Lipoprotein(a) and SARS-CoV-2 infections: Susceptibility to infections, ischemic heart disease and thromboembolic events

J Intern Med. 2022 Jan;291(1):101-107. doi: 10.1111/joim.13338. Epub 2021 Oct 29.

Abstract

Background: Comorbidities including ischemic heart disease (IHD) worsen outcomes after SARS-CoV-2 infections. High lipoprotein(a) [Lp(a)] concentrations are a strong risk factor for IHD and possibly for thromboembolic events. We therefore evaluated whether SARS-CoV-2 infections modify the risk of high Lp(a) concentrations for IHD or thromboembolic events during the first 8.5 months follow-up of the pandemic.

Method: Cohort study using data from the UK Biobank during the SARS-CoV-2 pandemic. Baseline Lp(a) was compared between SARS-CoV-2 positive patients and the population controls.

Results: SARS-CoV-2 positive patients had Lp(a) concentrations similar to the population controls. The risk for IHD increased with higher Lp(a) concentrations in both, the population controls (n = 435,104) and SARS-CoV-2 positive patients (n = 6937). The causality of the findings was supported by a genetic risk score for Lp(a). A SARS-CoV-2 infection modified the association with a steeper increase in risk for infected patients (interaction p-value = 0.03). Although SARS-CoV-2 positive patients had a five-times higher frequency of thromboembolic events compared to the population controls (1.53% vs. 0.31%), the risk was not influenced by Lp(a).

Conclusions: SARS-CoV-2 infections enforce the association between high Lp(a) and IHD but the risk for thromboembolic events is not influenced by Lp(a).

Keywords: SARS-CoV-2; ischemic heart disease; lipoprotein(a); thromboembolic events.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • COVID-19 / blood
  • COVID-19 / diagnosis*
  • COVID-19 Nucleic Acid Testing
  • Case-Control Studies
  • Cohort Studies
  • Female
  • Humans
  • Intensive Care Units
  • Lipoprotein(a) / blood*
  • Male
  • Middle Aged
  • Myocardial Ischemia / epidemiology*
  • Nasopharynx / virology*
  • Risk Factors
  • SARS-CoV-2 / genetics
  • SARS-CoV-2 / isolation & purification*
  • Thromboembolism / epidemiology*
  • Thromboembolism / etiology

Substances

  • Lipoprotein(a)