SAT-255 Metabolic Implications Of Covid-19: Exploring Lipids And Inflammation

Abstract Disclosure: F. Mohamed: None. S. Gunter: None. S. Currin: None. F.J. Raal: None. I.S. Kalla: None. A.M. Millen: None. Background: COVID-19 is associated with cardiometabolic complications, but its effect on lipoprotein(a) [Lp(a)] remains unclear. This study assessed the relationship between lipid profiles, Lp(a), disease severity, and recovery. Research Design and Methods: A multi-centre prospective cross-sectional study was conducted at two South African centres, enrolling adults with moderate-to-severe COVID-19 within two days of admission. Survivors were followed three months post-discharge. Lipid panels, Lp(a), and cytokines (Th1/Th2/Th17) were measured. Statistical analyses included regression and ROC analysis. Results: Among 169 participants (84 COVID-19 cases, 86 controls), COVID-19 patients had lower low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and total cholesterol (TC) but higher triglycerides (TG) and TG: HDL ratios compared to controls. Non-survivors were more likely to be male, had elevated BMI, fasting plasma glucose, and significantly lower LDL-C levels compared to survivors. Inflammatory markers were more pronounced in non-survivors, with predominantly Th1/Th17 cytokines predictive of mortality, admission to an intensive care unit and follow-up changes in lipid profiles. ROC analysis demonstrated LDL-C as a mortality predictor (AUC: 0.68), with improved accuracy when combined with body mass index (BMI) and inflammatory cytokines (AUC: 0.85). Post-discharge, survivors showed significantly increased BMI, blood pressure, LDL-C, and Lp(a). Lp(a) concentrations were significantly higher in Black and Mixed-Race participants compared to Indian, Asian and White participants, with median Lp(a) levels more than 8-fold higher in Black and Mixed-Race patients with COVID-19 compared to White patients at follow-up. Conclusion: This study reveals that acute COVID-19 disrupts lipid metabolism, with persistent cardiovascular risks post-recovery, including elevated Lp(a), hypertension, and dyslipidaemia. LDL-C may serve as a prognostic marker, supporting long-term cardiometabolic monitoring and intervention. Presentation: Saturday, July 12, 2025