Causal Associations Between Blood Lipids and COVID-19 Risk: A Two-Sample Mendelian Randomization Study

OBJECTIVE: Coronavirus disease 2019 (COVID-19) is a global pandemic caused by the severe acute respiratory syndrome coronavirus 2. It has been reported that dyslipidemia is correlated with COVID-19, and blood lipids levels, including total cholesterol, HDL-C (high-density lipoprotein cholesterol), and LDL-C (low-density lipoprotein cholesterol) levels, were significantly associated with disease severity. However, the causalities of blood lipids on COVID-19 are not clear. APPROACH AND RESULTS: We performed 2-sample Mendelian randomization (MR) analyses to explore the causal effects of blood lipids on COVID-19 susceptibility and severity. Using the outcome data from the UK Biobank (1221 cases and 4117 controls), we observed potential positive causal effects of dyslipidemia (odds ratio [OR], 1.27 [95% CI, 1.08-1.49], P=3.18×10^-3), total cholesterol (OR, 1.19 [95% CI, 1.07-1.32], P=8.54×10^-4), and ApoB (apolipoprotein B; OR, 1.18 [95% CI, 1.07-1.29], P=1.01×10^-3) on COVID-19 susceptibility after Bonferroni correction. In addition, the effects of total cholesterol (OR, 1.01 [95% CI, 1.00-1.02], P=2.29×10^-2) and ApoB (OR, 1.01 [95% CI, 1.00-1.02], P=2.22×10^-2) on COVID-19 susceptibility were also identified using outcome data from the host genetics initiative (14134 cases and 1284876 controls). CONCLUSIONS: In conclusion, we found that higher total cholesterol and ApoB levels might increase the risk of COVID-19 infection.