BMI, LDL Cholesterol Are Important Metrics in Assessing COVID-19 Risk

Using a novel approach to assess cardiovascular risk factors in coronavirus disease 2019 (COVID-19) infection, researchers at Queen Mary University of London found that several observational studies linked COVID-19 severity and cardiovascular risk factors, such as obesity, high blood pressure, diabetes, and high cholesterol. However, the researchers in these observational studies were not able to determine a cause and effect relationship.^1,2

The investigators used a novel approach called Mendelian Randomization to investigate the effects of cardiovascular risk factors on the risk of COVID-19 infection. The approach allowed the researchers to leverage data on the individual genetic information of patients.^1,2

During the study, investigators observed causal associations between body mass index (BMI), low-density lipoprotein (LDL) cholesterol, and susceptibility to COVID-19. Specifically, they found that individuals with higher genetic risk were predisposed to severe acute respiratory syndrome coronavirus 2 infection.¹

Additionally, the researchers noted that these results highlight the need to integrate BMI into the risk assessment for COVID-19 and the potential role of lipid modification in COVID-19 prevention and treatment.^1,2

"Our results show that individuals with high body mass index (BMI), a marker of obesity, and high low-density lipoprotein (LDL) cholesterol (also known as 'bad' cholesterol) are at an increased risk of getting COVID-19. Other cardiovascular risk factors (high blood pressure and diabetes) do not appear to elevate the COVID-19 risk,” said lead author Nay Aung, PhD, a researcher at the Queen Mary University of London, in a statement. "Our findings support the use of BMI and LDL cholesterol as important metrics alongside other known characteristics (such as age and ethnicity) in the risk assessment of vulnerability to COVID-19 infection."²

In terms of impact on public policy, these findings may shine light on the need to require more rigorous social distancing or shielding for people who are in the at-risk obese category or who have extreme hyperlipidemia.^1,2

The researchers also noted that further studies investigating the role of cholesterol modification therapy while patients with COVID-19 are ill or in the hospital could allow for a clearer understanding of the potential impact of such therapy on patient outcomes.^1,2

REFERENCES

• Aung N, Khanji MY, Munroe PB, Petersen SE. Causal Inference for Genetic Obesity, Cardiometabolic Profile and COVID-19 Susceptibility: A Mendelian Randomization Study. Frontiers in Genetics. 2020. doi: 10.3389/fgene.2020.586308.
• Obese people found to be at increased risk of COVID-19. London: Queen Mary University of London; November 16, 2020. eurekalert.org/pub_releases/2020-11/q. Accessed November 30, 2020.