Antioxidants (Nov 2023)

HDL-Related Parameters and COVID-19 Mortality: The Importance of HDL Function

  • Julia T. Stadler,
  • Hansjörg Habisch,
  • Florian Prüller,
  • Harald Mangge,
  • Thomas Bärnthaler,
  • Julia Kargl,
  • Anja Pammer,
  • Michael Holzer,
  • Sabine Meissl,
  • Alankrita Rani,
  • Tobias Madl,
  • Gunther Marsche

DOI
https://doi.org/10.3390/antiox12112009
Journal volume & issue
Vol. 12, no. 11
p. 2009

Abstract

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COVID-19, caused by the SARS-CoV-2 coronavirus, emerged as a global pandemic in late 2019, resulting in significant global public health challenges. The emerging evidence suggests that diminished high-density lipoprotein (HDL) cholesterol levels are associated with the severity of COVID-19, beyond inflammation and oxidative stress. Here, we used nuclear magnetic resonance spectroscopy to compare the lipoprotein and metabolic profiles of COVID-19-infected patients with non-COVID-19 pneumonia. We compared the control group and the COVID-19 group using inflammatory markers to ensure that the differences in lipoprotein levels were due to COVID-19 infection. Our analyses revealed supramolecular phospholipid composite (SPC), phenylalanine, and HDL-related parameters as key discriminators between COVID-19-positive and non-COVID-19 pneumonia patients. More specifically, the levels of HDL parameters, including apolipoprotein A-I (ApoA-I), ApoA-II, HDL cholesterol, and HDL phospholipids, were significantly different. These findings underscore the potential impact of HDL-related factors in patients with COVID-19. Significantly, among the HDL-related metrics, the cholesterol efflux capacity (CEC) displayed the strongest negative association with COVID-19 mortality. CEC is a measure of how well HDL removes cholesterol from cells, which may affect the way SARS-CoV-2 enters cells. In summary, this study validates previously established markers of COVID-19 infection and further highlights the potential significance of HDL functionality in the context of COVID-19 mortality.

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