Low serum level of apolipoprotein A1 may predict the severity of COVID‐19: A retrospective study. Issue 8 (14th July 2021)

• Record Type: Journal Article
• Authors: Zhu, Zhe; Yang, Yayun; Fan, Lingyan; Ye, Shuyuan; Lou, Kehong; Hua, Xin; Huang, Zuoan; Shi, Qiaoyun; Gao, Guosheng
• Is Part Of: Journal of clinical laboratory analysis. Volume 35:Issue 8(2021)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2021-07-14
• Subjects: ApoA1 -- blood lipid -- COVID‐19 -- disease severity -- SARS‐CoV‐2; Diagnosis, Laboratory -- Periodicals; Medical laboratory technology -- Periodicals; 616
• DOI: 10.1002/jcla.23911
• Languages: English
• ISSNs: 0887-8013

Abstract

Abstract: Background: Dyslipidemia has been observed in patients with coronavirus disease 2019 (COVID‐19). This study aimed to investigate blood lipid profiles in patients with COVID‐19 and to explore their predictive values for COVID‐19 severity. Methods: A total of 142 consecutive patients with COVID‐19 were included in this single‐center retrospective study. Blood lipid profile characteristics were investigated in patients with COVID‐19 in comparison with 77 age‐ and gender‐matched healthy subjects, their predictive values for COVID‐19 severity were analyzed by using multivariable logistic regression analysis, and their prediction efficiencies were evaluated by using receiver operator characteristic (ROC) curves. Results: There were 125 and 17 cases in the non‐severe and severe groups, respectively. Total cholesterol (TC), high‐density lipoprotein cholesterol (HDL‐C), low‐density lipoprotein cholesterol (LDL‐C), and apolipoprotein A1 (ApoA1) gradually decreased across the groups in the following order: healthy controls, non‐severe group, and severe group. ApoA1 was identified as an independent risk factor for COVID‐19 severity (adjusted odds ratio [OR]: 0.865, 95% confidence interval [CI]: 0.800–0.935, p < 0.001), along with interleukin‐6 (IL‐6) (adjusted OR: 1.097, 95% CI: 1.034–1.165, p = 0.002). ApoA1 exhibited the highest area under the ROC curve (AUC) among all single markers (AUC: 0.896, 95% CI: 0.834–0.941); moreover, the risk model established using ApoA1 and IL‐6 enhanced prediction efficiency (AUC: 0.977, 95% CI: 0.932–0.995). Conclusion: Blood lipid profiles in patients with COVID‐19 are quite abnormal compared with those in healthy subjects, especially in severe cases. Serum ApoA1 may represent a good indicator for predicting the severity of COVID‐19. Abstract : Total cholesterol (TC), high‐density lipoprotein cholesterol (HDL‐C), low‐density lipoprotein cholesterol (LDL‐C), and apolipoprotein A1 (ApoA1) were gradually decreased across healthy controls, non‐severe group, and severe group. Triglyceride (TG) was higher in the non‐severe group when compared with healthy controls; however, no significant differences were found between the severe and non‐severe group, and the severe group and healthy controls. There were no significant differences in ApoB and lipoprotein (a) among the three groups.