Association Analysis of Hyperlipidemia with the 28-Day All-Cause Mortality of COVID-19 in Hospitalized Patients

作     者：Bin Wu Jianghua Zhou Wenxin Wang Huilin Yang Meng Xia Binghong Zhang Zhigang She Hongliang Li Bin Wu;Jianghua Zhou;Wenxin Wang;Huilin Yang;Meng Xia;Binghong Zhang;Zhigang She;Hongliang Li

作者机构：Department of CardiologyRenmin Hospital of Wuhan UniversityWuhan 430071China Institute of Model AnimalWuhan UniversityWuhan 430071China Basic Medical SchoolWuhan UniversityWuhan 430071China Department of NeonatologyRenmin Hospital of Wuhan UniversityWuhan 430072China Medical Science Research CenterZhongnan Hospital of Wuhan UniversityWuhan 430071China 

出 版 物：《Chinese Medical Sciences Journal》 (中国医学科学杂志（英文版）)

年 卷 期：2021年第36卷第1期

页      面：17-26页

核心收录：

学科分类：1002[医学-临床医学] 10[医学] 

基　　金：National Key R&D Program of China(2016YFF0101500) the National Natural Science Foundation of China(81970364,81770053). 

主　　题：coronavirus disease 2019(COVID-19) lipid disorder mortality cardiovascular diseases diabetes 

摘      要：Objective This study aimed to determine the association of hyperlipidemia with clinical endpoints among hospitalized patients with COVID-19,especially those with pre-existing cardiovascular diseases(CVDs)and diabetes.Methods This multicenter retrospective cohort study included all patients who were hospitalized due to COVID-19 from 21 hospitals in Hubei province,China between December 31,2019 and April 21,2020.Patients who were aged18 or≥85 years old,in pregnancy,with acute lethal organ injury(e.g.,acute myocardial infarction,severe acute pancreatitis,acute stroke),hypothyroidism,malignant diseases,severe malnutrition,and those with normal lipid profile under lipid-lowering medicines(e.g,statin,niacin,fenofibrate,gemfibrozil,and ezetimibe)were excluded.Propensity score matching(PSM)analysis at 1:1 ratio was performed to minimize baseline differences between patient groups of hyperlipidemia and non-hyperlipidemia.PSM analyses with the same strategies were further conducted for the parameters of hyperlipidemia in patients with increased triglyceride(TG),increased low・density lipoprotein cholesterol(LDL-C),and decreased high-density lipoprotein cholesterol(HDL-C).Mixed-effect Cox model analysis was performed to investigate the associations of the 28-days all-cause deaths of COVID-19 patients with hyperlipidemia and the abnormalities of lipid parameters.The results were verified in male,female patients,and in patients with pre-existing CVDs and type 2 diabetes.Results Of 1094S inpatients confirmed as COVID-19,there were 9822 inpatients included in the study,comprising 3513(35.8%)cases without hyperlipidemia and 6309(64.2%)cases with hyperlipidemia.Based on a mixed-effect Cox model after PSM at 1:1 ratio,hyperlipidemia was not associated with increased or decreased 28-day all-cause death[adjusted hazard ratio(HR),1.17(95%C/,0.95-1.44),P二0.151].Wb found that the parameters of hyperlipidemia were not associated with the risk of 28-day all-cause mortality[adjusted HR,1.23(95%CI,0.98-1.55),P=0.075 in TG increase group;0.78(95%CI,0.57-1.07),P=0.123 in LDL-C increase group;and 1.12(95%CI,0.9-1.39),P=0.299 in HDL-C decrease group,respectively].Hyperlipidemia was also not significantly associated with the increased mortality of COVID-19 in patients accompanied with CVDs or type 2 diabetes,and in both male and female cohorts.Conclusion Our study support that the imbalanced lipid profile is not significantly associated with the 28-day all-cause mortality of COVID-19 patients,even in those accompanied with CVDs or diabetes.Similar results were also obtained in subgroup analyses of abnormal lipid parameters.Therefore,hyperlipidemia might be not a major causative factor for poor outcome of COVID-19,which provides guidance for the intervention of inpatients during the epidemic of COVID-19.