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Boccia F, Iossa D, Leonardi S, Peluso AM, Bertolino L, Patauner F, Palmieri E, Boenzi R, Zampino R, Durante-Mangoni E. Clinical correlates of circulating small dense low-density lipoproteins in acute infective endocarditis. Infection 2024; 52:935-944. [PMID: 38114685 DOI: 10.1007/s15010-023-02139-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 11/14/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND AND AIM Infective endocarditis (IE) is a complex thrombo-inflammatory disorder, the pathogenesis of which involves a multifaceted interplay between vascular damage and bacterial virulence factors. This study aimed to assess the prognostic role of small dense low-density lipoprotein (sdLDL) cholesterol in patients with IE and its correlation with various disease-related features. METHODS A cohort of 198 patients with definite IE was included in this study. Clinical, laboratory, and echocardiographic parameters were meticulously analyzed, with a specific focus on comorbidities. sdLDL levels were measured using stored plasma samples obtained upon admission during the acute phase of the disease. RESULTS The median level of sdLDL was 24 mg/dL [with an interquartile range of 17.9-35.2 mg/dL], and this value showed a statistically significant positive correlation with LDL/HDL cholesterol and triglycerides (p < 0.01 for all). Furthermore, a remarkable inverse correlation between C-reactive protein and D-dimer levels was observed (p < 0.0001). Univariate analysis revealed that patients with sdLDL levels ≤ 24 mg/dL had 2.75 times higher odds of in-hospital mortality (95% Confidence Interval:1.08-6.98, p = 0.031). In addition, nonsurvivors had significantly lower median sdLDL levels (19.7 vs. 26.0 mg/dL, p = 0.041). Lower sdLDL levels were also associated with embolic complications, larger vegetation size, and positive blood cultures for Staphylococci (p = 0.019, p = 0.022, and p < 0.001, respectively). CONCLUSIONS Low circulating sdLDL levels in the acute phase of IE were significantly correlated with unfavorable clinical outcomes. These results suggest that the sdLDL level may serve as an important marker of disease severity in IE and may represent a link between vascular damage, embolic complications, and disease progression.
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Affiliation(s)
- Filomena Boccia
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Napoli, Italy
| | - Domenico Iossa
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Napoli, Italy
- Unit of Infectious and Transplant Medicine, A.O.R.N. Ospedali dei Colli-Ospedale Monaldi, Naples, Italy
| | - Silvia Leonardi
- Unit of Clinical Biochemistry, A.O.R.N. Ospedali dei Colli, Naples, Italy
| | - Anna Maria Peluso
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Napoli, Italy
| | - Lorenzo Bertolino
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Napoli, Italy
| | - Fabian Patauner
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Napoli, Italy
| | - Emilio Palmieri
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Napoli, Italy
| | - Rita Boenzi
- Unit of Clinical Biochemistry, A.O.R.N. Ospedali dei Colli, Naples, Italy
| | - Rosa Zampino
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Napoli, Italy
- Unit of Infectious and Transplant Medicine, A.O.R.N. Ospedali dei Colli-Ospedale Monaldi, Naples, Italy
| | - Emanuele Durante-Mangoni
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Napoli, Italy.
- Unit of Infectious and Transplant Medicine, A.O.R.N. Ospedali dei Colli-Ospedale Monaldi, Naples, Italy.
- Ospedale Monaldi, Piazzale Ettore Ruggieri, 80131, Naples, Italy.
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Shukla A, Singh A, Tripathi S. Perturbed Lipid Metabolism Transduction Pathways in SARS-CoV-2 Infection and Their Possible Treating Nutraceuticals. JOURNAL OF THE AMERICAN NUTRITION ASSOCIATION 2024:1-13. [PMID: 38805016 DOI: 10.1080/27697061.2024.2359084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Accepted: 05/20/2024] [Indexed: 05/29/2024]
Abstract
The coronavirus disease 2019 (COVID-19) epidemic has evolved into an international public health concern. Its causing agent was SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), a lipid bilayer encapsulated virus. Lipids have relevance in the host's viral cycle; additionally; viruses have been speculated to manipulate lipid signaling and production to influence the lipidome of host cells. SARS-CoV-2 engages the host lipid pathways for replication, like fatty acid synthesis activation via upregulation of AKT and SREBP pathway and inhibiting lipid catabolism by AMPK and PPAR deactivation. Consequently, lipoprotein levels are altered in most cases, i.e., raised LDL, TG, VLDL levels and reduced HDL levels like a hyperlipidemic state. Apo lipoproteins, a subsiding structural part of lipoproteins, may also impact viral spike protein binding to host cell receptors. In a few studies conducted on COVID-19 patients, maintaining Apo lipoprotein levels has also shown antiviral activity against SARS-CoV-2 infection. It was speculated that several potent hypolipidemic drugs, such as statins, hydroxychloroquine, and metformin, could be used as add-on treatment in COVID-19 management. Nutraceuticals like Garlic, Fenugreek, and vinegar have the potency to lower the lipid capability acting via these pathways. A link between COVID-19 and post-COVID alteration in lipoprotein levels has not yet been fully understood. In this review, we try to look over the possible modifications in lipid metabolism due to SARS-CoV-2 viral exposure, besides the prospect of focusing on the potential of lipid metabolic processes to interrupt the viral cycle.
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Affiliation(s)
- Amrita Shukla
- Department of Pharmacology, Rameshwaram Institute of Technology and Management, Lucknow, India
| | - Ankita Singh
- Department of Pharmacology, Rameshwaram Institute of Technology and Management, Lucknow, India
| | - Smriti Tripathi
- Department of Pharmacology, Rameshwaram Institute of Technology and Management, Lucknow, India
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3
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Gunay-Polatkan S, Caliskan S, Sigirli D. Association of atherogenic indices with myocardial damage and mortality in COVID-19. PLoS One 2024; 19:e0302984. [PMID: 38753890 PMCID: PMC11098497 DOI: 10.1371/journal.pone.0302984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Accepted: 04/15/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Lipoproteins in cell membranes are related to membrane stability and play a role against microorganisms. Patients with COVID-19 often experience myocyte membrane damage. OBJECTIVE This study aimed to search the relationship of atherogenic indices with myocardial damage and mortality in COVID-19. METHODS This was an observational, single-center, retrospective study. The study population was grouped according to in-hospital mortality. C-reactive protein (CRP), CRP to albumin ratio (CAR), monocyte to high density lipoprotein cholesterol ratio (MHR), levels of total cholesterol (TC), triglycerides, high-density lipoprotein cholesterol (HDLc), and low-density lipoprotein cholesterol (LDLc) and cardiac troponin I (cTnI) were recorded. Atherogenic indices (plasma atherogenic index [AIP], atherogenic coefficient [AC], Castelli's risk indices I and II [CRI I and II], triglyceride to HDLc ratio (THR) were calculated. RESULTS A total of 783 patients were included. The mortality rate was 15.45% (n = 121). The median age of non-survivor group (NSG) was higher than survivor group (SG) [66.0 years (Q1 -Q3: 55.0-77.5) vs 54.0 years (Q1 -Q3: 43.0-63.0)] (p < 0.001). Study parameters which were measured significantly higher in the NSG were CRP, cTnI, triglyceride, CRI-I, CRI-II, AC, AIP, ferritin, CAR, MHR and THR. LDLc, HDLc, TC and albumin were significantly lower in NSG (p<0.001). CONCLUSION THR is positively correlated with myocardial damage and strongly predicts in-hospital mortality in COVID-19.
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Affiliation(s)
- Seyda Gunay-Polatkan
- Bursa Uludag University Faculty of Medicine, Department of Cardiology, Gorukle/Bursa, Turkey
| | - Serhat Caliskan
- Istanbul Bahcelievler State Hospital Department of Cardiology, Bahcelievler/Istanbul, Turkey
| | - Deniz Sigirli
- Bursa Uludag University Faculty of Medicine, Department of Biostatistics, Gorukle/Bursa, Turkey
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4
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Hao J, Du Z, Bo Z, Zhang H, Wang X. Impact of Metabolic Syndrome on Post-Operative Infection in Patients Undergoing Flexible Ureteroscopy Lithotripsy. Surg Infect (Larchmt) 2024; 25:140-146. [PMID: 38265838 DOI: 10.1089/sur.2023.205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2024] Open
Abstract
Background: To investigate retrospectively whether metabolic syndrome (MetS) of flexible ureteroscopy (fURS) lithotripsy can be used to predict post-operative infection. Patients and Methods: After screening, 1,110 patients who received fURS lithotripsy for upper urinary tract stones in our center between January 2015 and December 2022 were analyzed retrospectively. Patients were divided into MetS-positive group and MetS-negative group. Post-operative infection was divided into fever, urosepsis, and septic shock. Relevant data during the peri-operative period were collected. Univariable and multivariable logistic regression analyses were adopted to estimate the impact of metabolic syndrome on post-operative infection in patients undergoing fURS lithotripsy. Results: Among the 1,110 patients, 427 tested positive for MetS, whereas 683 tested negative. Eighty-eight patients suffered from fever (67 patients in the MetS-positive group and 21 in the MetS-negative group). Forty-nine patients had urosepsis (29 patients in the MetS-positive group and 20 in the MetS-negative group), of whom seven patients developed septic shock. No patient developed multiple organ failure or died because of infection. The prevalence of post-operative infections in the MetS-positive group was higher than that in the MetS-negative group (p < 0.001). Multivariable logistic regression analyses showed that diabetes mellitus, MetS-positive, positive urine culture, and longer operation time were positively correlated with post-operative fever. Positive MetS, positive urine culture, and longer operation time were strongly correlated with post-operative urosepsis. Conclusions: Metabolic syndrome was found to be associated with post-operative infection in patients undergoing fURS lithotripsy, suggesting it can serve as a predictive factor.
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Affiliation(s)
- Junxiu Hao
- Department of Urology, Tangshan Gongren Hospital, Lubei District, Tangshan, Hebei Province, People's Republic of China
| | - Zhiyong Du
- Department of Urology Surgery, Dingzhou People's Hospital, Dingzhou, Hebei Province, People's Republic of China
| | - Zhiqiang Bo
- Department of Urology, Tangshan Gongren Hospital, Lubei District, Tangshan, Hebei Province, People's Republic of China
| | - Huimin Zhang
- Department of Urology, Tangshan Gongren Hospital, Lubei District, Tangshan, Hebei Province, People's Republic of China
| | - Xiuyun Wang
- Department of Urology, Tangshan Gongren Hospital, Lubei District, Tangshan, Hebei Province, People's Republic of China
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5
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Makris A, Pagkali A, Nikolousis E, Filippatos TD, Agouridis AP. High-density lipoprotein cholesterol and multiple myeloma: A systematic review and meta-analysis. ATHEROSCLEROSIS PLUS 2023; 54:7-13. [PMID: 37780686 PMCID: PMC10539640 DOI: 10.1016/j.athplu.2023.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 08/19/2023] [Accepted: 09/18/2023] [Indexed: 10/03/2023]
Abstract
Background and aims To systematically investigate all relevant evidence on the association between high-density lipoprotein cholesterol (HDL-C) and multiple myeloma (MM). Methods We searched PubMed and Cochrane library databases (up to 20 September 2022) for studies with evidence on HDL-C in patients with MM. A qualitative synthesis of published prospective and retrospective studies for the role of HDL-C and other lipid profile parameters in MM was performed. Additionally, a meta-analysis on HDL-C mean differences (MD) between MM cases and controls was performed. Results Fourteen studies (3 prospective, 11 retrospective) including 895 MM patients were eligible for this systematic review. Ten studies compared HDL-C levels in MM patients with healthy controls. In these 10 studies (n = 17,213), pooled analyses showed that MM patients had significantly lower HDL-C levels compared to healthy controls (MD: -13.07 mg/dl, 95% CI: -17.83, -8.32, p < 0.00001). Regarding secondary endpoints, total cholesterol (TC) (MD: -22.19 mg/dl, 95% CI: -39.08, -5.30) and apolipoprotein A-I (apoA-I) (-40.20 mg/dl, 95% CI: -55.00, -25.39) demonstrated significant decreases, while differences in low-density lipoprotein cholesterol (LDL-C) (MD: -11.33 mg/dl, 95% CI: -36.95, 14.30) and triglycerides (MD: 9.93 mg/dl, 95% CI: -3.40, 23.26) were not shown to be significant. Conclusions HDL-C, as well as TC and apoA-I, levels are significantly decreased in MM. Hence, lipid profile parameters should be taken into account when assessing such patients.
