According to a study from the University of Oslo, patients hospitalized with severe COVID-19 have lasting changes in their cholesterol three months after recovery. This increases their risk of developing heart disease later in life.
Many clinicians and scientists have questioned whether COVID-19 disease affects people’s health later in life. Several recent studies have shown a link between COVID-19 and heart disease. Does being seriously ill with COVID-19 increase people’s risk of developing heart disease?
“Recent studies have suggested that COVID-19 increases the risk of cardiovascular disease. However, the mechanisms for this are still unclear,” said Ida Gregersen, a researcher at the University of Oslo and Oslo University Hospital.
Norwegian researchers have found that patients hospitalized with severe COVID-19 have lasting changes in their cholesterol after recovery.
“We believe that COVID-19 increases the risk of developing heart disease later in life, and that these changes are a possible explanation for this increased risk,” said Bente Halvorsen, a professor at the University of Oslo and the study’s principal investigator. .
“Bad” LDL cholesterol increases the risk of heart disease
Cholesterol is one of the body’s fats and is an important building block in the body. There are different types of cholesterol, including LDL, which consists of different LDL particles.
“LDL is responsible for transporting fat in the body and is also referred to as the ‘bad cholesterol’,” says Gregersen.
It is called the bad cholesterol because a high level of LDL cholesterol in the blood increases your risk of heart disease and stroke.
“It is a known fact that the risk of cardiovascular disease increases with high LDL levels in the blood. In addition, the risk also increases with changes in the composition of the LDL particles,” she says.
Changes in LDL particles observed in patients who have recovered from severe COVID-19
The researchers observed such changes in LDL composition in these patients 3 months after they recovered from severe COVID-19.
“In patients who have had severe COVID-19, the composition of these LDL particles has changed after their illness. They contain various inflammatory substances, among other things,” says Gregersen.
Such changes can cause these LDL particles to build up in the walls of your arteries. This can encourage the development of heart disease in the long run.
“We therefore believe that severe COVID-19 causes long-lasting changes in the composition of LDL particles, i.e. in the body’s system for transporting fat throughout the body. It could put patients at increased risk of cardiovascular disease later on. can cause vascular disease, but we don’t. I don’t know yet,” she says.
We can prevent heart disease if we know more about the risk
It is important that people who have had severe COVID-19 are aware of their increased risk of cardiovascular disease, the researchers said.
“It is incredibly important for patients who have had severe COVID-19 to know that they may have altered cholesterol composition in their bodies. We know from previous research that they have a greater risk of cardiovascular disease later in life” says Halvorsen.
By identifying people at risk, preventive measures can be taken. Among other things, there are effective measures aimed at people with a high LDL cholesterol level in their blood.
“The more we know, the more we can prevent and treat that risk. We have tools to manage the risk of heart disease in people with elevated LDL,” she says.
Lifestyle factors such as smoking and obesity are also important
Halvorsen recommends that those who have had a severe illness from COVID-19 contact their GP. To find out if you have an increased risk of developing cardiovascular disease, you can request a blood test.
“We cannot say with certainty that these patients will actually develop cardiovascular disease. Environmental and lifestyle factors such as smoking, obesity and high blood pressure will play a role in whether this will develop further,” says Halvorsen.
New method can isolate and measure changes in LDL particles
The researchers investigated a specific feature of the LDL particles, called LDL aggregation, in which the LDL particles group together in the blood vessels. To investigate LDL aggregation, the researchers teamed up with the Wihuri Research Institute in Finland, which has developed a method that can isolate and measure these changes in LDL.
“We know that LDL can aggregate, that is, group. However, this method can obtain quantitative measures that can show whether there is a change in LDL aggregation in the blood. We can therefore use this as a measure of risk of heart disease – and vascular diseases”, Halvorsen explains.
Persistent changes in LDL indicate active immune activation
“The fact that these differences in LDL composition become visible 3 months after patients have recovered from COVID-19 is important,” Halvorsen emphasizes.
LDL has a plasma half-life of only a few days before being renewed. Half-life means the time it takes for LDL to decrease by half. After a few days, new LDL is produced. Normally, therefore, one would expect changes in LDL composition to disappear after a few days.
“If we still see changes in LDL composition after 3 months, that suggests that COVID-19 may lead to long-term disruptions in the system that transports fat in our body. In addition, LDL carries markers of inflammation. This shows us that there is still immune activation in the body 3 months after recovery from COVID-19,” Halvorsen explains. The professor finds the findings surprising.
“We saw significant differences in the way LDL was grouped between healthy people who didn’t have COVID-19 and these patients, who had been sick and hospitalized with severe COVID-19. To me, this is pretty sensational. This is a new finding, and it will be interesting to see how this develops,” says Halvorsen.
Analysis of blood samples from Norway’s first COVID-19 patients
The researchers analyzed blood samples from 66 people hospitalized with severe COVID-19, taken during a follow-up 3 months after hospital discharge. These patients were hospitalized during the first wave of COVID-19 in March 2020. The researchers then compared these samples with 42 healthy adults who served as controls, and examined whether factors such as age, gender and ethnicity played a role.
More research is needed
“Our data suggest novel mechanisms for increased cardiovascular risk in COVID-19 patients. However, further and larger studies that can investigate the association between these LDL characteristics and the development of cardiovascular disease are needed to further validate our findings. support,” concludes Halvorsen.
University of Oslo, Faculty of Medicine
Ueland, T., et al. (2023). Low-density lipoprotein particles carrying pro-inflammatory proteins with altered aggregation pattern detected in COVID-19 patients 3 months after hospitalization. Journal of Infection. doi.org/10.1016/j.jinf.2023.02.024.