A new study conducted by researchers at Albert Einstein College of Medicine, which involved over 200,000 adults, found that the COVID-19 pandemic led to a 29% increase in the risk of developing dyslipidemia. This condition is characterized by abnormal blood lipid (fat) levels. Seniors and individuals with type 2 diabetes were particularly affected, facing nearly double the risk of developing dyslipidemia. This condition is a significant risk factor for cardiovascular diseases, including heart attacks and strokes. The research was published in the print edition of The Journal of Clinical Investigation.
“Considering the widespread impact of the pandemic, the increased risk of dyslipidemia is a global concern,” said study leader Gaetano Santulli, M.D., Ph.D., an associate professor of medicine and molecular pharmacology at Einstein. “Based on our findings, we recommend that individuals have their lipid levels monitored regularly and consult with their healthcare providers about treatment options for dyslipidemia if detected. This is especially important for elderly individuals and patients with diabetes.” He emphasized that this advice is relevant for all adults, not just those formally diagnosed with COVID-19, as many people may have been infected without realizing it.
To provide context for these findings, it is estimated that 53% of U.S. adults had dyslipidemia before the pandemic. If COVID-19 has caused a 29% increase in the incidence of dyslipidemia, this would suggest that approximately 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 increased the incidence of new cases of hypertension and type 2 diabetes. “In those analyses, we demonstrated that the risk of developing these disorders remained high three years after the pandemic. Additionally, we observed a concerning rise in total cholesterol levels, which warranted further investigation,” said Dr. Santulli. In the latest study, the researchers first identified the incidence of dyslipidemia among over 200,000 adults living in Naples, Italy, during the three years before the onset of the pandemic (2017-2019). They then examined the incidence of dyslipidemia in the same group during the COVID-19 period (2020-2022). This analysis excluded individuals who had been previously diagnosed with dyslipidemia or who had 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.