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Affiliation(s)
- Anastasios Makris
- School of Medicine, European University Cyprus, Nicosia, Cyprus
- School of Medicine, National and Kapodistrian University of Athens, Greece
| | - Antonia Pagkali
- School of Medicine, European University Cyprus, Nicosia, Cyprus
| | | | | | - Aris P. Agouridis
- School of Medicine, European University Cyprus, Nicosia, Cyprus
- Department of Internal Medicine, German Oncology Center, Limassol, Cyprus
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6
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Ghini V, Vieri W, Celli T, Pecchioli V, Boccia N, Alonso-Vásquez T, Pelagatti L, Fondi M, Luchinat C, Bertini L, Vannucchi V, Landini G, Turano P. COVID-19: A complex disease with a unique metabolic signature. PLoS Pathog 2023; 19:e1011787. [PMID: 37943960 PMCID: PMC10662774 DOI: 10.1371/journal.ppat.1011787] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 11/21/2023] [Accepted: 10/30/2023] [Indexed: 11/12/2023] Open
Abstract
Plasma of COVID-19 patients contains a strong metabolomic/lipoproteomic signature, revealed by the NMR analysis of a cohort of >500 patients sampled during various waves of COVID-19 infection, corresponding to the spread of different variants, and having different vaccination status. This composite signature highlights common traits of the SARS-CoV-2 infection. The most dysregulated molecules display concentration trends that scale with disease severity and might serve as prognostic markers for fatal events. Metabolomics evidence is then used as input data for a sex-specific multi-organ metabolic model. This reconstruction provides a comprehensive view of the impact of COVID-19 on the entire human metabolism. The human (male and female) metabolic network is strongly impacted by the disease to an extent dictated by its severity. A marked metabolic reprogramming at the level of many organs indicates an increase in the generic energetic demand of the organism following infection. Sex-specific modulation of immune response is also suggested.
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Affiliation(s)
- Veronica Ghini
- Department of Chemistry “Ugo Schiff”, University of Florence, Sesto Fiorentino Florence, Italy
- Magnetic Resonance Center (CERM), University of Florence, Sesto Fiorentino, Florence, Italy
| | - Walter Vieri
- Department of Chemistry “Ugo Schiff”, University of Florence, Sesto Fiorentino Florence, Italy
- Department of Biology, University of Florence, Sesto Fiorentino, Florence, Italy
| | - Tommaso Celli
- Internal Medicine, Santa Maria Nuova Hospital, Florence, Florence, Italy
| | - Valentina Pecchioli
- Department of Chemistry “Ugo Schiff”, University of Florence, Sesto Fiorentino Florence, Italy
- Magnetic Resonance Center (CERM), University of Florence, Sesto Fiorentino, Florence, Italy
| | - Nunzia Boccia
- Internal Medicine, Santa Maria Nuova Hospital, Florence, Florence, Italy
| | - Tania Alonso-Vásquez
- Department of Biology, University of Florence, Sesto Fiorentino, Florence, Italy
| | - Lorenzo Pelagatti
- Internal Medicine, Santa Maria Nuova Hospital, Florence, Florence, Italy
| | - Marco Fondi
- Department of Biology, University of Florence, Sesto Fiorentino, Florence, Italy
| | - Claudio Luchinat
- Department of Chemistry “Ugo Schiff”, University of Florence, Sesto Fiorentino Florence, Italy
- Magnetic Resonance Center (CERM), University of Florence, Sesto Fiorentino, Florence, Italy
- Consorzio Interuniversitario Risonanze Magnetiche di Metallo Proteine (CIRMMP), Sesto Fiorentino Florence, Italy
| | - Laura Bertini
- Internal Medicine, Santa Maria Nuova Hospital, Florence, Florence, Italy
| | - Vieri Vannucchi
- Internal Medicine, Santa Maria Nuova Hospital, Florence, Florence, Italy
| | - Giancarlo Landini
- Internal Medicine, Santa Maria Nuova Hospital, Florence, Florence, Italy
| | - Paola Turano
- Department of Chemistry “Ugo Schiff”, University of Florence, Sesto Fiorentino Florence, Italy
- Magnetic Resonance Center (CERM), University of Florence, Sesto Fiorentino, Florence, Italy
- Consorzio Interuniversitario Risonanze Magnetiche di Metallo Proteine (CIRMMP), Sesto Fiorentino Florence, Italy
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7
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Arent CO, Padilha APZ, Borba LA, de Azevedo Cardoso T, André MC, Martinello NS, Rosa T, Abelaira HM, de Moura AB, Andrade NM, Bertollo AG, de Oliveira GG, Bagatini MD, Ignácio ZM, Quevedo J, Ceretta LB, Réus GZ. ABO Blood Type and Metabolic Markers in COVID-19 Susceptibility and Severity: A Cross-Sectional Study. Metab Syndr Relat Disord 2023; 21:335-344. [PMID: 37352417 DOI: 10.1089/met.2023.0022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/25/2023] Open
Abstract
Background and Aims: To evaluate the effect of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) virus on the function and metabolic changes, as well as the relationship of the virus with blood groups. Methods and Results: This cross-sectional study included a matched sample of adult individuals with coronavirus disease 2019 (COVID-19) (n = 114) or without (controls; n = 236). Blood samples were collected and processed for triglycerides (TGs), total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol, and blood typing analysis. The results showed that subjects with COVID-19 had higher TG and lower HDL-C levels compared with the control group. As for blood typing, the risk of COVID-19 was higher in subjects with blood group A than in those with blood group B and in those with other blood groups. In addition, an association of COVID-19 with blood type and Rh A- was observed. When related to the severity of COVID-19 symptoms, blood type A was more protective against moderate/severe symptoms compared with blood type O. In addition, individuals with blood type O were 2.90 times more likely to have symptoms moderate/severe symptoms of COVID-19 than those with other blood groups and individuals with type A blood were less likely to have severe/moderate symptoms of COVID-19 compared with individuals without type A blood. Conclusion: The results suggest that blood type may play a role in susceptibility to SARS-CoV-2 infection and add evidence that infection with the novel coronavirus may be associated with changes in lipid metabolism.
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Affiliation(s)
- Camila O Arent
- Graduate Program in Health Sciences, Translational Psychiatry Laboratory, University of Southern Santa Catarina (UNESC), Criciúma, Brazil
| | - Alex Paulo Z Padilha
- Graduate Program in Health Sciences, Translational Psychiatry Laboratory, University of Southern Santa Catarina (UNESC), Criciúma, Brazil
| | - Laura A Borba
- Graduate Program in Health Sciences, Translational Psychiatry Laboratory, University of Southern Santa Catarina (UNESC), Criciúma, Brazil
| | | | - Monique C André
- Graduate Program in Health Sciences, Translational Psychiatry Laboratory, University of Southern Santa Catarina (UNESC), Criciúma, Brazil
| | - Nicoly S Martinello
- Graduate Program in Health Sciences, Translational Psychiatry Laboratory, University of Southern Santa Catarina (UNESC), Criciúma, Brazil
| | - Thayse Rosa
- Graduate Program in Health Sciences, Translational Psychiatry Laboratory, University of Southern Santa Catarina (UNESC), Criciúma, Brazil
| | - Helena M Abelaira
- Graduate Program in Health Sciences, Translational Psychiatry Laboratory, University of Southern Santa Catarina (UNESC), Criciúma, Brazil
| | - Airam B de Moura
- Graduate Program in Health Sciences, Translational Psychiatry Laboratory, University of Southern Santa Catarina (UNESC), Criciúma, Brazil
| | - Natalia M Andrade
- Graduate Program in Health Sciences, Translational Psychiatry Laboratory, University of Southern Santa Catarina (UNESC), Criciúma, Brazil
| | - Amanda G Bertollo
- Graduate Program in Biomedical Sciences, Laboratory of Physiology Pharmacology and Psychopathology, Federal University of the Southern Frontier, Chapecó, Brazil
| | - Gabriela G de Oliveira
- Graduate Program in Biomedical Sciences, Laboratory of Physiology Pharmacology and Psychopathology, Federal University of the Southern Frontier, Chapecó, Brazil
| | - Margarete D Bagatini
- Graduate Program in Biomedical Sciences, Laboratory of Physiology Pharmacology and Psychopathology, Federal University of the Southern Frontier, Chapecó, Brazil
| | - Zuleide Maria Ignácio
- Graduate Program in Biomedical Sciences, Laboratory of Physiology Pharmacology and Psychopathology, Federal University of the Southern Frontier, Chapecó, Brazil
| | - João Quevedo
- Graduate Program in Health Sciences, Translational Psychiatry Laboratory, University of Southern Santa Catarina (UNESC), Criciúma, Brazil
- Faillace Department of Psychiatry and Behavioral Sciences, Center of Excellence on Mood Disorders, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas, USA
| | - Luciane B Ceretta
- Graduate Program in Public Health, University of Southern Santa Catarina (UNESC), Criciúma, Brazil
| | - Gislaine Z Réus
- Graduate Program in Health Sciences, Translational Psychiatry Laboratory, University of Southern Santa Catarina (UNESC), Criciúma, Brazil
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8
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Abstract
COVID-19 infections decrease total cholesterol, LDL-C, HDL-C, and apolipoprotein A-I, A-II, and B levels while triglyceride levels may be increased or inappropriately normal for the poor nutritional status. The degree of reduction in total cholesterol, LDL-C, HDL-C, and apolipoprotein A-I are predictive of mortality. With recovery lipid/lipoprotein levels return towards pre-infection levels and studies have even suggested an increased risk of dyslipidemia post-COVID-19 infection. The potential mechanisms for these changes in lipid and lipoprotein levels are discussed. Decreased HDL-C and apolipoprotein A-I levels measured many years prior to COVID-19 infections are associated with an increased risk of severe COVID-19 infections while LDL-C, apolipoprotein B, Lp (a), and triglyceride levels were not consistently associated with an increased risk. Finally, data suggest that omega-3-fatty acids and PCSK9 inhibitors may reduce the severity of COVID-19 infections. Thus, COVID-19 infections alter lipid/lipoprotein levels and HDL-C levels may affect the risk of developing COVID-19 infections.
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9
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Lu Y, Yuan D, Pan J, Fang X, Ding M, Lu K, Ge X, Qu H, Ma R, Zhang L, Xu H, Wang X, Jiang Y. Dyslipidemia in the first 100 days and the association with acute graft-versus-host disease after allogeneic stem cell transplantation: A single-center retrospective study in China. Transpl Immunol 2023; 78:101829. [PMID: 36972854 DOI: 10.1016/j.trim.2023.101829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 03/23/2023] [Accepted: 03/23/2023] [Indexed: 03/28/2023]
Abstract
Dyslipidemia is a common complication after allogeneic hematopoietic stem cell transplantation (allo-HSCT). The interaction between post-transplant hyperlipidemia and acute graft-versus-host disease (aGVHD) is uncertain. In this study, we performed a retrospective study to explore the relationship between dyslipidemia and aGVHD and the potential mechanism of aGVHD on dyslipidemia in 147 recipients who underwent allo-HSCT. The lipid profiles, transplantation details, and other laboratory data of the subjects were collected in the first 100 days post-transplantation. Our results indicated 63 patients with new-onset hypertriglyceridemia and 39 patients with new-onset hypercholesterolemia. A total of 57 (38.8%) patients developed aGVHD after transplantation. In a multifactorial analysis, aGVHD was an independent factor in the development of dyslipidemia in recipients (P < 0.05). After transplantation, the median LDL-C level of patients with aGVHD was 3.04 mmol/L (standard deviation value (SD): 1.36 mmol/L, 95% confidence interval (CI): 2.62, 3.45 mmol/L), and the LDL-C level in patients without aGVHD was 2.51 mmol/L (SD: 1.38 mmol/L, CI: 2.67, 3.40 mmol/L) (P < 0.05). Female recipients had higher lipid levels than males (P < 0.05). LDL levels (≥ 3.4 mmol/L) post-transplant were an independent risk factor for the development of aGVHD (OR = 0.311, P < 0.05). In conclusion, larger sample studies are anticipated to confirm our preliminary result, and an accurate mechanism between lipid metabolism and aGVHD needs to be determined in the future.
