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
  1. 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.
  2. 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.