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<p>COVID-19 has been associated with significant alterations in lipid metabolism, which may influence disease severity, especially in patients with comorbidities such as diabetes. This meta-analysis aimed to assess the relationship between serum lipid profiles and COVID-19 severity in patients with and without diabetes. A total of 41 studies were included, comprising 11,372 COVID-19 patients—7,785 classified as mild to moderate and 3,587 as severe to critical cases. Data from 974 diabetic and 1,117 non-diabetic patients across 9 studies were also analyzed using RevMan V5.4 and STATA 14. The meta-analysis revealed that, compared to mild-moderate COVID-19 patients, the severe-critical group exhibited significantly lower levels of HDL-C [SMD: 0.38&#xa0;mmol/L; 95% CI = (0.24, 0.51); <i>p</i>-value &lt; 0.00001; I<sup>2</sup> = 83%], TC [SMD: 0.18&#xa0;mmol/L; 95% Cl = (0.01- 0.35); <i>p</i>-value 0.03; I<sup>2</sup> = 90%], and ApoA [SMD: 0.77&#xa0;mmol/L; 95% CI = (0.31,1.23); <i>p</i>-value 0.001; I<sup>2</sup> = 85%]. Conversely, the severe-critical group showed higher concentrations of TG [SMD: -0.20&#xa0;mmol/L; 95% CI = (-0.38, -0.02); <i>p</i> value = 0.03; I<sup>2</sup> = 92%] and Lp(a) [SMD: -0.07&#xa0;mmol/L; 95% CI = (-0.37, 0.22); <i>p</i> value = 0.31; I<sup>2</sup> = 4%], while LDL-C and ApoB did not show significant differences. When comparing diabetic to non-diabetic patients, TG levels were significantly higher [SMD: 1.16&#xa0;mmol/L; 95% Cl = (0.15, 2.16); <i>p</i> value = 0.2; I<sup>2</sup> = 99%] in diabetic patients, while no significant differences were observed for TC, HDL-C and LDL-C. These findings suggest that altered lipid profiles, particularly decreased HDL-C, TC, and ApoA levels, may serve as potential biomarkers of COVID-19 severity, especially in diabetic populations, and support the need for lipid monitoring in clinical assessments of high-risk patients.</p>

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Altered lipid profile and lipoproteins in COVID-19 severity: A meta-analysis

  • 期刊论文

  • 发表日期：

    2025年5月31日

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  • Hoimonti Debi,
  • Rahima Begum,
  • Zarin Tasnim Itu,
  • Mohammad Tohidul Amin,
  • Fahad Hussain,
  • Md. Mamun Or Rashid,
  • Mohammad Salim Hossain

摘要

COVID-19 has been associated with significant alterations in lipid metabolism, which may influence disease severity, especially in patients with comorbidities such as diabetes. This meta-analysis aimed to assess the relationship between serum lipid profiles and COVID-19 severity in patients with and without diabetes. A total of 41 studies were included, comprising 11,372 COVID-19 patients—7,785 classified as mild to moderate and 3,587 as severe to critical cases. Data from 974 diabetic and 1,117 non-diabetic patients across 9 studies were also analyzed using RevMan V5.4 and STATA 14. The meta-analysis revealed that, compared to mild-moderate COVID-19 patients, the severe-critical group exhibited significantly lower levels of HDL-C [SMD: 0.38 mmol/L; 95% CI = (0.24, 0.51); p-value < 0.00001; I2 = 83%], TC [SMD: 0.18 mmol/L; 95% Cl = (0.01- 0.35); p-value 0.03; I2 = 90%], and ApoA [SMD: 0.77 mmol/L; 95% CI = (0.31,1.23); p-value 0.001; I2 = 85%]. Conversely, the severe-critical group showed higher concentrations of TG [SMD: -0.20 mmol/L; 95% CI = (-0.38, -0.02); p value = 0.03; I2 = 92%] and Lp(a) [SMD: -0.07 mmol/L; 95% CI = (-0.37, 0.22); p value = 0.31; I2 = 4%], while LDL-C and ApoB did not show significant differences. When comparing diabetic to non-diabetic patients, TG levels were significantly higher [SMD: 1.16 mmol/L; 95% Cl = (0.15, 2.16); p value = 0.2; I2 = 99%] in diabetic patients, while no significant differences were observed for TC, HDL-C and LDL-C. These findings suggest that altered lipid profiles, particularly decreased HDL-C, TC, and ApoA levels, may serve as potential biomarkers of COVID-19 severity, especially in diabetic populations, and support the need for lipid monitoring in clinical assessments of high-risk patients.