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Affiliation(s)
- Yingxue Lu
- Shandong Provincial Hospital Affiliated to Shandong First Medical University, Shandong, China
| | - Dai Yuan
- Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Shandong, China
| | - Jie Pan
- Shandong Provincial Hospital Affiliated to Shandong First Medical University, Shandong, China
| | - Xiaosheng Fang
- Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Shandong, China
| | - Mei Ding
- Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Shandong, China
| | - Kang Lu
- Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Shandong, China
| | - Xueling Ge
- Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Shandong, China
| | - Huiting Qu
- Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Shandong, China
| | - Rongqiang Ma
- Shandong Provincial Hospital Affiliated to Shandong First Medical University, Shandong, China
| | - Lingyan Zhang
- Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Shandong, China
| | - Hongzhi Xu
- Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Shandong, China
| | - Xin Wang
- Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Shandong, China; Department of Hematology, Shandong Provincial Hospital, Shandong University, Shandong, China
| | - Yujie Jiang
- Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Shandong, China; Department of Hematology, Shandong Provincial Hospital, Shandong University, Shandong, China.
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10
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Bulgarelli C, Ciuffoli E, Troia R, Goggs R, Dondi F, Giunti M. Apolipoprotein A1 and serum amyloid A in dogs with sepsis and septic shock. Front Vet Sci 2023; 10:1098322. [PMID: 36937011 PMCID: PMC10019819 DOI: 10.3389/fvets.2023.1098322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 02/13/2023] [Indexed: 03/06/2023] Open
Abstract
Introduction Apolipoprotein-A1 (Apo-A1) acts as a negative acute phase protein (APP) during inflammatory states, and has a potential prognostic value in people and dogs with sepsis. The aim of this retrospective study was to investigate the association of serum Apo-A1 concentration with disease severity, multiorgan dysfunction syndrome (MODS) and outcome in a population of dogs with sepsis, and to assess its correlation with major canine APPs. Methods Ninety-nine dogs with uncomplicated sepsis (n = 78) or septic shock (n = 21) were included. The serum concentration of Apo-A1, C-reactive protein (CRP) and serum amyloid A (SAA) were recorded, alongside the canine acute patient physiologic and laboratory evaluation fast (APPLEfast) score and the presence of MODS. Results Dogs with septic shock had significantly lower serum Apo-A1 concentrations (106.3 ± 22.7 mg/dl; reference interval: 123.0-142.3 mg/dl), higher APPLEfast score (30, 13-38) and greater frequency of MODS (67%) compared to those with uncomplicated sepsis (117.9 ± 19.3 mg/dl; 25, 6-33 and 8%, respectively) (P = 0.0201; P = 0.0005; P < 0.0001, respectively). Similarly, dogs with MODS had significantly lower serum Apo-A1 concentrations (104.1 ± 4.6 mg/dl) and higher APPLEfast score values (31, 13-38) compared to those without MODS (118.32 ± 2.1 mg/dl and 26, 6-33, respectively) (P = 0.0050 and P = 0.0038, respectively). Conversely, neither CRP nor SAA were different between these groups. No difference in serum APPs concentrations was detected between survivors and non-survivors. Significant negative correlations were detected between serum Apo-A1 and SAA (P = 0.0056, r = -0.277), and between serum Apo-A1 and the APPLEfast score (P = 0.0027, r = -0.3). In this population, higher values of the APPLEfast score and the presence of MODS were independently associated with a higher risk of death. Discussion Our study shows that Apo-A1 is a useful biomarker of sepsis severity in dogs, since it is decreased in those with septic shock and MODS. Further prospective investigations are deemed to evaluate the applicability of Apo-A1 to predict sepsis course and response to treatment in septic dogs.
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Affiliation(s)
- Cecilia Bulgarelli
- Department of Veterinary Medical Sciences, Alma Mater Studiorum—University of Bologna, Bologna, Italy
| | - Elena Ciuffoli
- Department of Veterinary Medical Sciences, Alma Mater Studiorum—University of Bologna, Bologna, Italy
| | - Roberta Troia
- Department of Veterinary Medical Sciences, Alma Mater Studiorum—University of Bologna, Bologna, Italy
| | - Robert Goggs
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, United States
| | - Francesco Dondi
- Department of Veterinary Medical Sciences, Alma Mater Studiorum—University of Bologna, Bologna, Italy
| | - Massimo Giunti
- Department of Veterinary Medical Sciences, Alma Mater Studiorum—University of Bologna, Bologna, Italy
- *Correspondence: Massimo Giunti
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Kowalska K, Sabatowska Z, Forycka J, Młynarska E, Franczyk B, Rysz J. The Influence of SARS-CoV-2 Infection on Lipid Metabolism—The Potential Use of Lipid-Lowering Agents in COVID-19 Management. Biomedicines 2022; 10:biomedicines10092320. [PMID: 36140421 PMCID: PMC9496398 DOI: 10.3390/biomedicines10092320] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 08/31/2022] [Accepted: 09/07/2022] [Indexed: 12/15/2022] Open
Abstract
Several studies have indicated lipid metabolism alterations during COVID-19 infection, specifically a decrease in high-density lipoprotein (HDL) and low-density lipoprotein (LDL) concentrations and an increase in triglyceride (TG) levels during the infection. However, a decline in triglycerides can also be observed in critical cases. A direct correlation can be observed between a decrease in serum cholesterol, HDL-C, LDL-C and TGs, and the severity of the disease; these laboratory findings can serve as potential markers for patient outcomes. The transmission of coronavirus increases proportionally with rising levels of cholesterol in the cell membrane. This is due to the fact that cholesterol increases the number of viral entry spots and the concentration of angiotensin-converting enzyme 2 (ACE2) receptor, crucial for viral penetration. Studies have found that lower HDL-C levels correspond with a higher susceptibility to SARS-CoV-2 infection and infections in general, while higher HDL-C levels were related to a lower risk of developing them. However, extremely high HDL-C levels in serum increase the risk of infectious diseases and is associated with a higher risk of cardiovascular events. Low HDL-C levels are already accepted as a marker for risk stratification in critical illnesses, and higher HDL-C levels prior to the infection is associated with a lower risk of death in older patients. The correlation between LDL-C levels and disease severity is still unclear. However, TG levels were significantly higher in non-surviving severe patients compared to those that survived; therefore, elevated TG-C levels in COVID-19 patients may be considered an indicator of uncontrolled inflammation and an increased risk of death.
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12
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AbdelHafez MA. Protective and therapeutic potentials of HDL and ApoA1 in COVID-19 elderly and chronic illness patients. BULLETIN OF THE NATIONAL RESEARCH CENTRE 2022; 46:222. [PMID: 35915785 PMCID: PMC9330984 DOI: 10.1186/s42269-022-00886-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 06/25/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for coronavirus disease-2019 (COVID-19). Elderly subjects, obese, and patients with chronic illnesses, are the most affected group. HDL has pleiotropic physiological functions that are affected with alteration(s) in its structure. MAIN TEXT Inflammation whether septic, immune, or other affects HDL structure and function. COVID-19 is associated with systemic immune-inflammation due to cytokine surge. Viral interaction with erythrocytes and hemoglobin-related compounds (may cause anemia and hypoxia) and other factors may affect HDL function. Trials have been conducted to resume HDL functions using peptide preparation, nutritional, and herbal elements. CONCLUSIONS In this review article, I'll discuss the use of reconstituted HDL (rHDL), Apo-A1 mimetic peptide D-4F, ω-3 polyunsaturated fatty acids, and the powdered roots and/or extract of Saussurea lappa (costus) to avoid comorbidity and mortality of COVID-19 in patients with chronic illness or elderly-age mortality.
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Affiliation(s)
- Mohamed Aly AbdelHafez
- Department of Medical Biochemistry and Molecular Biology, School of Medicine, Cairo University, Kasr AlAiny, Al-Manyal, Cairo, Cairo 11562 Egypt
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13
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Thyroid-Stimulating Hormone Predicts Total Cholesterol and Low-Density Lipoprotein Cholesterol Reduction during the Acute Phase of COVID-19. J Clin Med 2022; 11:jcm11123347. [PMID: 35743420 PMCID: PMC9225372 DOI: 10.3390/jcm11123347] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 06/03/2022] [Accepted: 06/08/2022] [Indexed: 02/05/2023] Open
Abstract
A complex dysregulation of lipid metabolism occurs in COVID-19, leading to reduced total cholesterol (TC), LDL-cholesterol (LDL-C), and HDL-cholesterol (HDL-C) levels, along with a derangement of thyroid function, leading to reduced thyroid-stimulating hormone (TSH) levels. This study aimed to explore the association between TSH levels during COVID-19 and the variation (Δ) of lipid profile parameters in the period preceding (from 1 month up to 1 year) hospital admission due to COVID-19. Clinical data of 324 patients (mean age 76 ± 15 years, 54% males) hospitalized due to COVID-19 between March 2020 and March 2022 were retrospectively analyzed. The association between TSH levels at hospital admission and either Δ-TC, Δ-LDL-C, or Δ-HDL-C over the selected time frame was assessed through univariable and multivariable analyses. TSH levels were below the lower reference limit of 0.340 μUI/mL in 14% of COVID-19 patients. A significant reduction of plasma TC, LDL-C, and HDL-C was recorded between the two time points (p < 0.001 for all the comparisons). TSH was directly associated with Δ-TC (rho = 0.193, p = 0.001), Δ-LDL-C (rho = 0.201, p = 0.001), and Δ-HDL-C (rho = 0.160, p = 0.008), and inversely associated with C-reactive protein (CRP) (rho = −0.175, p = 0.004). Moreover, TSH decreased with increasing COVID-19 severity (p < 0.001). CRP and COVID-19 severity were inversely associated with Δ-TC, Δ-LDL-C, and Δ-HDL-C (p < 0.05 for all associations). A significant independent association was found between TSH and either Δ-TC (β = 0.125, p = 0.044) or Δ-LDL-C (β = 0.131, p = 0.036) after adjusting for multiple confounders including CRP and COVID-19 severity. In conclusion, lower levels of TSH may contribute to explain TC and LDL-C reduction in the acute phase of COVID-19.
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Chidambaram V, Shanmugavel Geetha H, Kumar A, Majella MG, Sivakumar RK, Voruganti D, Mehta JL, Karakousis PC. Association of Lipid Levels With COVID-19 Infection, Disease Severity and Mortality: A Systematic Review and Meta-Analysis. Front Cardiovasc Med 2022; 9:862999. [PMID: 35402531 PMCID: PMC8988060 DOI: 10.3389/fcvm.2022.862999] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 02/25/2022] [Indexed: 12/15/2022] Open
Abstract
Background Coronavirus disease 2019 (COVID-19) ranges from asymptomatic infection to severe illness. Cholesterol in the host cell plasma membrane plays an important role in the SARS-CoV-2 virus entry into cells. Serum lipids, especially low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C), are in constant interaction with the lipid rafts in the host cell membranes and can modify the interaction of virus with host cells and the resultant disease severity. Recent studies on serum lipid levels and COVID-19 disease severity lack consistency. Objectives Our systematic review and meta-analysis compared the serum levels of total cholesterol (TC), LDL-C, HDL-C, and triglycerides (TG) between (1) COVID-19 patients vs. healthy controls; (2) severe vs. non-severe COVID-19 disease; (3) deceased vs. surviving COVID-19 patients. Methods PRISMA guidelines were followed. We included peer-reviewed articles on observational (case-control and cohort) studies from PubMed and Embase published from the database inception until September 1, 2021. We used random-effects meta-analysis for pooled mean-differences (pMD) in lipid levels (mg/dL) for the above groups. Results Among 441 articles identified, 29 articles (26 retrospective and 3 prospective cohorts), with an aggregate of 256,721 participants, were included. COVID-19 patients had lower TC (pMD-14.9, 95%CI-21.6 to −8.3) and HDL-C (pMD-6.9, 95%CI −10.2 to −3.7) levels (mg/dL). Severe COVID-19 patients had lower TC (pMD-10.4, 95%CI −18.7 to −2.2), LDL-C (pMD-4.4, 95%CI −8.4 to −0.42), and HDL-C (pMD-4.4, 95%CI −6.9 to −1.8) at admission compared to patients with non-severe disease. Deceased patients had lower TC (pMD-14.9, 95%CI −21.6 to −8.3), LDL-C (pMD-10.6, 95%CI −16.5 to −4.6) and HDL-C (pMD-2.5, 95%CI −3.9 to −1.0) at admission. TG levels did not differ based on COVID-19 severity or mortality. No publication bias was noted. Conclusion We demonstrated lower lipid levels in patients with COVID-19 infection and an association with disease severity and mortality. Their potential role in COVID-19 pathogenesis and their utility as prognostic factors require further investigation.
