Good cholesterol factors in virus clearance time in COVID-19

For some COVID-19 patients, virus clearance takes more than half a month, a study has found. Risk factors for prolonged clearance include low high-density lipoprotein cholesterol (HDL-C) levels, as well as liver damage and hyperglycaemia.

The study included 115 COVID-19 patients (mean age, 60.5 years; 53 percent male) with SARS-COV-2 nucleic acid positive time exceeding 14 days. Most patients presented with fever (80.9 percent) and had comorbidities (65.2 percent), including hypertension (n=23), diabetes (n=22), or both (n=11).

A total of 101 patients had severe COVID-19 infection (87.8 percent), and eight had the critical type (7.0 percent). In terms of antiviral drugs, 63 patients (54.8 percent) received arbidol, 43 (37.4 percent) were given lopinavir/ritonavir, five (4.3 percent) were on other drugs, and four (3.5 percent) did not receive treatment. Antibiotics, on the other hand, were given in the majority of the population: 59 patients (51.3 percent) received one while 16 (13.9 percent) received two or more. Glucocorticoid was used in 14 patients (12.2 percent), while Chinese traditional medicine was given in 105 patients (91.3 percent).

Overall, nucleic acid turned negative a mean of 32.5 days after the onset of symptoms. Viral clearance time was longer in the no-fever vs fever group, in the diabetes vs no-comorbidity group, among patients with elevated levels of alanine aminotransferase (ALT) or fasting blood glucose (GLU), and among those with lower levels of albumin (ALB) or HDLC (p<0.05).

In multivariate Cox regression models, risk factors for prolonged viral clearance included ALT (odds ratio [OR], 2.164, 95 percent confidence interval [CI], 1.276–3.670; p=0.004), GLU (OR, 2.064, 95 percent CI, 1.195–3.566; p=0.009), and HDLC (OR, 0.527, 95 percent CI, 0.307–0.907; p=0.021).

Given the findings, clinicians should look out for COVID-19 patients with dyslipidemia.