Low high-density lipoprotein level is correlated with the severity of COVID-19 patients

Abstract Background The aim of the present study was to describe the clinical characteristics of patients with different levels of high-density lipoproteins (HDLs) and analyze the correlation between HDL levels and prognosis of coronavirus disease 2019 (COVID-19) patients. Methods In the clinical retrospective analysis, a total of 228 adult COVID-19 patients admitted to Public Health Treatment Center of Changsha, China from January 17 to March 14, 2020 were enrolled. Median with interquartile range and Mann-Whitney test were used to depict and analyze the clinical characteristics of patients. The Kaplan-Meier (KM) curve and cox regression were adopted to analyze the association between HDLs and severe events of COVID-19 patients. Results Median levels of high-density lipoprotein cholesterol (HDL-C) in adult COVID-19 patients were below normal range. Compared with patients with high HDL-C, patients with low HDL-C showed higher proportion of male (69.6% vs 45.6%, P = 0.004), higher levels of C-reactive protein (CRP) (median, 27.83 vs 12.56 mg/L, P = 0.000) and alanine aminotransferase (ALT) (median, 21.49 vs 18.81 U/L, P = 0.044), as well as higher proportion of severe events (37.0% vs 14.8%, P = 0.001). Moreover, they presented a higher risk of developing severe events compared with those with high HDL-C (Log Rank P < 0.001, Fig. 1). After adjusting for age, gender and underlying diseases, patients with low HDL-C still had elevated possibility of developing to severe cases than those with high HDL-C (HR 2.852, 95% CI 1.505–5.407, P = 0.001). Conclusions HDL-C level decreased in COVID-19 adult patients, and low HDL-C in COVID-19 patients was correlated with a higher risk of developing severe events.