The bidirectional interaction of COVID-19 infections and lipoproteins

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 stu-dies 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 le-vels 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 infec-tions alter lipid/lipoprotein levels and HDL-C levels may affect the risk of developing COVID-19 infections.& COPY; 2023 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creative-commons.org/licenses/by-nc-nd/4.0/).

Automated summary

COVID-19 infections lead to decreased levels of total cholesterol, LDL-C, HDL-C, and apolipoprotein A-I, A-II, and B, while triglyceride levels may be increased. The reduction in total cholesterol, LDL-C, HDL-C, and apolipoprotein A-I levels predicts mortality. After recovery, lipid/lipoprotein levels return to pre-infection levels, but there may be an increased risk of dyslipidemia post-COVID-19 infection. Omega-3 fatty acids and PCSK9 inhibitors may reduce the severity of COVID-19 infections. HDL-C levels may affect the risk of developing COVID-19 infections.