COVID-19-induced Dyslipidemia and Disease Severity: Perspectives from Southern Nigeria

Abstract

Background: The relationship between dyslipidemia and the severity of coronavirus disease 2019 (COVID-19) has extensively been characterized in the Western population with a dearth of data among Nigerians. Hence, the current study evaluated the lipid/lipoprotein disorders inherent in COVID-19 and its relationship with disease severity among Nigerians. Methods: This was a retrospective study conducted among 600 patients with RT-PCR-confirmed COVID-19 at the Eleme COVID-19 treatment facility in Port Harcourt, Southern Nigeria. Data were obtained from medical records using validated acquisition templates and analyzed based on lipid/lipoprotein abnormalities and disease severity status. Results: Among those studied, 54.7% had dyslipidemia while others were normolipidemic. HDL-C dyslipidemia was the most common with a preponderance of hypoalphalipoproteinemia (84.4%). Dyslipidemia afflicted mostly middle-aged, males, urban dwellers, the overweight, and those with classic COVID-19-induced respiratory symptoms. Dyslipidemic cohorts had higher pro-calcitonin, C-reactive protein, D-dimer, total white cell count, and neutrophils, but lower albumin, lymphocyte, and platelet counts compared to the normolipidemic cohorts. Dyslipidemic cohorts with concurrent severe COVID-19 had lower levels of TChol, Tg, HDL-C, and LDL-C levels compared to patients with the less-severe disease. HDL-C was the only lipid/lipoprotein parameter that was associated with severe COVID-19 on crude (OR:8.65; CI:5.96-11.44; p<0.001) and adjusted (OR:8.11; CI:5.65-10.87; p<0.001) regression models compared to other lipid/lipoprotein indices. At 96.77% sensitivity and 89.20% specificity, HDL-C had robust predictive potentials (AUC:0.97; CI:0.84-1.00; p<0.001) over COVID-19 severity. Conclusion: Dyslipidemia is frequent among those presenting with COVID-19 in association with disease severity, especially among the HDL-C dyslipidemic cohorts. Hence, these findings should be factored in during COVID-19 treatment among Nigerians with the disease.