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ORIGINAL RESEARCH article

Front. Cell. Infect. Microbiol.

Sec. Clinical Infectious Diseases

Volume 15 - 2025 | doi: 10.3389/fcimb.2025.1617266

This article is part of the Research TopicPerspectives in Clinical Infectious Diseases: 2024/2025View all 10 articles

The prognostic value of serum apolipoprotein A1 levels in elderly patients with de novo SARS-CoV-2 omicron infection

Provisionally accepted
Cong  ShiCong ShiRuishuang  MaRuishuang MaMiao  ZhouMiao ZhouYang  ShujunYang ShujunShengping  GongShengping Gong*
  • The First Affiliated Hospital of Ningbo University, Ningbo, China

The final, formatted version of the article will be published soon.

The coronavirus disease of 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2, has affected millions of people worldwide. The omicron variant is currently the predominant strain circulating worldwide. Serum apolipoprotein A1 (ApoA1) is linked to endothelial cell injury and serves as a valuable biomarker for monitoring the progression of inflammation in infected individuals. However, the potential roles of ApoA1 in the context of the omicron variant remain elusive.To investigate the prognostic value of serum ApoA1 levels at diagnosis, using mortality rate as the primary evaluation indicator, we performed a 65-day monitoring and retrospectively analyzed a cohort of 237 individuals diagnosed with omicron. Patients were categorized into two groups based on their ApoA1 levels, high and low. The Kaplan-Meier method was employed to assess overall survival (OS), while the log-rank test was utilized for comparative analysis between the groups. Additionally, both univariate and multivariate Cox proportional hazards models were applied to evaluate the prognostic significance of ApoA1 levels.Our results indicated that ApoA1 levels were significantly reduced in patients infected with the omicron variant. Notably, ApoA1 levels in severe cases were lower than those in mild-to-moderate cases, with this difference reaching statistical significance. Additionally, we observed a significant increase in C-reactive protein (CRP) and beta-2 microglobulin (β2-MG) levels in individuals with decreased ApoA1 levels. Furthermore, patients with reduced ApoA1 levels exhibited a statistically significant decline in OS (P = 0.001). A decreased ApoA1 level (< 0.87 g/L) was identified as an independent adverse prognostic factor for OS in omicron patients, as determined by multivariate cox proportional hazards regression analysis (P = 0.035).Throughout a monitoring period of 65 days, all patients were observed, with mortality serving as the primary outcome measure.

Keywords: omicron, SARS-CoV-2, Short-term, prognosis, apolipoprotein A1

Received: 24 Apr 2025; Accepted: 16 Jul 2025.

Copyright: © 2025 Shi, Ma, Zhou, Shujun and Gong. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Shengping Gong, The First Affiliated Hospital of Ningbo University, Ningbo, China

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