Dyslipidemia Increases the Risk of Severe COVID-19: A Systematic Review, Meta-analysis, and Meta-regression

Objective: This systematic review and meta-analysis aimed to evaluate whether dyslipidemia affects the mortality and severity of COVID-19, we also aimed to evaluate whether other comorbidities influence the association. Methods: A systematic literature search using PubMed, Embase, and EuropePMC was...

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Bibliographic Details
Main Authors: Indriwanto Sakidjan Atmosudigdo, Michael Anthonius Lim, Basuni Radi, Joshua Henrina, Emir Yonas, Rachel Vania, Raymond Pranata
Format: Article
Language:English
Published: SAGE Publishing 2021-03-01
Series:Clinical Medicine Insights: Endocrinology and Diabetes
Online Access:https://doi.org/10.1177/1179551421990675
Description
Summary:Objective: This systematic review and meta-analysis aimed to evaluate whether dyslipidemia affects the mortality and severity of COVID-19, we also aimed to evaluate whether other comorbidities influence the association. Methods: A systematic literature search using PubMed, Embase, and EuropePMC was performed on 8 October 2020. This study’s main outcome is a poor composite outcome, comprising of mortality and severe COVID-19. Results: There were 9 studies with 3663 patients. The prevalence of dyslipidemia in this pooled analysis was 18% (4%-32%). Dyslipidemia was associated with increased composite poor outcome (RR 1.39 [1.02, 1.88], P  = .010; I 2 : 56.7%, P  = .018). Subgroup analysis showed that dyslipidemia was associated with severe COVID-19 (RR 1.39 [1.03, 1.87], P  = .008; I 2 : 57.4%, P  = .029). Meta-regression showed that the association between dyslipidemia and poor outcome varies by age (coefficient: −0.04, P  = .033), male gender (coefficient: −0.03, P  = .042), and hypertension (coefficient: −0.02, P  = .033), but not diabetes (coefficient: −0.24, P  = .135) and cardiovascular diseases (coefficient: −0.01, P  = .506). Inverted funnel-plot was relatively symmetrical. Egger’s test indicates that the pooled analysis was not statistically significant for small-study effects ( P  = .206). Conclusion: Dyslipidemia potentially increases mortality and severity of COVID-19. The association was stronger in patients with older age, male, and hypertension. PROSPERO Registration Number: CRD42020213491
ISSN:1179-5514