COVID-19 Sharply Boosts Risk for Blood-Fat Disorders

November 1, 2024—(BRONX NY)—A new study led by researchers at Albert Einstein College of Medicine involving more than 200,000 adults found that the COVID-19 pandemic caused a 29% increase in risk for developing dyslipidemia, a condition involving abnormal lipid (fat) levels in the blood. Seniors and people with type 2 diabetes were even more strongly affected, experiencing an approximately two-fold increased risk for developing dyslipidemia, which is a major risk factor for cardiovascular diseases such as heart attack and stroke. The research was published today in the print edition of The Journal of Clinical Investigation.

“Given the extent of the pandemic, this increase in dyslipidemia risk is a cause for concern around the world,” said study leader Gaetano Santulli, M.D., Ph.D., associate professor of medicine and of molecular pharmacology at Einstein. “Based on our findings, we would advise people to have their lipid levels monitored regularly and to consult with their healthcare providers about ways to treat dyslipidemia if detected, especially elderly individuals and patients with diabetes.” He noted that this advice would apply to all adults, not just those formally diagnosed with COVID-19, considering that many people have been infected without realizing it.

To put these findings into context, it has been estimated that 53% of U.S. adults had dyslipidemia before the pandemic; a 29% increase in dyslipidemia incidence due to COVID-19 would mean that 68% of Americans may now be at risk for having lipid abnormalities.

In two previous studies, Dr. Santulli and his team found that COVID-19 raised the incidence of new cases of hypertension and type 2 diabetes. “In those analyses, we demonstrated that the risk of developing these disorders was still high three years after the pandemic; moreover, we noticed a suspicious increase in total cholesterol levels, which warranted a closer look,” said Dr. Santulli. In the new study, the researchers first determined the incidence of dyslipidemia in a group of more than 200,000 adults living in Naples, Italy, during the three years prior to the start of the pandemic (2017-2019). They then assessed the incidence of dyslipidemia in the same group during the three-year COVID-19 period (2020-2022), excluding from the analysis those people earlier diagnosed with dyslipidemia or who had previously been taking lipid-lowering medications.

The investigators found that COVID-19 raised the risk for developing dyslipidemia in the entire study group by an average of 29%. The increase was even higher among people over age 65 and those with chronic conditions, particularly diabetes and obesity, cardiovascular disease, chronic obstructive pulmonary disease, and hypertension. The findings are the most definitive to date because other studies—most of them linking COVID-19 with modestly increased risks for blood-lipid problems—used as control groups different populations or people thought to have gone through the pandemic without becoming infected. However, significant numbers of people classified as “COVID-free” actually developed the disease but were either never tested or didn’t seek medical care.

“Our study did not attempt to determine whether participants had tested positive for COVID-19,” Dr. Santulli said. “Instead, because we had been following this group for many years prior to the pandemic, we were able to measure COVID’s overall impact on the population by simply comparing levels of dyslipidemia in the same group before and after the pandemic. Any increase in dyslipidemia incidence would almost certainly have to be the result of COVID-19.”

How COVID-19 might have increased the incidence of dyslipidemia remains unclear. One possible explanation is a finding Dr. Santulli made in an earlier study: that SARS-CoV-2 (the virus that causes COVID) disrupts the function of endothelial cells, which line the inside of blood vessels throughout the body and play a critical role in regulating blood lipids.

A separate study found that COVID-19 is a powerful risk factor for heart attacks and strokes for as long as nearly three years after an infection. “This investigation, published online a month after ours, essentially confirms our observations in this study, since dyslipidemia is a major contributor to cardiovascular disease,” said Dr. Santulli. “It also suggests that tackling dyslipidemia should reduce the risk of cardiovascular disease in those who have had COVID.”  

The researchers are now studying the effects of COVID-19 on cardiovascular-kidney-metabolic (CKM) syndrome, a recently described condition involving four connected medical problems—heart disease, kidney disease, diabetes, and obesity—all of which involve endothelial dysfunction.

The study is titled “A six-year study in a real-world population reveals an increased incidence of dyslipidemia during COVID-19”. The other contributors include: Stanislovas S. Jankauskas, Ph.D., and Fahimeh Varzideh, Ph.D., both at Einstein, Pasquale Mone, M.D., Ph.D., at Einstein and Molise University, Campobasso, Italy, Valentina Trimarco, Raffaele Izzo, Maria Virginia Manzi, Maria Lembo, Paola Gallo, Giovanni Esposito, and Francesco Rozza, at the Federico II University of Naples, Italy, Roberto Piccinocchi, at the Vanvitelli Hospital, Naples, Italy, Carmine Morisco and Bruno Trimarco, at the International Translational Research and Medical Education (ITME) Consortium and Federico II University of Naples, Gaetano Piccinocchi, at the Italian Society of General Medicine, Mario Fordellone and Giuseppe Signoriello, at the Campania University, Naples, Italy.

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About Albert Einstein College of Medicine 

Albert Einstein College of Medicine is one of the nation’s premier centers for research, medical education and clinical investigation. During the 2023-24 academic year, Einstein is home to 737 M.D. students, 209 Ph.D. students, 124 students in the combined M.D./Ph.D. program, and approximately 239 postdoctoral research fellows. The College of Medicine has more than 2,000 full-time faculty members located on the main campus and at its clinical affiliates. In 2023, Einstein received more than $192 million in awards from the National Institutes of Health. This includes the funding of major research centers at Einstein in cancer, aging, intellectual development disorders, diabetes, clinical and translational research, liver disease, and AIDS. Other areas where the College of Medicine is concentrating its efforts include developmental brain research, neuroscience, cardiac disease, and initiatives to reduce and eliminate ethnic and racial health disparities. Its partnership with Montefiore, the University Hospital and academic medical center for Einstein, advances clinical and translational research to accelerate the pace at which new discoveries become the treatments and therapies that benefit patients. For more information, please visit einsteinmed.edu, follow us on Twitter, Facebook, Instagram, LinkedIn, and view us on YouTube.