Serum 25-hydroxycholesterol levels are increased in patients with coronavirus disease 2019

Background: 25-hydroxycholesterol (25HC), produced by cholesterol 25-hydroxylase (CH25H) in macrophages, has been reported to inhibit the replication of viral pathogens such as severe acute respira-tory syndrome coronavirus-2. Also, CH25H expression in macrophages is robustly induced by interferons (IFNs).Objective: To better understand the serum level increase of 25HC in coronavirus disease 2019 (COVID-19) and how it relates to the clinical picture.Methods: We measured the serum levels of 25HC and five other oxysterols in 17 hospitalized COVID-19 patients.Results: On admission, 25HC and 27-hydroxycholesterol (27HC) serum levels were elevated; how-ever, 7-ketocholesterol (7KC) levels were lower in patients with COVID-19 than in the healthy controls. There was no significant correlation between 25HC serum levels and disease severity markers, such as interferon-gamma (IFN-gamma) and interleukin 6. Dexamethasone effectively suppressed cholesterol 25-hydroxylase (CH25H) mRNA expression in RAW 264.7 cells, a murine leukemia macrophage cell line, with or without lipopolysaccharide or IFNs; therefore, it might mitigate the increasing effects of COVID-19 on the serum levels of 25HC.

Automated summary

This study found that the serum levels of 25HC and 27HC were elevated in COVID-19 patients, while the levels of 7KC were lower compared to healthy controls. However, there was no significant correlation between 25HC levels and disease severity markers. Dexamethasone effectively suppressed CH25H expression, mitigating the increased effects of COVID-19 on 25HC serum levels.