A longitudinal case study: Persistent dyslipidemia in post-COVID-19 syndrome

Abstract

Post-acute sequelae of severe acute respiratory syndrome coronavirus 2 encompass multisystem disorders, with 
emerging evidence indicating metabolic disturbances such as dyslipidemia in recovered patients. This case study 
presents a 48-year-old male with no prior dyslipidemia or cardiovascular disease, hospitalized for moderate-to-severe COVID-19 pneumonia. Five months post-discharge, he reported fatigue and cognitive symptoms and was found to have a profoundly atherogenic lipid profile. Despite 3 months of structured lifestyle intervention (Mediterranean diet and graded exercise), his dyslipidemia persisted for over 6 months, characterized by elevated total cholesterol (242 mg/dL), triglycerides (285 mg/dL), low-density lipoprotein cholesterol (165 mg/dL), and reduced high-density lipoprotein cholesterol (32 mg/dL). Elevated high-sensitivity C-reactive protein (8.2 mg/L) indicated ongoing inflammation. Due to persistent abnormalities, atorvastatin 20 mg daily was initiated for primary prevention. This longitudinal case highlights that COVID-19 can induce significant and persistent atherogenic dyslipidemia even in individuals without traditional cardiovascular risk factors. The findings underscore the need for proactive metabolic screening, including a fasting lipid panel, as a standard component of post-COVID assessment, particularly after moderate-to-severe illness, to mitigate long-term cardiovascular risk.