Department of Laboratory Medicine, Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China.
Department of Laboratory Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China.
J Clin Lipidol. 2020 May-Jun;14(3):297-304. doi: 10.1016/j.jacl.2020.04.008. Epub 2020 Apr 30.
Many patients with coronavirus disease 2019 (COVID-19) suffer multiple organ dysfunctions. However, whether patients develop dyslipidemia is unknown.
In this study, we aimed to investigate the pathological alterations of low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c), and total cholesterol (TC) in COVID-19 patients and their relationships with the disease severity.
A retrospective study was performed to examine serum levels of LDL-c, HDL-c, and TC on 597 COVID-19 patients (mild: 394; severe, 171; critical: 32) who were hospitalized in our center between February 1 and March 3, 2020. Age- and gender-matched normal subjects (n = 50) who had routine laboratory lipid tests between October 1 and November 1, 2019 in our center were included as the control group.
LDL-c and TC levels were significantly lower in COVID-19 patients as compared with normal subjects (P < .001). There were significant and gradual decreases in levels of LDL-c (median (IQR) in mg/dL, mild: 91 (76, 104); severe: 86 (69, 102); critical: 69 (48, 81); P < .02) and TC (mild: 173 (148, 203); severe: 167 (138, 197); critical: 125 (95, 162); P < .05) across all three groups. HDL-c levels only decreased significantly in critical cases as compared with levels in mild and severe cases. LDL-c and TC levels inversely correlated with C-reactive protein and interleukin-6, and positively correlated with the number of lymphocytes in patients.
Development of hypolipidemia begins in patients with mild symptoms. It progressively becomes worse in an association with the disease severity.
许多新型冠状病毒肺炎（COVID-19）患者存在多个器官功能障碍。然而，患者是否会发生血脂异常尚不清楚。
本研究旨在探讨 COVID-19 患者低密度脂蛋白胆固醇（LDL-c）、高密度脂蛋白胆固醇（HDL-c）和总胆固醇（TC）的病理变化及其与疾病严重程度的关系。
回顾性研究分析了 2020 年 2 月 1 日至 3 月 3 日期间在我院住院的 597 例 COVID-19 患者（轻症 394 例，重症 171 例，危重症 32 例）的 LDL-c、HDL-c 和 TC 血清水平。选择我院于 2019 年 10 月 1 日至 11 月 1 日期间进行常规实验室血脂检查的年龄和性别匹配的 50 例正常受试者作为对照组。
与正常对照组相比，COVID-19 患者的 LDL-c 和 TC 水平显著降低（P<0.001）。LDL-c（中位数（IQR），mg/dL：轻症组 91（76，104）；重症组 86（69，102）；危重症组 69（48，81），P<0.02）和 TC（轻症组 173（148，203）；重症组 167（138，197）；危重症组 125（95，162），P<0.05）水平在三组患者中均呈逐渐下降趋势。仅在危重症组中，HDL-c 水平与轻症组和重症组比较差异有统计学意义。LDL-c 和 TC 水平与 C 反应蛋白和白细胞介素 6 呈负相关，与淋巴细胞数呈正相关。
轻症患者开始出现血脂异常，且随着病情严重程度的增加而逐渐恶化。