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Affiliation(s)
- Vignesh Chidambaram
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, MD, United States
- Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, United States
- Vignesh Chidambaram,
| | | | - Amudha Kumar
- Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Marie Gilbert Majella
- Department of Community Medicine, Sri Venkateshwaraa Medical College Hospital and Research Centre, Pondicherry, India
| | - Ranjith Kumar Sivakumar
- Department of Anaesthesia and Intensive Care, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Dinesh Voruganti
- Division of Cardiovascular Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Jawahar L. Mehta
- Division of Cardiovascular Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, United States
- Division of Cardiovascular Medicine, Central Arkansas Veterans Healthcare System, Little Rock, AR, United States
| | - Petros C. Karakousis
- Department of Medicine, Division of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, MD, United States
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
- *Correspondence: Petros C. Karakousis,
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15
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Zampino R, Patauner F, Karruli A, Iossa D, Ursi MP, Bertolino L, Peluso AM, D’Amico F, Cavezza G, Durante-Mangoni E. Prognostic Value of Decreased High-Density Lipoprotein Cholesterol Levels in Infective Endocarditis. J Clin Med 2022; 11:jcm11040957. [PMID: 35207230 PMCID: PMC8877683 DOI: 10.3390/jcm11040957] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 02/04/2022] [Accepted: 02/10/2022] [Indexed: 02/05/2023] Open
Abstract
(1) Background: Simple parameters to be used as early predictors of prognosis in infective endocarditis (IE) are lacking. The aim of this study was to evaluate the prognostic role of high-density-lipoprotein cholesterol (HDL-C) and also of total-cholesterol (TC), low-density-lipoprotein cholesterol (LDL-C), and triglycerides, in relation to clinical features and mortality, in IE. (2) Methods: Retrospective analysis of observational data from 127 consecutive patients with a definite diagnosis of IE between 2016 and 2019. Clinical, laboratory and echocardiography data, mortality, and co-morbidities were analyzed in relation to HDL-C and lipid profile. (3) Results: Lower HDL-C levels (p = 0.035) were independently associated with in-hospital mortality. HDL-C levels were also significantly lower in IE patients with embolic events (p = 0.036). Based on ROC curve analysis, a cut-off value was identified for HDL-C equal to 24.5 mg/dL for in-hospital mortality. HDL-C values below this cut-off were associated with higher triglyceride counts (p = 0.008), higher prevalence of S. aureus etiology (p = 0.046) and a higher in-hospital mortality rate (p = 0.004). Kaplan–Meier survival analysis showed higher 90-day mortality in patients with HDL-C ≤ 24.5 mg/dL (p = 0.001). (4) Conclusions: Low HDL-C levels could be used as an easy and low-cost marker of severity in IE, particularly to predict complications, in-hospital and 90-day mortality.
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Affiliation(s)
- Rosa Zampino
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Piazza Luigi Miraglia, 2, 80138 Napoli, Italy; (R.Z.); (F.P.); (M.P.U.); (L.B.); (A.M.P.)
- Unit of Infectious & Transplant Medicine, AORN Ospedali dei Colli—Ospedale Monaldi, Piazzale Ettore Ruggieri, 80131 Napoli, Italy; (D.I.); (F.D.)
| | - Fabian Patauner
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Piazza Luigi Miraglia, 2, 80138 Napoli, Italy; (R.Z.); (F.P.); (M.P.U.); (L.B.); (A.M.P.)
| | - Arta Karruli
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Via de Crecchio, 7, 80138 Napoli, Italy; (A.K.); (G.C.)
| | - Domenico Iossa
- Unit of Infectious & Transplant Medicine, AORN Ospedali dei Colli—Ospedale Monaldi, Piazzale Ettore Ruggieri, 80131 Napoli, Italy; (D.I.); (F.D.)
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Via de Crecchio, 7, 80138 Napoli, Italy; (A.K.); (G.C.)
| | - Maria Paola Ursi
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Piazza Luigi Miraglia, 2, 80138 Napoli, Italy; (R.Z.); (F.P.); (M.P.U.); (L.B.); (A.M.P.)
| | - Lorenzo Bertolino
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Piazza Luigi Miraglia, 2, 80138 Napoli, Italy; (R.Z.); (F.P.); (M.P.U.); (L.B.); (A.M.P.)
| | - Anna Maria Peluso
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Piazza Luigi Miraglia, 2, 80138 Napoli, Italy; (R.Z.); (F.P.); (M.P.U.); (L.B.); (A.M.P.)
| | - Fabiana D’Amico
- Unit of Infectious & Transplant Medicine, AORN Ospedali dei Colli—Ospedale Monaldi, Piazzale Ettore Ruggieri, 80131 Napoli, Italy; (D.I.); (F.D.)
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Via de Crecchio, 7, 80138 Napoli, Italy; (A.K.); (G.C.)
| | - Giusi Cavezza
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Via de Crecchio, 7, 80138 Napoli, Italy; (A.K.); (G.C.)
| | - Emanuele Durante-Mangoni
- Unit of Infectious & Transplant Medicine, AORN Ospedali dei Colli—Ospedale Monaldi, Piazzale Ettore Ruggieri, 80131 Napoli, Italy; (D.I.); (F.D.)
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Via de Crecchio, 7, 80138 Napoli, Italy; (A.K.); (G.C.)
- Correspondence: ; Tel.: +39-081-7062475; Fax: +39-081-7062686
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Aydın SŞ, Aksakal E, Aydınyılmaz F, Gülcü O, Saraç İ, Kalkan K, Aydemir S, Doğan R, Aksu U, Tanboğa İH. Relationship Between Blood Lipid Levels and Mortality in Hospitalized COVID-19 Patients. Angiology 2022; 73:724-733. [PMID: 35124978 PMCID: PMC8832133 DOI: 10.1177/00033197211072346] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
People with comorbid conditions are at increased risk of developing severe/fatal coronavirus disease 2019 (COVID-19). We aimed to investigate the relationship between lipid levels and mortality in patients hospitalized for COVID-19 infection. In this retrospective study, we collected the details of 5274 COVID-19 patients who were diagnosed using the polymerase chain reaction and/or computed tomography and were hospitalized between March and November 2020. Patients (n = 4118) whose blood lipid levels were checked within the first 24 h after hospitalization were included in the study. Multivariable cox proportional hazards regression was used to assess the relationship between lipid variables such as low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and triglycerides (TG) and death. There was a statistically significant association between LDL-C, HDL-C, and TG levels and the risk of death (P =.002, <.001, and .035, respectively). Low and high LDL-C, low HDL-C, and high TG levels were negatively associated with COVID-19-related mortality. Blood lipid levels may be useful predictors of mortality in COVID-19 patients.
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Affiliation(s)
- Sidar Ş Aydın
- Department of Cardiology, Doğubeyazıt State Hospital, Ağrı, Turkey
| | - Emrah Aksakal
- Department of Cardiology, University of Health Sciences, Erzurum Education and Research Hospital, Erzurum, Turkey
| | - Faruk Aydınyılmaz
- Department of Cardiology, University of Health Sciences, Erzurum Education and Research Hospital, Erzurum, Turkey
| | - Oktay Gülcü
- Department of Cardiology, University of Health Sciences, Erzurum Education and Research Hospital, Erzurum, Turkey
| | - İbrahim Saraç
- Department of Cardiology, University of Health Sciences, Erzurum Education and Research Hospital, Erzurum, Turkey
| | - Kamuran Kalkan
- Department of Cardiology, University of Health Sciences, Erzurum Education and Research Hospital, Erzurum, Turkey
| | - Selim Aydemir
- Department of Cardiology, Mareşal Çakmak State Hospital, Erzurum, Turkey
| | - Remziye Doğan
- Department of Cardiology, Düzce State Hospital, Düzce, Turkey
| | - Uğur Aksu
- Department of Cardiology, 563947Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - İbrahim H Tanboğa
- Department of Cardiology, Nişantaşı University, 599103Hisar Intercontinental Hospital, Istanbul, Turkey
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UYAROĞLU OA, ÖZDEDE M, ÇALIK BAŞARAN N, KÖYLÜ B, SAHİN TK, ÖZIŞIK L, TANRIÖVER MD, GÜVEN GS. Hyperlipidemia in Post-COVID patients; a unique observational follow-up study on lipid levels in post-COVID patients. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2022. [DOI: 10.32322/jhsm.1027661] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
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18
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Papotti B, Macchi C, Favero C, Iodice S, Adorni MP, Zimetti F, Corsini A, Aliberti S, Blasi F, Carugo S, Bollati V, Vicenzi M, Ruscica M. HDL in COVID-19 Patients: Evidence from an Italian Cross-Sectional Study. J Clin Med 2021; 10:jcm10245955. [PMID: 34945250 PMCID: PMC8708284 DOI: 10.3390/jcm10245955] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 12/09/2021] [Accepted: 12/16/2021] [Indexed: 02/07/2023] Open
Abstract
A number of studies have highlighted important alterations of the lipid profile in COVID-19 patients. Besides the well-known atheroprotective function, HDL displays anti-inflammatory, anti-oxidative, and anti-infectious properties. The aim of this retrospective study was to assess the HDL anti-inflammatory and antioxidant features, by evaluation of HDL-associated Serum amyloid A (SAA) enrichment and HDL-paraoxonase 1 (PON-1) activity, in a cohort of COVID-19 patients hospitalized at the Cardiorespiratory COVID-19 Unit of Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico of Milan. COVID-19 patients reached very low levels of HDL-c (mean ± SD: 27.1 ± 9.7 mg/dL) with a marked rise in TG (mean ± SD: 165.9 ± 62.5 mg/dL). Compared to matched-controls, SAA levels were significantly raised in COVID-19 patients at admission. There were no significant differences in the SAA amount between 83 alive and 22 dead patients for all-cause in-hospital mortality. Similar findings were reached in the case of PON-1 activity, with no differences between alive and dead patients for all-cause in-hospital mortality. In conclusion, although not related to the prediction of in-hospital mortality, reduction in HDL-c and the enrichment of SAA in HDL are a mirror of SARS-CoV-2 positivity even at the very early stages of the infection.
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Affiliation(s)
- Bianca Papotti
- Department of Food and Drug, University of Parma, 43124 Parma, Italy; (B.P.); (F.Z.)
| | - Chiara Macchi
- Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, 20100 Milan, Italy; (C.M.); (A.C.)
| | - Chiara Favero
- EPIGET Lab, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20100 Milan, Italy; (C.F.); (S.I.); (V.B.)
| | - Simona Iodice
- EPIGET Lab, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20100 Milan, Italy; (C.F.); (S.I.); (V.B.)
| | - Maria Pia Adorni
- Department of Medicine and Surgery, University of Parma, 43125 Parma, Italy;
| | - Francesca Zimetti
- Department of Food and Drug, University of Parma, 43124 Parma, Italy; (B.P.); (F.Z.)
| | - Alberto Corsini
- Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, 20100 Milan, Italy; (C.M.); (A.C.)
