Abstract: medRxiv preprint doi: https://doi.org/10.1101/2020.10.06.20207092; this version posted October 8, 2020. The copyright holder has placed this preprint (which was not certified by peer review) in the Public Domain. It is no longer restricted by copyright. Anyone can legally share, reuse, remix, or adapt this material for any purpose without crediting the original authors. Low-density lipoprotein cholesterol levels are associated with poor clinical outcomes in COVID-19 Álvaro Aparisi, MD1#; Carolina Iglesias-Echeverría, MD1; Cristina Ybarra-Falcón, MD1; Iván Cusácovich, MD, PhD3; Aitor Uribarri MD, PhD1 ; Mario García-Gómez, MD1 ; Raquel Ladrón MD1; Raúl Fuertes ; MD⁴; Jordi Candela, MD1; Williams Hinojosa, MD1; Carlos Dueñas, MD3; Roberto González, MD, PhD3; Leonor Nogales, MD5; Dolores Calvo MD6; Manuel Carrasco-Moraleja, MSc1; J. Alberto San Román, MD, PhD1,2; Ignacio J.Amat-Santos, MD, PhD1,2 ; David Andaluz-Ojeda, MD, PhD5* ¹Cardiology Department, Hospital Clínico Universitario, Valladolid, Spain ²CIBERCV, Cardiology Department, Hospital Clínico Universitario, Valladolid, Spain 3 Internal Medicine Deparment, Hospital Clínico Universitario de Valladolid, Spain 4 5 Medicine School, University of Valladolid, Valladolid, Spain Intensive Care Unit Department, Hospital Clínico Universitario de Valladolid, Spain 6 Clinical analysis department, Hospital Clínico Universitario de Valladolid, Spain Short title: LDL levels in COVID-19 Word count: 3,010 Abstract word count: 200 Conflicts of interest: None. Financial sources: This work was partially funded by Gerencia Regional de Salud de Castilla y León under grant number GRS COVID 111/A/20 and GRS COVID 108/A/20 Ethics of protocol: According to the Declaration of Helsinki, the local ethics committee approved this study. *Corresponding author: David Andaluz Ojeda, MD, Ph.D. Intensive Care Department. Hospital Clínico Universitario de Valladolid, Spain. Ramón y Cajal 3. 47005. Valladolid. Spain. Telephone. 0034 983 42 00 26. Fax. 0034 983 25 53 05 e-mail: dandaluz@saludcastillayleon.es 1 NOTE: This preprint reports new research that has not been certified by peer review and should not be used to guide clinical practice. medRxiv preprint doi: https://doi.org/10.1101/2020.10.06.20207092; this version posted October 8, 2020. The copyright holder has placed this preprint (which was not certified by peer review) in the Public Domain. It is no longer restricted by copyright. Anyone can legally share, reuse, remix, or adapt this material for any purpose without crediting the original authors. STRUCTURED ABSTRACT Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the sole causative agent of coronavirus infectious disease-19 (COVID-19). Methods: We performed a retrospective single-center study of consecutively admitted patients between March 1st and May 15th, 2020, with a definitive diagnosis of SARS-CoV-2 infection. The primary end-point was to evaluate the association of lipid markers with 30-days all-cause mortality in COVID-19. Results: A total of 654 patients were enrolled, with an estimated 30-day mortality of 22.8% (149 patients). Non-survivors had lower total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-c) levels during the entire course of the disease with complete resolution among survivors. Both showed a significant inverse correlation with inflammatory markers and a positive correlation with lymphocyte count. In a multivariate analysis, LDL-c ≤..