Metabolic Implications of COVID-19: Exploring Lipids and Inflammation

COVID-19 is associated with cardiometabolic complications, including lipid abnormalities, but its effect on lipoprotein(a) [Lp(a)] remains unclear. This study evaluated the relationship between lipid profiles, Lp(a), disease severity, and recovery. Among 169 participants assessed, 84 were hospitalised with moderate-to-severe COVID-19 and 86 were controls (42 diabetic, 43 healthy). On admission, COVID-19 patients exhibited lower low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and total cholesterol (TC) but higher triglycerides (TG) and TG:HDL ratios compared to controls. Non-survivors were more likely to be male, had elevated body mass index (BMI), fasting plasma glucose, and significantly lower LDL-C levels compared to survivors. Inflammatory markers were more pronounced in non-survivors, with predominantly Th1/Th17 cytokines predictive of mortality, admission to an intensive care unit and follow-up changes in lipid profiles. ROC analysis demonstrated LDL-C as a mortality predictor (AUC: 0.68), with improved accuracy when combined with BMI and inflammatory markers (AUC: 0.85). At follow-up, survivors exhibited increases in BMI, waist circumference, LDL-C, and Lp(a), which rose by 15% and remained significantly higher than healthy controls. Black and Mixed-Race participants showed persistently higher Lp(a) levels compared to other racial groups. These findings emphasise the potential need for long-term monitoring of cardiometabolic risks in post-COVID-19 survivors.