Follow-up study on serum cholesterol profiles and potential sequelae in recovered COVID-19 patients

  1. Guiling Li
  2. Li Du
  3. Xiaoling Cao
  4. Xiuqi Wei
  5. Yao Jiang
  6. Yuqi Lin
  7. Vi Nguyen
  8. Wenbin Tan
  9. Hui Wang

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Abstract

Background

COVID-19 patients develop hypolipidemia. However, it is unknown whether lipid levels have improved and there are potential sequlae in recovered patients.

Objective

In this follow-up study, we evaluated serum lipidemia and various physiopathological laboratory values in recovered patients.

Methods

A 3–6 month follow-up study was performed between June 15 and September 3, 2020, to examine serum levels of laboratory values in 107 discharged COVID-19 patients (mild = 59; severe/critical = 48; diagnoses on admission). Sixty-one patients had a revisit chest CT scan. A Wilcoxon signed-rank test was used to analyze changes in laboratory values at admission and follow-up.

Results

LDL-c and HDL-c levels were significantly higher at follow-up than at admission in severe/critical cases ( p  <  0.05). LDL-c levels were significantly higher at follow-up than at admission in mild cases ( p  <  0.05). Coagulation and liver functional values were significantly improved at follow-up than at admission for patients ( p  <  0.05). Increases in HDL-c significantly correlated with increases in numbers of white blood cells ( p  <  0.001) during patients’ recovery. With exclusion of the subjects taking traditional Chinese medicines or cholesterol-lowering drugs, LDL-c and HDL-c levels were significantly increased at follow-up than at admission in severe/critical cases ( p  <  0.05). Residue lesions were observed in CT images in 72% (44 of 61) of follow-up patients.

Conclusions

Improvements of LDL-c, HDL-c, liver functions, and incomplete resolution of lung lesions were observed at 3–6 month follow-up for recovered patients, indicating that a long-term recovery process could be required and the development of sequelae such as pulmonary fibrosis could be expected in some patients.

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  1. Version published to 10.1186/s12879-021-05984-1
  2. ScreenIT

    SciScore for 10.1101/2020.12.08.20245977: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementIRB: Study design and patients: This follow-up study was carried out at the Cancer Center at the Union Hospital of Tongji Medical College in Wuhan, P. R. China, and was approved by the Institutional Review Board (IRB) at the Union Hospital.
    Consent: The requirement for written informed consent was waived by the IRB committee.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Statistical analysis: Statistical analyses were performed with the statistical software SPSS (IBM, Armonk, New York, USA).
    SPSS
    suggested: (SPSS, RRID:SCR_002865)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    There were several limitations of this study. First, less than one-fifth of the patients from our original cohort participated in this study, which might cause a biased representative sample group from the original cohort. Second, the sample size for follow-up critical cases was limited; this might lead to an overall insignificant increase in levels of LDL-c in this subgroup. Third, many patients might have been taking various medications or remedies at home for recovery, including Chinese traditional medicines or nutritional supplements. In this study, we found that about 58% of patients in mild group and 37% of patients in severe group had taken TCHMs during their illness or / and recovery courses. Our data indicated that TCHMs might have a negative impact on the improvement of lipid profiles in patients with severe symptoms. However, due to the complexity of ingredients in those TCHMs, it will be very difficult to determine which factor(s) and how they interfere with lipid metabolisms in some patients’ recoveries in the severe group; this will need a thorough investigation in future. We, however, did not find so far that TCHMs caused any significant changes in the overall lipid profiles at the time of admission and follow-up crossing all the subgroups. Therefore, TCHMs might have a minor effect on lipid values in our patient which resulted in a negligible impact on the conclusions we drew in this study. We are aware that these data and analyses only apply to this specific ...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  3. Version published to 10.1101/2020.12.08.20245977 on medRxiv