- IRCCS Multimedica, 20099 Sesto San Giovanni, Italy
| | - Stefano Aliberti
- Department of Biomedical Sciences, Humanitas University, 20100 Milan, Italy;
| | - Francesco Blasi
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Internal Medicine Department, Respiratory Unit and Cystic Fibrosis Adult Center, 20100 Milan, Italy;
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, 20100 Milan, Italy
| | - Stefano Carugo
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Cardiovascular Disease Unit, Internal Medicine Department, 20100 Milan, Italy;
- Dyspnea Lab, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20100 Milan, Italy
| | - Valentina Bollati
- EPIGET Lab, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20100 Milan, Italy; (C.F.); (S.I.); (V.B.)
| | - Marco Vicenzi
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Cardiovascular Disease Unit, Internal Medicine Department, 20100 Milan, Italy;
- Dyspnea Lab, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20100 Milan, Italy
- Correspondence: (M.V.); (M.R.)
| | - Massimiliano Ruscica
- Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, 20100 Milan, Italy; (C.M.); (A.C.)
- Correspondence: (M.V.); (M.R.)
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Felici N, Liu D, Maret J, Restrepo M, Borovskiy Y, Hajj J, Chung W, Laudanski K. Long-Term Abnormalities of Lipid Profile After a Single Episode of Sepsis. Front Cardiovasc Med 2021; 8:674248. [PMID: 34869619 PMCID: PMC8634493 DOI: 10.3389/fcvm.2021.674248] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 09/29/2021] [Indexed: 01/15/2023] Open
Abstract
Background: Acute disturbances of the lipid profile are commonplace during acute sepsis episode. However, their long-term persistence has not to be investigated despite pivotal role of dyslipidemia in several comorbidities excessively noted in sepsis survivors (stroke, cardiomyopathy). Methods: A total of 9,861 individuals hospitalized for a singular episode of sepsis between 2009 and 2019 were identified from electronic medical records. Lab measurements of total cholesterol (Tchol), high-density lipoprotein (HDL-c), low-density lipoprotein (LDL-c), very low-density lipoprotein (VLDL), triglycerides (TG), lipoprotein(a) [Lp (a)], apolipoprotein B (ApoB), and C-reactive protein (CRP). The data were examined as baseline values before sepsis, during hospitalization, and <3 months, 3–6 months, 6–12 months, 1–2 years, and more than 2 years from initial sepsis. Results: Significant reductions in HDL-c (HDLbaseline = 44.06 vs. HDLsepsis = 28.2; U = −37.79, p < 0.0001, Cohen's d = 0.22) and LDL-c serum levels were observed during and up to three months post sepsis, with females much less affected. In contrast, male subjects had derangement in HDL present for up to two years after a singular septic episode. Total cholesterol levels were slightly yet significantly elevated for up to two years after sepsis. TG were elevated up to one year [TGbaseline = 128.26 vs. TGsepsis = 170.27, t(8255) = −21.33, p < 0.0001, Cohen's d = 0.49] and normalized. Lp(a) was elevated up to two years after initial episode [Lp(a)baseline = 24.6 ± 16.06; Lp(a)sepsis−2year = 8.25 ± 5.17; Lp(a)morethan2years = 61.4 ± 40.1; ANOVA F(2, 24) = 7.39; p = 0.0032]. Response to statin therapy was blunted in sepsis survivors for several years after sepsis resolution. Significant drop-out in prescription of statins and niacin after sepsis was observed. Serum high sensitivity C-reactive protein was elevated for up to five years after sepsis resolution (H [6;1685] = 502.2; p < 0.0001). Discussion: Lipid abnormalities persisted long after the initial septic insult suggesting potential role in accelerating atherosclerosis and other abnormalities. In addition, sepsis seems to blunt statin effectiveness. Additionally, a significant and unexplained drop in statin use was seen in post-septic period. Conclusions: Our study suggests that persistent derangements of lipid profile components for up to two years after sepsis may be associated with altered risk of atherosclerosis-related events among sepsis survivors.
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Affiliation(s)
| | - Da Liu
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Josh Maret
- College Arts and Sciences, Drexel University, Philadelphia, PA, United States
| | - Mariana Restrepo
- College Arts and Science, University of Pennsylvania, Philadelphia, PA, United States
| | - Yuliya Borovskiy
- Corporate Informational Service, Penn Medicine, Philadelphia, PA, United States.,Data Analytics Core, Penn Medicine, Philadelphia, PA, United States
| | - Jihane Hajj
- Department of Nursing, Widener University, Chester, PA, United States
| | - Wesley Chung
- Society for HealthCare Innovation, San Francisco, CA, United States
| | - Krzysztof Laudanski
- Department of Anesthesiology and Critical Care, Hospital of the University of Pennsylvania, Philadelphia, PA, United States.,Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia, PA, United States.,Leonard Davis Institute of Health Economics, Philadelphia, PA, United States
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20
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Huang YJ, Jiang ZP, Zhou JF, Zhang X, Xiong LP, Liang MJ, Shi HR, Su N, Zhang R. Hypertriglyceridemia is a risk factor for treatment failure in patients with peritoneal dialysis-related peritonitis. Int Urol Nephrol 2021; 54:1583-1589. [PMID: 34689313 DOI: 10.1007/s11255-021-03027-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 10/08/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Disorders of triglycerides (TG) are common in patients with peritoneal dialysis (PD). Hypertriglyceridemia has been demonstrated in various infections. The association between triglycerides and the outcomes of peritoneal dialysis-related peritonitis (PDRP) was investigated in this study. METHODS We retrospectively investigated patients with PDRP from January 1, 2013 to October 31, 2020. Hypertriglyceridemia was defined as triglycerides ≥ 1.7 mmol/L. PDRP episodes were divided into two groups: hypertriglyceridemia and normal levels of triglycerides. The clinical and laboratory baseline data of the two groups were collected and compared. The association between triglycerides and treatment failure was analyzed by logistic regression analysis. RESULTS Ninety episodes in 66 patients were recorded in our center. Hypertriglyceridemia occurred in 38% (34/90) of episodes. Twenty-five episodes were not cured in 90 episodes (27.8%, 25/90). The levels of thrombocytes, high-sensitivity C-reactive protein (hs-CRP), low-density lipoprotein cholesterol (LDL-C) and glycated hemoglobin, were higher in hypertriglyceridemia episodes of PDRP at baseline. The bacterial classification was different between elevated triglyceride group and normal triglyceride group. Adjusted for age, duration of dialysis, residual renal function, diabetes, thrombocytes, hs-CRP, serum albumin, cholesterol, HDL-C, LDL-C, intact parathyroid hormone (iPTH), glycated hemoglobin and spectrum of bacteria, hypertriglyceridemia were associated significantly with treatment failure of PDRP in our study (OR 3.416, 95% CI 1.223-9.540 p < 0.05). CONCLUSION Hypertriglyceridemia at baseline was an independent risk factor for treatment failure of PDRP.
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Affiliation(s)
- Ya-Juan Huang
- Department of Nephrology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China
| | - Zong-Pei Jiang
- Department of Nephrology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China
| | - Ja-Fan Zhou
- Department of Nephrology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China
| | - Xing Zhang
- Department of Nephrology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China
| | - Li-Ping Xiong
- Department of Nephrology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China
| | - Meng-Jun Liang
- Department of Nephrology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China
| | - Hong-Rui Shi
- Department of Nephrology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China
| | - Ning Su
- Department of Nephrology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China.
| | - Rui Zhang
- Department of Nephrology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510655, China.
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21
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Barman HA, Pala AS, Dogan O, Atıcı A, Yumuk MT, Alici G, Sit O, Gungor B, Dogan SM. Prognostic significance of temporal changes of lipid profile in COVID-19 patients. ACTA ACUST UNITED AC 2021; 28:100373. [PMID: 34671707 PMCID: PMC8516440 DOI: 10.1016/j.obmed.2021.100373] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 08/06/2021] [Accepted: 10/13/2021] [Indexed: 01/08/2023]
Abstract
Background COVID-19 is a multisystemic disease that affects many organs and has metabolic effects. Aims This study aims to investigate the effect of the temporal changes of lipid levels on the prognosis during the course of the disease. Study design Retrospective cross-sectional study. Methods For this single-center study, data of patients who were treated for COVID-19 were collected. Fasting lipid parameters including total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglyceride (TG) levels were collected within 24 h of hospitalization. For investigation of temoral changes in lipid parameters, the results of the same parameters in the one-year period before COVID-19 were collected from medical records. A total number of 324 eligible COVID-19 patients were included in this study. The association of changes of lipid parameters with COVID-19 symptom severity and in-hospital mortality were investigated. Results The mean age of the severe group (n = 139) was 65.4 ± 15.5 years, and 60% were male. TC, LDL-C and HDL-C levels were significantly lower compared to pre-COVID measurements in the study population. Multiple linear regression analysis determined age, acute kidney injury, hs-Troponin, D-dimer, temporal changes in TC, and TG levels were determined as independent predictors for the development of COVID-19 mortality. Conclusion Our findings showed that temporal changes in lipid parameters before and after COVID-19 may be associated with mortality and in-hospital adverse outcomes.
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Affiliation(s)
- Hasan Ali Barman
- Istanbul University-Cerrahpaşa, Institute of Cardiology, Department of Cardiology, Istanbul, Turkey.,University of Health Sciences, Okmeydani Training and Research Hospital, Department of Cardiology, Istanbul, Turkey
| | - Ayse Selcen Pala
- University of Health Sciences, Okmeydani Training and Research Hospital, Department of Internal Medicine, Istanbul, Turkey
| | - Omer Dogan
- Istanbul University-Cerrahpaşa, Institute of Cardiology, Department of Cardiology, Istanbul, Turkey
| | - Adem Atıcı
- Istanbul Medeniyet University, Faculty of Medicine, Goztepe Training and Research Hospital, Department of Cardiology, Istanbul, Turkey
| | - Mehmet Tugay Yumuk
- Istanbul University-Cerrahpaşa, Institute of Cardiology, Department of Cardiology, Istanbul, Turkey
| | - Gokhan Alici
- University of Health Sciences, Okmeydani Training and Research Hospital, Department of Cardiology, Istanbul, Turkey
| | - Omer Sit
- University of Health Sciences, Okmeydani Training and Research Hospital, Department of Cardiology, Istanbul, Turkey
| | - Baris Gungor
- University of Health Sciences, Dr. Siyami Ersek Training and Research Hospital, Department of Cardiology, Istanbul, Turkey
| | - Sait Mesut Dogan
- Istanbul University-Cerrahpaşa, Institute of Cardiology, Department of Cardiology, Istanbul, Turkey
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22
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Agouridis AP, Pagkali A, Zintzaras E, Rizos EC, Ntzani EE. High-density lipoprotein cholesterol: A marker of COVID-19 infection severity? ATHEROSCLEROSIS PLUS 2021; 44:1-9. [PMID: 34622242 PMCID: PMC8383482 DOI: 10.1016/j.athplu.2021.08.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 08/01/2021] [Accepted: 08/23/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND AND AIMS To systematically address all the relevant evidence of the association between high-density lipoprotein cholesterol (HDL-C) and COVID-19 infection. METHODS We searched PubMed, PubMed Central and medRxiv databases (up to May 2021) for studies related to HDL-C and COVID-19 infection. A qualitative synthesis of published prospective and retrospective studies for the role of low HDL-C levels on COVID-19 infection severity was performed. RESULTS Thirty-three studies (6 prospective, 27 retrospective) including 11,918 COVID-19 patients were eligible for the systematic review. Twelve studies compared HDL-C levels on admission in COVID-19 patients with healthy controls. In these 12 studies, COVID-19 patients had significantly lower HDL-C levels on admission compared with that of healthy controls. Twenty-eight studies observed the HDL-C levels among COVID-19 diagnosed patients, to establish the role of low HDL-C values in the prognosis of the infection. Twenty-four studies showed a correlation between low HDL-C levels with disease severity, while only 4 studies showed no association. CONCLUSIONS Low HDL-C levels should be added in the list of the others well-known risk factors for COVID-19 severity.
