Elevated HDL-C Linked to Reduced Odds of Testing Positive for SARS-COV-2

Takeaway

• Elevated high-density lipoprotein-cholesterol (HDL-C) and apolipoprotein A-I (ApoA-I) levels were associated with reduced odds of testing positive for SARS-CoV-2.
• High body mass index (BMI), type 2 diabetes (T2D), glycated haemoglobin (HbA1c) and hyperlipidaemia were associated with increased odds of testing positive for SARS-CoV-2.
• The effect of BMI, T2D and HbA1c were eliminated when controlling for HDL-C.

Why this matters

• Findings suggest that baseline HDL-C level may be useful for stratifying SARS-CoV-2 infection risk and corroborates the emerging picture that elevated HDL-C may confer protection against SARS-CoV-2 infection.

Study details

• Study of 9005 participants from the UK Biobank who were tested for SARS-CoV-2 (1508 tested positive [cases]; 7497 tested negative [controls]).
• Funding: National Institute of General Medicines and National Heart, Lung and Blood Institute.

Key results

• Elevated HDL-C (OR, 0.845; 95% CI, 0.788-0.907) and ApoA-I (OR, 0.849; 95% CI, 0.793-0.910) levels were associated with reduced odds of testing positive for SARS-CoV-2.
• The effect of HDL-C (OR, 0.863; 95% CI, 0.801-0.93) and ApoA-I (OR, 0.865; 95% CI, 0.806-0.929) remained significant when controlling for BMI.
• Higher BMI was associated with increased odds of testing positive for SARS-CoV-2 (OR, 1.12; 95% CI, 1.06-1.18), but when HDL was controlled for, this effect was no longer significant.
• Hyperlipidaemia (OR, 1.362; 95% CI, 1.021-1.817), T2D (OR, 1.213; 95% CI, 1.028-1.432) and HbA1c (OR, 1.061; 95% CI, 1.005-1.121) were significantly associated with increased odds of testing positive for SARS-CoV-2.
• However, when ApoA-I, HDL-C or BMI were controlled for, this effect was no longer significant.
• Low-density lipoprotein-cholesterol (OR, 0.995; 95% CI, 0.939-1.055), apolipoprotein B (OR, 1.003; 95% CI, 0.947-1.063), triglycerides (OR, 1.026; 95% CI, 0.969-1.087) and type 1 diabetes (OR, 0.817; 95% CI, 0.529-1.261) were not significantly associated with odds of testing positive for SARS-CoV-2.

Limitations

• Sampling bias.
• Risk of potential confounding.
• Baseline cardiometabolic data were collected prior to the pandemic.

This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.