Role of Lipid Profile and Its Relative Ratios (Cholesterol/HDL-C, Triglyceride/HDL-C, LDL-C/HDL-C, WBC/HDL-C, and FBG/HDL-C) on Admission Predicts In-Hospital Mortality COVID-19

Abstract

Background. Lipid profile and its related ratios such as total cholesterol (TC), low-density lipoprotein-cholesterol (LDL-C), triglyceride (TG), high-density lipoprotein-cholesterol (HDL-C), TG/HDL-C ratio, TC/HDL-C ratio, LDL-C/HDL-C ratio, white blood cell (WBC)/HDL-C ratio, and fasting blood glucose (FBG)/HDL-C ratio are valuable indicators that have been studied in various disorders to predict mortality. The present study was conducted with the aim of investigating the role of lipid profile ratios in predicting mortality in COVID-19 patients. Methods. At the beginning of hospitalization, laboratory tests were taken from all patients ( $n=300$ ). The ability of lipid profile ratios to determine the COVID-19 severity was evaluated using receiver-operating characteristic (ROC). In addition, survival probability was determined with the average of Kaplan-Meier curves, so that the end point was death. Results. In deceased patients, TG, TC, LDL-C, HDL-C, TC/HDL-C, TG/HDL-C, and LDL-C/HDL-C parameters were significantly lower than those of surviving patients, while WBC/HDL-C and FBG/HDL-C were significantly higher. TC ( $\text{HR}=3.178$ , $95\%\text{CI}=1.064$ to 9.491, $P<0.05$ ), TG ( $\text{HR}=3.276$ , $95\%\text{CI}=1.111$ to 9.655, $P<0.05$ ), LDL-C ( $\text{HR}=3.207$ , $95\%\text{CI}=1.104$ to 9.316, $P<0.05$ ), and HDL-C ( $\text{HR}=3.690$ , $95\%\text{CI}=1.290$ to 10.554, $P<0.05$ ), as well as TC/HDL-C ( $\text{HR}=3.860$ , $95\%\text{CI}=1.289$ to 11.558, $P<0.05$ ), TG/HDL-C ( $\text{HR}=3.860$ , $95\%\text{CI}=1.289$ to 11.558, $P<0.05$ ), LDL-C/HDL-C ( $\text{HR}=3.915$ , $95\%\text{CI}=1.305$ to 11.739, $P<0.05$ ), WBC/HDL-C ( $\text{HR}=3.232$ , $95\%\text{CI}=1.176$ to 8.885, $P<0.05$ ), and FBG/HDL-C ratios ( $\text{HR}=4.474$ , $95\%\text{CI}=1.567$ to 12.777, $P<0.01$ ), were detectably related to survival. The multivariate Cox regression models showed that only FBG/HDL-C ratio ( $\text{HR}=5.477$ , $95\%\text{CI}=1.488$ to 20.153, $P<0.01$ ) was significantly related to survival. Conclusion. The results suggested that FBG/HDL-C ratio in hospital-admitted COVID-19 patients was a reliable predictor of mortality.