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Affiliation(s)
- Aris P. Agouridis
- School of Medicine, European University Cyprus, Nicosia, Cyprus,Department of Biomathematics, School of Medicine, University of Thessaly, Larissa, Greece,Corresponding author. Internal Medicine/Pathophysiology, School of Medicine, European University Cyprus, Diogenis Str 6, Nicosia, 2404, Cyprus
| | - Antonia Pagkali
- School of Medicine, European University Cyprus, Nicosia, Cyprus
| | - Elias Zintzaras
- Department of Biomathematics, School of Medicine, University of Thessaly, Larissa, Greece
| | - Evangelos C. Rizos
- School of Medicine, European University Cyprus, Nicosia, Cyprus,Department of Internal Medicine, University Hospital of Ioannina, Ioannina, Greece
| | - Evangelia E. Ntzani
- Department of Biomathematics, School of Medicine, University of Thessaly, Larissa, Greece,Clinical and Molecular Epidemiology Unit, Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
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23
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D’Ardes D, Rossi I, Bucciarelli B, Allegra M, Bianco F, Sinjari B, Marchioni M, Di Nicola M, Santilli F, Guagnano MT, Cipollone F, Bucci M. Metabolic Changes in SARS-CoV-2 Infection: Clinical Data and Molecular Hypothesis to Explain Alterations of Lipid Profile and Thyroid Function Observed in COVID-19 Patients. Life (Basel) 2021; 11:life11080860. [PMID: 34440605 PMCID: PMC8400261 DOI: 10.3390/life11080860] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 08/08/2021] [Accepted: 08/20/2021] [Indexed: 12/11/2022] Open
Abstract
It seems that during SARS-CoV-2 infection, total cholesterol, LDL-C, and HDL-C values decrease and lipids could play a fundamental role in viral replication. Moreover, it has been shown that SARS-CoV-2 infection could influence thyroid function. We performed a retrospective analysis of 118 hospitalized patients with COVID-19, comparing pre-infection lipid profile (53 patients) and thyroid-stimulating hormone (TSH) values (45 patients) to those measured on admission. Our aim was to evaluate whether SARS-CoV-2 infection could be involved in thyroid and lipid profile alterations and study possible correlations with disease severity and clinical outcome. Median baseline values at the admission time were: total cholesterol at 136.89 ± 42.73 mg/dL, LDL-C 81.53 ± 30.35 mg/dL, and HDL-C 32.36 ± 15.13 mg/dL; and triglycerides at 115.00 ± 40.45 mg/dL, non-HDL-C 104.53 ± 32.63 md/dL, and TSH 1.15 ± 1.08 μUI/mL. Median values of pre-infection total cholesterol, HDL-C, and TSH were significantly higher than those measured at the admission time (p value < 0.05). The C-reactive protein (CRP) negatively correlated with LDL-C (p = 0.013) and HDL-C (p = 0.05). Our data underline a possible impact of SARS-CoV-2 infection on thyroid function. Moreover it suggests a possible relation between COVID-19 and the lipid profile with a negative correlation between CRP, LDL-C, and HDL-C values, proposing the hypothesis that lipid lowering could follow the rising of the COVID-19 inflammatory state.
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Affiliation(s)
- Damiano D’Ardes
- “Clinica Medica” Institute, Department of “Medicine and Science of Aging”, “G. d’Annunzio” University, 66100 Chieti, Italy; (B.B.); (M.A.); (F.S.); (M.T.G.); (F.C.); (M.B.)
- Azienda Sanitaria Locale n° 2 Abruzzo Lanciano-Vasto-Chieti, 66100 Chieti, Italy
- Correspondence: (D.D.); (I.R.)
| | - Ilaria Rossi
- “Clinica Medica” Institute, Department of “Medicine and Science of Aging”, “G. d’Annunzio” University, 66100 Chieti, Italy; (B.B.); (M.A.); (F.S.); (M.T.G.); (F.C.); (M.B.)
- Correspondence: (D.D.); (I.R.)
| | - Benedetta Bucciarelli
- “Clinica Medica” Institute, Department of “Medicine and Science of Aging”, “G. d’Annunzio” University, 66100 Chieti, Italy; (B.B.); (M.A.); (F.S.); (M.T.G.); (F.C.); (M.B.)
| | - Marco Allegra
- “Clinica Medica” Institute, Department of “Medicine and Science of Aging”, “G. d’Annunzio” University, 66100 Chieti, Italy; (B.B.); (M.A.); (F.S.); (M.T.G.); (F.C.); (M.B.)
| | - Francesco Bianco
- Pediatric Cardiology and Adult Congenital Heart Disease, Azienda Ospedaliero-Universitaria “Ospedali Riuniti” of Ancona, 60126 Ancona, Italy;
| | - Bruna Sinjari
- Department of Innovative Technologies in Medicine and Dentistry, “G. d’Annunzio” University, Chieti-Pescara, 66100 Chieti, Italy;
| | - Michele Marchioni
- Laboratory of Biostatistics, Department of “Medical, Oral and Biotechnological Sciences”, “G. d’Annunzio” University, Chieti-Pescara, 66100 Chieti, Italy; (M.M.); (M.D.N.)
| | - Marta Di Nicola
- Laboratory of Biostatistics, Department of “Medical, Oral and Biotechnological Sciences”, “G. d’Annunzio” University, Chieti-Pescara, 66100 Chieti, Italy; (M.M.); (M.D.N.)
| | - Francesca Santilli
- “Clinica Medica” Institute, Department of “Medicine and Science of Aging”, “G. d’Annunzio” University, 66100 Chieti, Italy; (B.B.); (M.A.); (F.S.); (M.T.G.); (F.C.); (M.B.)
- Azienda Sanitaria Locale n° 2 Abruzzo Lanciano-Vasto-Chieti, 66100 Chieti, Italy
| | - Maria Teresa Guagnano
- “Clinica Medica” Institute, Department of “Medicine and Science of Aging”, “G. d’Annunzio” University, 66100 Chieti, Italy; (B.B.); (M.A.); (F.S.); (M.T.G.); (F.C.); (M.B.)
- Azienda Sanitaria Locale n° 2 Abruzzo Lanciano-Vasto-Chieti, 66100 Chieti, Italy
| | - Francesco Cipollone
- “Clinica Medica” Institute, Department of “Medicine and Science of Aging”, “G. d’Annunzio” University, 66100 Chieti, Italy; (B.B.); (M.A.); (F.S.); (M.T.G.); (F.C.); (M.B.)
- Azienda Sanitaria Locale n° 2 Abruzzo Lanciano-Vasto-Chieti, 66100 Chieti, Italy
| | - Marco Bucci
- “Clinica Medica” Institute, Department of “Medicine and Science of Aging”, “G. d’Annunzio” University, 66100 Chieti, Italy; (B.B.); (M.A.); (F.S.); (M.T.G.); (F.C.); (M.B.)
- Azienda Sanitaria Locale n° 2 Abruzzo Lanciano-Vasto-Chieti, 66100 Chieti, Italy
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24
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The Inflammatory Effects of Dietary Lipids Regulate Growth of Parasites during Visceral Leishmaniasis. mSphere 2021; 6:e0042321. [PMID: 34259561 PMCID: PMC8386445 DOI: 10.1128/msphere.00423-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Visceral leishmaniasis is a potentially fatal disease caused by the protozoon Leishmania donovani or L. infantum (Li). Although previous studies revealed that high lipid intake reduces parasite burdens in Leishmania donovani-infected mice, the specific contributions of dietary lipids to Li-associated pathogenesis are not known. To address this, we evaluated parasite growth, liver pathology, and transcriptomic signatures in Li-infected BALB/c mice fed either a control, high-fat, high-cholesterol, or high-fat–high-cholesterol diet. Using quantitative PCR (qPCR), we observed significantly reduced liver parasite burdens in mice fed the high-fat–high-cholesterol diet compared to mice fed the control diet. In contrast to the liver, parasite expansion occurred earlier in the spleens of mice fed the experimental diets. Histological examination revealed an intense inflammatory cell infiltrate in livers predominantly composed of neutrophils caused by the high-fat–high-cholesterol diet specifically. After 8 weeks of infection (12 weeks of diet), Illumina microarrays revealed significantly increased expression of transcripts belonging to immune- and angiogenesis-related pathways in livers of both uninfected and Li-infected mice fed the high-fat–high-cholesterol diet. These data suggest that increased fat and cholesterol intake prior to Li infection leads to a hepatic inflammatory environment and thus reduces the parasite burden in the liver. Defining inflammatory signatures as well as pathology in the liver may reveal opportunities to modify the therapeutic approach to Li infection. IMPORTANCE Leishmaniasis is a spectrum of diseases caused by Leishmania species protozoa that is most common in warm climates, coinciding with impoverished regions. Visceral leishmaniasis is a potentially fatal disease in which parasites infect reticuloendothelial organs and cause progressive wasting and immunocompromise. The distribution and demographics of visceral leishmaniasis have changed over recent years, coinciding with modernizing societies and the increased availability of Western diets rich in lipid content. We report here that increased dietary fat and cholesterol intake affected disease pathogenesis by increasing inflammation and reducing localized parasite burdens in the liver. These diet-induced changes in disease pathogenesis might explain in part the changing epidemiology of visceral leishmaniasis. A relationship between diet and inflammatory responses may occur in leishmaniasis and other microbial or immune-mediated diseases, possibly revealing opportunities to modify the therapeutic approach to microbial infections.
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25
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Masana L, Correig E, Ibarretxe D, Anoro E, Arroyo JA, Jericó C, Guerrero C, Miret ML, Näf S, Pardo A, Perea V, Pérez-Bernalte R, Plana N, Ramírez-Montesinos R, Royuela M, Soler C, Urquizu-Padilla M, Zamora A, Pedro-Botet J. Low HDL and high triglycerides predict COVID-19 severity. Sci Rep 2021; 11:7217. [PMID: 33785815 PMCID: PMC8010012 DOI: 10.1038/s41598-021-86747-5] [Citation(s) in RCA: 101] [Impact Index Per Article: 33.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 03/15/2021] [Indexed: 12/13/2022] Open
Abstract
Lipids are indispensable in the SARS-CoV-2 infection process. The clinical significance of plasma lipid profile during COVID-19 has not been rigorously evaluated. We aim to ascertain the association of the plasma lipid profile with SARS-CoV-2 infection clinical evolution. Observational cross-sectional study including 1411 hospitalized patients with COVID-19 and an available standard lipid profile prior (n: 1305) or during hospitalization (n: 297). The usefulness of serum total, LDL, non-HDL and HDL cholesterol to predict the COVID-19 prognosis (severe vs mild) was analysed. Patients with severe COVID-19 evolution had lower HDL cholesterol and higher triglyceride levels before the infection. The lipid profile measured during hospitalization also showed that a severe outcome was associated with lower HDL cholesterol levels and higher triglycerides. HDL cholesterol and triglyceride concentrations were correlated with ferritin and D-dimer levels but not with CRP levels. The presence of atherogenic dyslipidaemia during the infection was strongly and independently associated with a worse COVID-19 infection prognosis. The low HDL cholesterol and high triglyceride concentrations measured before or during hospitalization are strong predictors of a severe course of the disease. The lipid profile should be considered as a sensitive marker of inflammation and should be measured in patients with COVID-19.
