University of California San Francisco, San Francisco, CA, USA.
Best Pract Res Clin Endocrinol Metab. 2023 Jul;37(4):101751. doi: 10.1016/j.beem.2023.101751. Epub 2023 Feb 24.
COVID-19 infections decrease total cholesterol, LDL-C, HDL-C, and apolipoprotein A-I, A-II, and B levels while triglyceride levels may be increased or inappropriately normal for the poor nutritional status. The degree of reduction in total cholesterol, LDL-C, HDL-C, and apolipoprotein A-I are predictive of mortality. With recovery lipid/lipoprotein levels return towards pre-infection levels and studies have even suggested an increased risk of dyslipidemia post-COVID-19 infection. The potential mechanisms for these changes in lipid and lipoprotein levels are discussed. Decreased HDL-C and apolipoprotein A-I levels measured many years prior to COVID-19 infections are associated with an increased risk of severe COVID-19 infections while LDL-C, apolipoprotein B, Lp (a), and triglyceride levels were not consistently associated with an increased risk. Finally, data suggest that omega-3-fatty acids and PCSK9 inhibitors may reduce the severity of COVID-19 infections. Thus, COVID-19 infections alter lipid/lipoprotein levels and HDL-C levels may affect the risk of developing COVID-19 infections.
COVID-19 感染会降低总胆固醇、LDL-C、HDL-C 和载脂蛋白 A-I、A-II 和 B 的水平，而甘油三酯水平可能因营养不良而升高或异常正常。总胆固醇、LDL-C、HDL-C 和载脂蛋白 A-I 的降低程度可预测死亡率。随着病情的恢复，血脂/脂蛋白水平恢复到感染前的水平，研究甚至表明 COVID-19 感染后发生血脂异常的风险增加。讨论了这些脂质和脂蛋白水平变化的潜在机制。在 COVID-19 感染之前多年测量的降低的 HDL-C 和载脂蛋白 A-I 水平与严重 COVID-19 感染的风险增加相关，而 LDL-C、载脂蛋白 B、Lp(a)和甘油三酯水平与风险增加并不一致。最后，数据表明ω-3 脂肪酸和 PCSK9 抑制剂可能降低 COVID-19 感染的严重程度。因此，COVID-19 感染会改变脂质/脂蛋白水平，而 HDL-C 水平可能会影响 COVID-19 感染的风险。
