High Cholesterol and COVID-19: What’s the Connection?

Cholesterol is a waxy and fat-like substance in your body. It’s important for things like making cell membranes and producing certain hormones and vitamins.

Experts have observed changes in cholesterol levels in people with COVID-19. Specifically, levels of LDL-C, HDL-C, and total cholesterol become lower when a person has COVID-19.

According to a 2022 research article, various other viral, bacterial, and parasitic infections can lead to similar findings. Some examples of other viruses that can lead to altered cholesterol levels include:

Experts currently do not know how COVID-19 leads to lower cholesterol levels. Overall, experts believe that increases in inflammation during infection impact various pathways associated with cholesterol production, transport, and metabolism in the body.

With COVID-19, the extent of a drop in cholesterol levels can link with illness severity. A 2022 research review found that upon hospital admission, people with severe COVID-19 had lower levels of:

• total cholesterol
• LDL-C
• HDL-C

According to researchers, HDL-C has anti-inflammatory and anti-thrombotic properties. So, it’s possible that a steep drop in HDL-C during COVID-19 may increase the risk of problems due to high levels of inflammation and blood clots.

Although cholesterol has important functions in the body, too much of it can be harmful. When there’s too much cholesterol in your blood, you usually have high cholesterol.

The Centers for Disease Control and Prevention (CDC) estimates that about 38% of adults in the United States have high cholesterol. As such, you may be wondering if having high cholesterol increases your risk of getting COVID-19.

Currently, high cholesterol isn’t on the CDC’s list of conditions that increase the risk of COVID-19. However, several conditions that often happen along with high cholesterol are, including:

High cholesterol may increase your risk of getting COVID-19

A 2021 study found that higher body mass index and cholesterol linked with COVID-19 cases and deaths.

The researchers suggested that this finding could be one reason why areas of the world with high occurrences of obesity and high cholesterol have seen more COVID-19 cases and deaths.

Another 2021 study used data from the UK Biobank to look at the effect of cholesterol on COVID-19 susceptibility. After their analysis, the researchers found that having higher total cholesterol linked with increased COVID-19 susceptibility.

How does high cholesterol increase your risk?

Cholesterol is present in the membranes of the cells in the body. As such, it’s possible that higher cholesterol increases susceptibility to COVID-19 by promoting viral entry into host cells.

A 2021 study investigated this idea. In a laboratory, experts loaded cell membranes with extra blood-derived cholesterol. Experts exposed the cell membranes to a test virus with the spike protein of SARS-CoV-2, the virus that causes COVID-19. The researchers saw that infection was higher in cholesterol-loaded cells.

They suggested that since the virus more effectively infected cells with higher cholesterol, this may add another reason why COVID-19 can be more severe in older adults, as they may be more likely to have underlying medical conditions like high cholesterol.

High HDL-C may protect against COVID-19

A 2022 study also looked at the effect of cholesterol levels on the risk of developing COVID-19. The researchers found that having high levels of HDL-C linked with a lower risk of getting COVID-19.

Experts found the lowest level of risk in people that had high levels of HDL-C and low levels of LDL-C.

Unlike the other studies discussed, other types of cholesterol, like total cholesterol and LDL-C, weren’t independently associated with the risk of developing COVID-19.

Long COVID is a collection of symptoms that can last weeks, months, or even years after you have COVID-19. People with long COVID can experience a wide variety of symptoms. A few examples include:

Having COVID-19 can change cholesterol levels. But do some people continue to have altered cholesterol levels even after they recover from COVID-19?

A 2021 study followed up with people who had come to the hospital for COVID-19 after 3 to 6 months. Compared with their levels at admission, both LDL-C and HDL-C levels improved significantly at the follow-up appointment.

Having high cholesterol may actually increase your risk of long COVID as well as prolonged symptoms from other non-COVID illnesses. At least that’s according to a 2022 study.

The study involved people with a wide spectrum of COVID-19 severity, from asymptomatic individuals to those with long COVID. It also included people who tested negative for COVID-19, but had…