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Affiliation(s)
- Lluís Masana
- Facultat de Medicina, Universitat Rovira I Virgili, LIPIDCAS, University Hospital Sant Joan, IISPV, CIBERDEM, C/. Sant Llorenç, 21, 43201, Reus, Spain.
| | - Eudald Correig
- Statistics Department, Institut Investigació Sanitaria Pere Virgili, Universitat Rovira I Virgili, Reus, Spain
| | - Daiana Ibarretxe
- Facultat de Medicina, Universitat Rovira I Virgili, LIPIDCAS, University Hospital Sant Joan, IISPV, CIBERDEM, C/. Sant Llorenç, 21, 43201, Reus, Spain
| | - Eva Anoro
- LIPIDCAS, Pius Hospital Valls, Valls, Spain
| | - Juan Antonio Arroyo
- Lipid Unit, University Hospital Santa Creu I Sant Pau, Barcelona Autonomous University, Barcelona, Spain
| | - Carlos Jericó
- Lipid Unit, Hospital Moises Broggi, Consorci Sanitari Integral, Sant Joan Despí, Spain
| | - Carolina Guerrero
- Internal Medicine Department, Terrasa Hospital, Consorci Sanitari Terrassa, Barcelona, Spain
| | - Marcel la Miret
- LIPIDCAS, Endocrinology Department, Hospital Verge de La Cinta, Tortosa, Spain
| | - Silvia Näf
- LIPIDCAS, Endocrinology Department, University Hospital Joan XXIII, IISPV. CIBERDEM, Universitat Rovira I Virgili, Tarragona, Spain
| | - Anna Pardo
- Internal Medicine Department, Hospital Delfos, Barcelona, Spain
| | | | | | - Núria Plana
- Facultat de Medicina, Universitat Rovira I Virgili, LIPIDCAS, University Hospital Sant Joan, IISPV, CIBERDEM, C/. Sant Llorenç, 21, 43201, Reus, Spain
| | | | - Meritxell Royuela
- Lipid Unit, ALTHAIA, Xarxa Assistencial Universitària de Manresa, Barcelona, Spain
| | | | - Maria Urquizu-Padilla
- Lipid Unit, University Hospital Vall d'Hebron, Barcelona Autonomous University, Barcelona, Spain
| | - Alberto Zamora
- Lipid Unit, Corporació de Salut del Maresme I La Selva, Hospital de Blanes, Blanes, Spain
| | - Juan Pedro-Botet
- Lipid Unit, University Hospital del Mar, Barcelona Autonomous University, Barcelona, Spain
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26
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Chen L, Zheng Y, Zhao L, Zhang Y, Yin L, He Y, Ma X, Xu Y, Gao Z. Lipid profiles and differential lipids in serum related to severity of community-acquired pneumonia: A pilot study. PLoS One 2021; 16:e0245770. [PMID: 33705428 PMCID: PMC7951898 DOI: 10.1371/journal.pone.0245770] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 01/08/2021] [Indexed: 11/18/2022] Open
Abstract
This study aimed to characterize the lipidomic responses to community-acquired pneumonia (CAP) and provide new insight into the underlying mechanisms of pathogenesis and potential avenues for diagnostic and therapeutic treatments. This study was performed from January 2017 to October 2018. Lipidomic profiles were generated using ultra high-performance liquid chromatography with tandem mass spectrometry (UHPLC-MS/MS) platform. Spearman's rank correlation test and multiple linear regression analysis were applied to explore the correlation between changes in the relative abundance of lipids and clinical parameters. Kaplan-Meier methods were used to build 30-day survival curves. From the UHPLC-MS/MS results, a total of 509 and 195 lipid species were detected in the positive and negative ionization mode respectively. Positive ionization covered six lipid classes (glycerol-phospholipids, glycerolipids, sphingolipids, sterol-lipids, prenol-lipids, and fatty acid), whilst negative ionization covered three (glycerol-phospholipids, sphingolipids, fatty acid). Four lipids were selected as targets: PC (16:0_18:1), PC (18:2_20:4), PC (36:4), and PC (38:6). The relative increase of the areas under the curves for all four lipids were superior to the pneumonia severity index and CURB-65 (confusion, urea, respiratory rate, blood pressure, and age ≥65 years old) for discriminating severe CAP from CAP. Decreasing relative levels of PC (18:2_20:4), PC (38:6), and PC (36:4) were negatively related to fraction of inspiration O2; Changes in the relative abundance of PC (16:0_18:1) and PC (18:2_20:4) had significantly linear relationship with procalcitonin. Patients with an elevated level of PC (16:0_18:1) had significantly longer duration of hospital stays. As the relative abundance of PC (18:2_20:4), PC (36:4), and PC (38:6) decreased, the length of hospitalization days and 30-day mortality rate increased significantly (all log-rank p<0.05). Therefore, using the UHPLC-MS/MS platform's serum lipidomic approach can help reveal changes in lipid abundance during CAP and establish lipid profiles related to disease severity.
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Affiliation(s)
- Li Chen
- Department of Respiratory & Critical Care Medicine, Peking University People’s Hospital, Beijing, China
| | - Yali Zheng
- Department of Respiratory, Critical Care & Sleep Medicine, Xiang’an Hospital of Xiamen University, Xiamen, China
| | - Lili Zhao
- Department of Respiratory & Critical Care Medicine, Peking University People’s Hospital, Beijing, China
| | - Ying Zhang
- Department of Respiratory & Critical Care Medicine, Peking University People’s Hospital, Beijing, China
| | - Lu Yin
- Department of Respiratory & Critical Care Medicine, Peking University People’s Hospital, Beijing, China
| | - Yukun He
- Department of Respiratory & Critical Care Medicine, Peking University People’s Hospital, Beijing, China
| | - Xinqian Ma
- Department of Respiratory & Critical Care Medicine, Peking University People’s Hospital, Beijing, China
| | - Yu Xu
- Department of Respiratory & Critical Care Medicine, Peking University People’s Hospital, Beijing, China
- * E-mail: (ZG); (YX)
| | - Zhancheng Gao
- Department of Respiratory & Critical Care Medicine, Peking University People’s Hospital, Beijing, China
- * E-mail: (ZG); (YX)
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Li Y, Zhang Y, Lu R, Dai M, Shen M, Zhang J, Cui Y, Liu B, Lin F, Chen L, Han D, Fan Y, Zeng Y, Li W, Li S, Chen X, Li H, Pan P. Lipid metabolism changes in patients with severe COVID-19. Clin Chim Acta 2021; 517:66-73. [PMID: 33639119 PMCID: PMC7903909 DOI: 10.1016/j.cca.2021.02.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 02/07/2021] [Accepted: 02/10/2021] [Indexed: 02/09/2023]
Abstract
Background We investigated the dynamic changes in lipid profiles and their correlations with disease severity and clinical outcome in patients with severe COVID-19. Methods We retrospectively reviewed 519 severe COVID-19 patients with confirmed outcomes (discharged or deceased), admitted to the West Court of Union Hospital in Wuhan, China, between 29 January and 8 April 2020. Results Altogether, 424 severe COVID-19 patients, including 34 non-survivors and 390 survivors, were included in the final analyses. During hospitalization, low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and apolipoprotein A-I (apoA-I) showed an increasing trend in survivors, but showed a downward trend in non-survivors. The serum concentrations of HDL-C and apoA-I were inversely correlated with C-reactive protein (CRP), length of hospital stay of survivors, and disease severity scores. For in-hospital deaths, the areas under the receiver operating characteristic curves (AUCs) of the ratios of CRP/HDL-C and CRP/apoA-I at admission were 0.84 and 0.83, respectively. Moreover, patients with high ratios of CRP/HDL-C (>77.39) or CRP/apoA-I (>72.37) had higher mortality rates during hospitalization (log-rank p < 0.001). Logistic regression analysis demonstrated that hypertension, lactate dehydrogenase, SOFA score, and High CRP/HDL-C ratio were independent predictors of in-hospital mortality. Conclusions During severe COVID-19, HDL-C and apoA-I concentrations are dramatically decreased in non-survivors. Moreover, High CRP/HDL-C ratio is significantly associated with an increase in mortality and a poor prognosis.
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Affiliation(s)
- Yi Li
- Department of Respiratory and Critical Care Medicine, Central South University, Changsha 410008, China
| | - Yan Zhang
- Department of Respiratory and Critical Care Medicine, Central South University, Changsha 410008, China
| | - Rongli Lu
- Department of Respiratory and Critical Care Medicine, Central South University, Changsha 410008, China
| | - Minhui Dai
- Department of Respiratory and Critical Care Medicine, Central South University, Changsha 410008, China
| | - Minxue Shen
- Department of Dermatology, Central South University, Changsha 410008, China; Department of Social Medicine and Health Management, Central South University, Changsha 410008, China
| | - Jianchu Zhang
- Department of Respiratory and Critical Care Medicine, Union Hospital of Huazhong University of Science and Technology, Wuhan 430022, Hubei, China
| | - Yanhui Cui
- Department of Respiratory and Critical Care Medicine, Central South University, Changsha 410008, China
| | - Ben Liu
- Department of Respiratory and Critical Care Medicine, Central South University, Changsha 410008, China; Department of Emergency Medicine, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Fengyu Lin
- Department of Respiratory and Critical Care Medicine, Central South University, Changsha 410008, China
| | - Lingli Chen
- Department of Respiratory and Critical Care Medicine, Central South University, Changsha 410008, China
| | - Duoduo Han
- Department of Respiratory and Critical Care Medicine, Central South University, Changsha 410008, China
| | - Yifei Fan
- Department of Respiratory and Critical Care Medicine, Central South University, Changsha 410008, China
| | - Yanjun Zeng
- Department of Respiratory and Critical Care Medicine, Central South University, Changsha 410008, China
| | - Wen Li
- Department of Respiratory and Critical Care Medicine, Central South University, Changsha 410008, China
| | - Sha Li
- Department of Radiology, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Xiang Chen
- Department of Dermatology, Central South University, Changsha 410008, China
| | - Haitao Li
- First Department of Thoracic Medicine, Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University
| | - Pinhua Pan
- Department of Respiratory and Critical Care Medicine, Central South University, Changsha 410008, China.
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Barkas F, Milionis H, Anastasiou G, Liberopoulos E. Statins and PCSK9 inhibitors: What is their role in coronavirus disease 2019? Med Hypotheses 2020; 146:110452. [PMID: 33333472 PMCID: PMC7724447 DOI: 10.1016/j.mehy.2020.110452] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 11/22/2020] [Accepted: 12/05/2020] [Indexed: 02/06/2023]
Abstract
Statins and proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors interfere with several pathophysiological pathways of coronavirus disease 2019 (COVID-19). Statins may have a direct antiviral effect on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by inhibiting its main protease. Statin-induced up-regulation of angiotensin-converting enzyme 2 (ACE2) may also be beneficial, whereas cholesterol reduction might significantly suppress SARS-CoV-2 by either blocking its host-cell entry through the disruption of lipid rafts or by inhibiting its replication. Available human studies have shown beneficial effects of statins and PCSK9 inhibitors on pneumonia and sepsis. These drugs may act as immunomodulators in COVID-19 and protect against major complications, such as acute respiratory distress syndrome and cytokine release syndrome. Considering their antioxidative, anti-arrhythmic, antithrombotic properties and their beneficial effect on endothelial dysfunction, along with the increased risk of mortality of patients at high cardiovascular risk infected by SARS-CoV-2, statins and PCSK9 inhibitors might prove effective against the cardiovascular and thromboembolic complications of COVID-19. On the whole, randomized clinical trials are needed to establish routine use of statins and PCSK9 inhibitors in the treatment of SARS-CoV-2 infection. In the meantime, it is recommended that lipid-lowering therapy should not be discontinued in COVID-19 patients unless otherwise indicated.
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Affiliation(s)
- Fotios Barkas
- Department of Internal Medicine, Faculty of Medicine, School of Health Sciences, University of Ioannina, Greece
| | - Haralampos Milionis
- Department of Internal Medicine, Faculty of Medicine, School of Health Sciences, University of Ioannina, Greece
| | - Georgia Anastasiou
- Department of Internal Medicine, Faculty of Medicine, School of Health Sciences, University of Ioannina, Greece
| | - Evangelos Liberopoulos
- Department of Internal Medicine, Faculty of Medicine, School of Health Sciences, University of Ioannina, Greece.
