What to Know About High Cholesterol and COVID-19

COVID-19 severity has been linked to cardiovascular risk factors, such as obesity, high blood pressure, diabetes, and high cholesterol.

One study found that in people with active COVID-19, low-density lipoprotein (LDL) and triglyceride (TG) levels decreased based on the severity of the infection. Research on the causal link between the two is ongoing.

High Cholesterol and COVID-19 Risk

Recent research has shown that individuals with high body mass index (BMI), a marker of obesity, and high LDL cholesterol—also known as “bad” cholesterol—are at an increased risk of getting COVID-19, but the causal link between the two is unknown.

COVID-19 research is rapidly evolving, and more is being learned about the connections between high cholesterol levels and COVID-19 risk. Scientists theorize that LDL contributes to vasculopathy—or blood vessel abnormalities—in patients with COVID-19. The virus does so by invading endothelial cells (EC) and causing injury, triggering an inflammatory reaction that leads to widespread blood clotting called coagulopathies.

The ECs within atherosclerotic plaques are more vulnerable to an attack from COVID-19 or inflammatory storms, causing a rupture of plaques and a high risk of developing coagulopathy in patients with associated cardiovascular preconditions.

High cholesterol, therefore, is a significant contributor to blood vessel injury that can lead to atherosclerosis.

If you have COVID-19 or high cholesterol, you may be at a higher risk of cardiovascular complications, but when the two are present at the same time, you may have a higher risk of experiencing:

• Blood clots
• Heart attack
• Stroke

Complications of High Cholesterol and COVID-19

When LDL builds up in the blood, it can narrow or clog the arteries, raising your risk of having a:

• Heart attack
• Stroke
• Heart condition

COVID-19 puts the body in a pro-inflammatory state, damaging the heart and lung tissues while also increasing the risk of coagulopathy or blood clots. Those with high cholesterol and COVID-19 are at even higher risk of experiencing a cardiovascular event.

If you are obese or have high cholesterol levels, you may require more rigorous social distancing or shielding from people to avoid COVID-19 infection and subsequent complications.

High Cholesterol Treatments and COVID-19

If you are already taking cholesterol-lowering drugs like statins, you should continue to do so until advised otherwise by a healthcare professional, even if you are diagnosed as COVID-19 positive.

If you have been recently diagnosed with high cholesterol levels, your healthcare provider may recommend lowering LDL levels using statins, cholesterol-lowering medications, to prevent heart disease. 

Of note, some statins may cause severe side effects such as muscle aches and liver damage. If you are experiencing statin-associated muscle symptoms, inform a healthcare professional. Statin therapy may need to be discontinued if skeletal muscle symptoms and elevated liver enzymes persist.

Frequently Asked Questions 

Should I get a COVID-19 vaccine if I have high cholesterol?

Yes. Data shows that getting the COVID-19 vaccine protects you from contracting and transmitting the disease. It also helps to protect others in society who are particularly vulnerable or susceptible to infection, especially those with high cholesterol who do not present with obesity or other noticeable markers of disease. 

While getting the COVID-19 vaccine decreases your risk of severe disease in those with high cholesterol levels, you should also adopt a healthy lifestyle that includes eating a diet high in fruits and vegetables, and routinely exercising to maximize your protection against the disease and its negative health impacts.

All FDA-approved or authorized vaccine candidates—Pfizer-BioNtech, Moderna, Johnson & Johnson, and Novavax—have been proven to be nearly 100% effective in preventing severe cases, hospitalizations, and death from COVID-19.

Therefore, the CDC recommends that everyone 6 months and older get the COVID-19 vaccination. In addition, they recommend an updated bivalent booster shot for everyone 6 months and over, regardless of the vaccine series they initially received.

Is COVID-19 more dangerous for those with high cholesterol?

COVID-19 is more likely to cause an inflammatory reaction that can lead to injured blood vessels, massive blood clotting throughout the body, and a higher likelihood of having a heart attack or stroke.

Why are people with high cholesterol more likely to get COVID-19?

High cholesterol is an independent risk factor for heart health. COVID-19 infection heightens the possibility of having a heart attack or stroke. Research has shown that higher levels of total cholesterol may increase susceptibility to COVID-19 by making it easier for SARS-Cov-2 viruses to enter cells.

BMI and LDL cholesterol have become important metrics alongside other known characteristics such as age and ethnicity in the risk assessment of vulnerability to COVID-19 infection. However, more research is needed, as the answer remains unclear.

How to Stay Safe

Taking your medication as prescribed and eating a low-sodium diet are keys to living a heart-healthy life. Healthy adults should have their cholesterol tested every 4 to 6 years, and individuals with a family history should be especially diligent.

To prevent high cholesterol:

• Eat heart-healthy foods like colorful vegetables and whole grains.
• Reduce saturated fats and eliminate trans fats. Saturated fats, found primarily in red meat and full-fat dairy products, are the biggest culprits in raising your total cholesterol, so they should be consumed in moderation. Junk food and processed meals may be high in trans fat and should be avoided. 
• Lose weight.
• Exercise for at least 30 minutes a day.
• Quit smoking.
• Limit alcohol use.
• Manage stress.

Lifestyle changes alone can lower cholesterol or maintain healthy numbers. Foods that help lower your cholesterol include:

• Green, leafy vegetables
• Oats
• Whole grains
• Fatty fish
• Beans
• Eggplant and okra
• Fresh fruits such as apples, strawberries, grapes, and citrus fruits
• Soy

When lifestyle changes are coupled with strict adherence to social distancing protocols, the risk of catching COVID-19 plummets. To decrease your risk of infection:

• Limit the number of people you come into contact with.
• Wear a mask, especially around people.
• Wash your hands with soap and water for at least 20 seconds.
• Wipe surfaces with sanitation wipes.
• If you are taking a cholesterol-lowering medication—such as a statin—without major side effects, continue to take it unless told to do otherwise by a healthcare professional.

A Word From Verywell

High cholesterol can be the result of an unhealthy diet, genetics, being overweight, or smoking. The most important steps to avoiding COVID-19 complications are adhering to social distancing guidelines, getting vaccinated, and pinpointing the cause of your high cholesterol.

Oftentimes, the cause of your high cholesterol is multifactorial in nature. Fortunately, a few small lifestyle changes, while not always easy, may greatly improve your heart health. Limiting unhealthy foods, exercising regularly, and checking in regularly with a healthcare professional can go a long way to living a happy, healthy, and COVID-19-free life.

The information in this article is current as of the date listed. As new research becomes available, we’ll update this article. For the latest on COVID-19, visit our coronavirus news page.