Association of Hypoalphalipoproteinemia and Its Outcome in Patients Hospitalized in Covid-19 Area at a Tertiary Care Center in Mexico Prior to Vaccination

HDL-C has anti-inflammatory properties and low levels are associated with a more severe presentation of COVID-19. Objective: To identify the association of hypoalphalipoproteinemia and outcome in patients hospitalized in the COVID area in a tertiary center in Mexico prior to vaccination. Methods: A cross-sectional, prolective and analytical study was carried out on hospitalized patients with suspected/confirmed SARS COV-2 infection. Inclusion criteria: age 18 or older, with hospital admission criteria for SARS-CoV-2 infection (PCR-confirmed cases, PCR-negative with pulmonary lesion) in a COVID-19 area with hypoalphalipoproteinemia according to international criteria (women c-HDL 1.3 mmol/L [<50 mg/dL], men 1.04 mmol/L [<40 mg/dL]), both sexes. Non-inclusion criteria: pregnancy or breastfeeding. Exclusion criteria: patients whose file is incomplete. Chi-square tests were performed to demonstrate associations in dichotomous qualitative variables (outcome) and Sperman for freely distributed quantitative variables. Kruskal-Wallis and Friedman were used for freely distributed ordinal variables. Finally, Kaplan-Meier survival curves and ROC curves were calculated. Results: Of a total of 822 patients, 773 subjects were eligible. 60.70% (n=469) were discharged home, and 39.30% (n=304) died. Of the patients who died, 96.05% (n=304) had hypoalphalipoproteinemia, with statistical significance (p<0.001), with higher mortality in women, with a HR of 2.40 (95% CI 1.03–5.61; p<0.043). Conclusion: The HDL-C cutoff of ≥ 0.64 mmol/L ( ≥ 24.7 mg/dL) provided a sensitivity of 69.94%, specificity of 51.64%, positive predictive value of 69.05%, negative predictive value of 52.68%, positive likelihood ratio of 1.45, negative likelihood ratio of 0.58, and diagnostic accuracy of 62.74% (p < 0.001) for survival in patients with suspected/pre-vaccinated SARS-CoV-2 infection.