Cholesterol Levels and Long COVID: What You Need to Know

Long COVID and Cholesterol: Understanding the Link Between Heart Health and Recovery

As the world learns more about Long COVID the condition where symptoms last weeks or months after the initial COVID-19 infection, researchers are discovering surprising links between the illness and other parts of our health, including cholesterol levels.

If you’ve been feeling unusually tired, short of breath, or struggling with brain fog (difficulty concentrating or thinking clearly), your lipid profile a blood test showing your levels of different types of fats, might be an important piece of your recovery story.

The Cholesterol–Long COVID Link: What the Evidence Shows

Most of what we know so far comes from observational studies. That means scientists have spotted patterns, but they can’t yet prove cause and effect.

• King’s College London study (observational): In a group of 4,787 people, those with higher LDL-C (“bad” cholesterol) were more likely to still have COVID-related symptoms months later. They also had higher levels of certain fatty acids linked to heart disease and diabetes.
• HDL-C drop: Some Long COVID patients had significantly lower HDL-C (“good” cholesterol), which helps protect the heart by carrying cholesterol away from the arteries.
• Inflammation markers: Another study found higher LDL-C and higher ferritin (a protein linked to inflammation and iron storage) in people with more severe ongoing symptoms.

These results suggest Long COVID might not just affect the lungs and nervous system, it could also disturb metabolic balance (how the body processes fats and energy).

How Cholesterol Changes Might Affect Long COVID Symptoms

We can’t yet say cholesterol changes cause Long COVID symptoms, but scientists think they may play a role:

• Fatigue: High LDL-C can be linked to increased inflammation, which drains energy and slows recovery.
• Chest discomfort and breathlessness: Unhealthy lipid levels can stress the heart and blood vessels over time. (This is about long-term heart strain, not immediate clotting risks, which involve different COVID-related mechanisms.)
• Brain fog: Low HDL-C is linked in other health conditions to poorer brain performance.
• Blood sugar swings: High LDL-C and triglycerides (another type of blood fat) often occur alongside insulin resistance, which has been seen in some Long COVID patients and can cause energy crashes.

Managing Cholesterol During Long COVID Recovery

Even if cholesterol is not the main driver of symptoms, managing your lipid levels supports your heart, brain, and overall health.

1. Monitor your levels

Ask your GP for a fasting lipid profile, a blood test that measures LDL, HDL, triglycerides, and total cholesterol. In some cases, doctors may also check apoB (a protein found in harmful cholesterol particles) or non-HDL cholesterol for a fuller picture.

2. Eat for heart and metabolic health

• Increase foods rich in omega-3 fatty acids (oily fish like salmon, mackerel, sardines; flaxseed; walnuts).
• Eat fibre-rich foods (oats, beans, lentils, berries, vegetables) to help remove cholesterol from the body.
• Limit saturated fats from processed meats, high-fat dairy, and fried foods.

3. Move as you can and pace yourself

Gentle, regular activity can help raise HDL-C and improve blood flow.
If you have post-exertional symptom exacerbation (PESE) when symptoms flare up after activity focus on pacing: break movement into short sessions with plenty of rest in between, and avoid pushing through exhaustion.

Supplements That May Support Cholesterol Balance

Always speak to your GP or pharmacist before taking supplements, as they may interact with medications or other conditions.

• Barberry / Berberine:
  Research and traditional use suggest berberine may lower LDL and triglycerides and help with blood sugar control. Possible side effects include digestive upset; it can interact with certain prescription medicines.
• Red Yeast Rice:
  Contains monacolin K, which is chemically similar to some prescribed statins (cholesterol-lowering medicines). Studies show it can lower LDL-C, but the strength varies by product, and it can cause side effects such as muscle pain or liver changes. Should only be taken under medical supervision and not during pregnancy, breastfeeding, or if you are already taking statins.

Looking Ahead

The link between cholesterol and Long COVID is an emerging area of research. For now, it’s a promising clue rather than a proven cause-and-effect relationship.
What we do know is that maintaining a healthy cholesterol profile benefits your cardiovascular health in the long term and may also help you feel better during recovery.

Final Word

Long COVID is complex, and there’s rarely a single cause behind ongoing symptoms. Cholesterol changes may be one factor, and improving your lipid health could be part of a broader recovery plan.
The most effective approach is to monitor your health, make manageable lifestyle adjustments, and work with your healthcare team.

Disclaimer: This article is for education only and is not medical advice. Always seek guidance from your GP or another qualified healthcare professional before making changes to your treatment, diet, or supplements.