Elevated serum apolipoprotein E level associated with poor prognosis of patients with acute omicron variant COVID-19 infection

Abstract

Abstract Background: The SARS-CoV-2 virus is responsible for the human disease known as COVID-19. This virus is capable of generating a spectrum of infections ranging from moderate to severe. The omicron variant is currently the predominant mutant strain of the pandemic on a global scale. Serum apolipoprotein E (ApoE) inhibits inflammation by preserving immune regulatory function. Nonetheless, the relationship between serum ApoE and clinical prognosis in omicron remains elusive. Methods: A cohort of 231 patients with omicron was studied retrospectively to determine the prognostic usefulness of blood ApoE levels upon diagnosis. All patients were observed for 65 days, with death as the primary outcome. Based on their ApoE levels, the patients were categorized into two groups: individuals with elevated ApoE levels and those with lower ApoE levels. In order to do statistical comparisons, the log-rank test was utilized, and the Kaplan-Meier method was utilized in order to estimate survival rates. Cox hazard models, both univariate and multivariate, were employed to examine the prognostic relevance. Results: According to our research, omicron had significantly greater ApoE levels. In mild-to-moderate and severe cases, the study identified a statistically significant variation in ApoE levels. Procalcitonin (PCT), Interleukin-6 (IL-6) and Interleukin-10 (IL-10) levels were found to be considerably higher, and the absolute count of CD3 lymphocyte, absolute count of CD8 lymphocytes was found to be fewer in people with high levels of ApoE. Additionally, there was a drop in overall survival that is statistically significant (OS, P < 0.0001) for patients with greater ApoE levels. Multiple Cox proportional hazards regression analysis indicates that (P = 0.022), an elevated ApoE level, specifically more than 49.8 mg/L, was determined to be an adverse and independent prognostic factor of overall survival in patients with omicron. Conclusion: The level of serum ApoE at the time of initial diagnosis was substantially connected to the severity and prognosis of omicron. Consequently, we propose that ApoE might be a poor prognostic factor in individuals afflicted with the omicron variant.