesh and Baghal, Ahmad and Gates, Kim and Kumari, Annu and Al'Aref, Subhi J. and Galiatsatos, Panagis and Karakousis, Petros and Mehta, JL, Higher HDL Cholesterol Levels Decrease Susceptibility to COVID-19 Infection. Available at SSRN: https://ssrn.com/abstract=4074563 or http://dx.doi.org/10.2139/ssrn.4074563

Vignesh Chidambaram

Johns Hopkins University - Department of Medicine ( email )

University of Arkansas for Medical Sciences - Department of Internal Medicine ( email )

Amudha Kumar

University of Arkansas for Medical Sciences ( email )

4301 W. Markham St.
Suite 605
Little Rock, AR 72205
United States

University of Arkansas for Medical Sciences - Department of Internal Medicine ( email )

Marie Gilbert Majella

Sri Venkateswara Medical College ( email )

Bhavna Seth

Johns Hopkins University - Division of Pulmonary and Critical Care Medicine ( email )

Ranjith Kumar Sivakumar

Prince of Wales Hospital - The Chinese University of Hong Kong ( email )

China

Dinesh Voruganti

University of Arkansas for Medical Sciences ( email )

4301 W. Markham St.
Suite 605
Little Rock, AR 72205
United States

Mahesh Bavineni

University of Arkansas for Medical Sciences ( email )

4301 W. Markham St.
Suite 605
Little Rock, AR 72205
United States

Ahmad Baghal

University of Arkansas for Medical Sciences ( email )

4301 W. Markham St.
Suite 605
Little Rock, AR 72205
United States

Kim Gates

University of Arkansas for Medical Sciences ( email )

4301 W. Markham St.
Suite 605
Little Rock, AR 72205
United States

Annu Kumari

University of Arkansas for Medical Sciences ( email )

4301 W. Markham St.
Suite 605
Little Rock, AR 72205
United States

Subhi J. Al'Aref

University of Arkansas for Medical Sciences ( email )

4301 W. Markham St.
Suite 605
Little Rock, AR 72205
United States

Panagis Galiatsatos

Johns Hopkins University - Division of Pulmonary and Critical Care Medicine ( email )

Petros Karakousis

Johns Hopkins University - Department of Medicine ( email )

720 Rutland Avenue
Baltimore, MD 21205-2196
United States

JL Mehta (Contact Author)

University of Arkansas for Medical Sciences ( email )

4301 W. Markham St.
Suite 605
Little Rock, AR 72205
United States

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