Dynamic of lipoprotein responses in patients with severe COVID-19

Background and Aims: Hypolipidaemia is a known consequence of sepsis, predominantly from HDL-C (HDL-cholesterol) lowering. The dynamic of lipoprotein responses is in COVID-19 is not yet elucidated. We aim to describe a lipoprotein response pattern in patients with severe COVID-19 admitted to Intensive Care Department (ICU) at TUH during the first wave of the pandemic in Ireland. Methods: A multidisciplinary team extracted the clinical data and laboratory results of all patients diagnosed with COVID-19 by RT-PCR and admitted to the ICU department in March and April 2020. Data are presented as means, apart from laboratory data where patients had more than one set of results in 24 hours, when median results were calculated for each 24-h period. Results: Twenty-five patients were admitted to ICU (table 1). Presenting comorbidities included hypertension in 10, cardiovascular disease in 5 and diabetes mellitus in 8 patients. Lipoprotein median concentrations demonstrated initial reduction at admission to ICU, followed by rise in concentration during ICU stay (table 1 and figure 1). A significant negative correlation was observed between ICU outcome and HDL-C area under the curve (AUC) (R=-0.506, p=0.004) and LDL-AUC (R=-0.575, p=0.003). Delta LDL-AUC had the strongest correlation with ICU length of stay (LOS) (R=0.455, p=0.02), hospital LOS (R=0.484, p=0.02) and ICU outcomes (R=-0.454, p=0.02). Individual lipoprotein parameters did not demonstrate significant correlation. [Formula presented] [Formula presented] Conclusions: Lipoprotein concentrations (HDL-C and LDL-C) upon ICU admission are low in severe COVID-19 pneumonia patients and subsequent changes in concentrations may be associated with patient outcomes.