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Qin C, Minghan H, Ziwen Z, Yukun L. Alteration of lipid profile and value of lipids in the prediction of the length of hospital stay in COVID-19 pneumonia patients. Food Sci Nutr 2020; 8:6144-6152. [PMID: 33282265 PMCID: PMC7684619 DOI: 10.1002/fsn3.1907] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 08/31/2020] [Accepted: 09/04/2020] [Indexed: 01/08/2023] Open
Abstract
To observe lipid profiles and their alterations in hospitalized patients with COVID-19 pneumonia (NCP) and evaluate the value of lipids for the prediction of the length of hospital stay (LOS), a total of 248 patients aged 18 years or older were enrolled in this retrospective study. At admission, the median levels of triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) in all patients were 1.11, 4.00, 0.89, and 2.11 mmol/L, respectively. Compared with common cases (n = 174), severe cases (n = 74) exhibited higher TG and HDL-C, and lower LDL-C. Levels of TC and LDL-C were negatively correlated with LOS. In 68 severe cases, serum lipids were followed up during hospitalization, and the median LOS was 29 days. The average levels of serum lipids were lowest at admission and gradually increased during hospitalization. Compared with the LOS ≤ 29 days group, serum levels of TC, HDL-C, and LDL-C were significantly lower in the LOS > 29 days group at admission; this lower trend was found in the subsequent tests for TC and LDL-C but not for HDL-C or TG. Multiple-variant COX regression showed that levels of TC or LDL-C at admission were independent risk of LOS prolongation. Together, these findings suggest that in patients with NCP, levels of TC and LDL-C at admission were negatively correlated with LOS. In severe cases, the gradual increase in TC, LDL-C, and HDL-C during hospitalization might indicate gradual recovery. TC < 3.75 mmol/L or LDL-C < 1.7 mmol/L at admission may act as an independent predictor of prolonged LOS.
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Affiliation(s)
- Chen Qin
- Department of CardiologyFujian Medical University Union HospitalFuzhouChina
- Fujian Institute of Coronary Artery DiseaseFuzhouChina
- Fujian Heart Medical CenterFuzhouChina
| | - Huang Minghan
- Department of GastroenterologyThe Second People’s Hospital Affiliated to Fujian University of Traditional Chinese MedicineFuzhouChina
| | - Zhao Ziwen
- Department of CardiologyFujian Medical University Union HospitalFuzhouChina
- Fujian Institute of Coronary Artery DiseaseFuzhouChina
- Fujian Heart Medical CenterFuzhouChina
| | - Luo Yukun
- Department of CardiologyFujian Medical University Union HospitalFuzhouChina
- Fujian Institute of Coronary Artery DiseaseFuzhouChina
- Fujian Heart Medical CenterFuzhouChina
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30
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Banoei MM, Vogel HJ, Weljie AM, Yende S, Angus DC, Winston BW. Plasma lipid profiling for the prognosis of 90-day mortality, in-hospital mortality, ICU admission, and severity in bacterial community-acquired pneumonia (CAP). CRITICAL CARE : THE OFFICIAL JOURNAL OF THE CRITICAL CARE FORUM 2020; 24:461. [PMID: 32718333 PMCID: PMC7385943 DOI: 10.1186/s13054-020-03147-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Accepted: 07/03/2020] [Indexed: 12/22/2022]
Abstract
Introduction Pneumonia is the most common cause of mortality from infectious diseases, the second leading cause of nosocomial infection, and the leading cause of mortality among hospitalized adults. To improve clinical management, metabolomics has been increasingly applied to find specific metabolic biopatterns (profiling) for the diagnosis and prognosis of various infectious diseases, including pneumonia. Methods One hundred fifty bacterial community-acquired pneumonia (CAP) patients whose plasma samples were drawn within the first 24 h of hospital admission were enrolled in this study and separated into two age- and sex-matched cohorts: non-survivors (died ≤ 90 days) and survivors (survived > 90 days). Three analytical tools, 1H-NMR spectroscopy, GC-MS, and targeted DI-MS/MS, were used to prognosticate non-survivors from survivors by means of metabolic profiles. Results We show that quantitative lipid profiling using DI-MS/MS can predict the 90-day mortality and in-hospital mortality among patients with bacterial CAP compared to 1H-NMR- and GC-MS-based metabolomics. This study showed that the decreased lysophosphatidylcholines and increased acylcarnitines are significantly associated with increased mortality in bacterial CAP. Additionally, we found that decreased lysophosphatidylcholines and phosphatidylcholines (> 36 carbons) and increased acylcarnitines may be used to predict the prognosis of in-hospital mortality for bacterial CAP as well as the need for ICU admission and severity of bacterial CAP. Discussion This study demonstrates that lipid-based plasma metabolites can be used for the prognosis of 90-day mortality among patients with bacterial CAP. Moreover, lipid profiling can be utilized to identify patients with bacterial CAP who are at the highest risk of dying in hospital and who need ICU admission as well as the severity assessment of CAP.
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Affiliation(s)
- Mohammad M Banoei
- Department of Critical Care Medicine, Faculty of Medicine, Health Research Innovation Center (HRIC), University of Calgary, Room 4C64, 3280 Hospital Drive N.W, Calgary, Alberta, T2N 4Z6, Canada
| | - Hans J Vogel
- Department of Biological Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Aalim M Weljie
- Department of Biological Sciences, University of Calgary, Calgary, Alberta, Canada.,Department of Pharmacology, University of Pennsylvania, Philadelphia, PA, USA
| | - Sachin Yende
- The Clinical Research, Investigation, and Systems Modeling of Acute Illness (CRISMA) Laboratory, University of Pittsburgh, Pittsburgh, PA, USA.,Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Derek C Angus
- The Clinical Research, Investigation, and Systems Modeling of Acute Illness (CRISMA) Laboratory, University of Pittsburgh, Pittsburgh, PA, USA.,Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Brent W Winston
- Department of Critical Care Medicine, Faculty of Medicine, Health Research Innovation Center (HRIC), University of Calgary, Room 4C64, 3280 Hospital Drive N.W, Calgary, Alberta, T2N 4Z6, Canada. .,Departments of Medicine and Biochemistry and Molecular Biology, Health Research Innovation Center (HRIC), University of Calgary, Room 4C64, 3280 Hospital Drive N.W., Calgary, Alberta, T2N 4Z6, Canada.
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Giunti M, Grossi G, Troía R, Fracassi F, Dondi F. Evaluation of Serum Apolipoprotein A1 in Canine Sepsis. Front Vet Sci 2020; 7:263. [PMID: 32478112 PMCID: PMC7238865 DOI: 10.3389/fvets.2020.00263] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 04/20/2020] [Indexed: 11/28/2022] Open
Abstract
Decreased serum apolipoprotein A1 (Apo-A1) concentration is associated with mortality in human sepsis. The diagnostic and prognostic role of serum Apo-A1 concentrations in canine sepsis was evaluated. Serum samples from septic dogs (n = 91) and healthy controls (n = 15) were retrospectively analyzed. According to the sepsis origin, four categories were identified: parvoviral enteritis (n = 26), pyometra (n = 20), septic peritonitis (n = 19), and miscellanea (n = 26). The canine acute patient physiologic and laboratory evaluation fast score (APPLEfast), serum C-reactive protein (CRP) and albumin concentrations were reviewed in all enrolled dogs. Increased CRP (252.6 ± 119.2 mg/L; Reference Interval: 0–8.5 mg/L) and significant lower serum albumin and Apo-A1 concentrations were documented in dogs with sepsis (22.8 ± 5.3 g/L and 1.17 ± 0.27 g/L, respectively) compared to healthy ones (33.1 ± 2.5 g/L and 1.32 ± 0.05 g/L, respectively) (P < 0.0001). According to the origin of sepsis, only the subgroup of dogs with septic peritonitis had significantly lower Apo-A1 (1.03 ± 0.26 g/L) concentrations compared to healthy dogs (P < 0.001). No significant differences were found in serum albumin and CRP concentrations, and in APPLEfast score values among the different subgroups of sepsis. Diagnosis of septic peritonitis was associated with a higher frequency of death (P = 0.006). In septic dogs, significant lower Apo-A1 concentrations were detected in non-survivors (1.02 ± 0.28 g/L; n = 27) compared to survivors (1.23 ± 0.24 g/L; n = 64; P = 0.0007). Moreover, significant higher values of the APPLEfast score were calculated in non-survivors (26 ± 4; n = 19) compared to survivors (23 ± 4; n = 51) (P = 0.0114). According to the area under the ROC curve analysis, Apo-A1 <96 mg/dl had a fair accuracy (AUC = 0.72) to correctly predict mortality (P = 0.0004). Apo-A1 might support a diagnosis of canine septic peritonitis with a potential prognostic significance. Further prospective studies are warranted.
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Affiliation(s)
- Massimo Giunti
- Department of Veterinary Medical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Giorgio Grossi
- Department of Veterinary Medical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Roberta Troía
- Department of Veterinary Medical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Federico Fracassi
- Department of Veterinary Medical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Francesco Dondi
- Department of Veterinary Medical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
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Nabavi A, Allami A, QasemiBarqi R. Changes in plasma lipid and in-hospital deaths in patients with sepsis. Med J Islam Repub Iran 2020; 34:45. [PMID: 32884920 PMCID: PMC7456431 DOI: 10.34171/mjiri.34.45] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Indexed: 12/15/2022] Open
Abstract
Background: Lipid profiles are infrequently measured in clinical management of sepsis patients. Sepsis leads to significant alterations in the metabolism of lipids. The aim of the present study was to determine whether changes in plasma lipid concentrations during sepsis treatment were associated with clinical outcome. Methods: In this study, 74 adult septic patients were included in this prospective observational study from January to December 2017. Patients taking lipid lowering agents were excluded. A detailed medical history was obtained and clinical examination was performed. Serum total cholesterol (STC) and its fractions [low-and high-density lipoprotein] and triglyceride levels were measured in the morning of the first day after admission and then once weekly. The primary outcomes of the study were in-hospital mortality, and hospital stay and hypocholesterolemia were defined as STC levels < 50 mg/dL. Manne-Whitney U and chi-squared tests were used for data analysis, and significance level was set at p<0.05. Results: In this study, 78.4% (CI 95%: 67.3-87.1) of patients had hypocholesterolemia. During the study period, 21.6% (CI 95%: 12.9- 32.7) of patients died. All lipid (except TG) concentrations continuously decreased in deceased sepsis patients but increased in recovering patient (p value for STC (p=0.004), LDL (p=0.006), HDL (p=0.010), and TG (p=0.052)). The serum lipids concentration was not associated with length of hospital stay (p value for STC (p=0.524), LDL (p=0.813), HDL (p=0.799) and TG (p=0.581)). Conclusion: In this study it was found that the additional decline of lipid profile was significantly associated with increased mortality rate of sepsis patients. Thus, the clinically termed 'the lipaemia of sepsis' is not true in all situations.
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Affiliation(s)
- Azam Nabavi
- Department of Infectious Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Abbas Allami
- Department of Infectious Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Reza QasemiBarqi
- Department of Infectious Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
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Castellanos-Castro S, Bolaños J, Orozco E. Lipids in Entamoeba histolytica: Host-Dependence and Virulence Factors. Front Cell Infect Microbiol 2020; 10:75. [PMID: 32211340 PMCID: PMC7075943 DOI: 10.3389/fcimb.2020.00075] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 02/14/2020] [Indexed: 11/19/2022] Open
Abstract
Lipids are essential players in parasites pathogenesis. In particular, the highly phagocytic trophozoites of Entamoeba histolytica, the causative agent of amoebiasis, exhibit a dynamic membrane fusion and fission, in which lipids strongly participate; particularly during the overstated motility of the parasite to reach and attack the epithelia and ingest target cells. Synthesis and metabolism of lipids in this protozoan present remarkable difference with those performed by other eukaryotes. Here, we reviewed the current knowledge on lipids in E. histolytica. Trophozoites synthesize phosphatidylcholine and phosphatidylethanolamine by the Kennedy pathway; and sphingolipids, phosphatidylserine, and phosphatidylinositol, by processes similar to those used by other eukaryotes. However, trophozoites lack enzymes for cholesterol and fatty acids synthesis, which are scavenged from the host or culture medium by specific mechanisms. Cholesterol, a fundamental molecule for the expression of virulence, is transported from the medium into the trophozoites by EhNPC1 and EhNPC2 proteins. Inside cells, lipids are distributed by different pathways, including by the participation of the endosomal sorting complex required for transport (ESCRT), involved in vesicle fusion and fission. Cholesterol interacts with the phospholipid lysobisphosphatidic acid (LBPA) and EhADH, an ALIX family protein, also involved in phagocytosis. In this review, we summarize the known information on phospholipids synthesis and cholesterol transport as well as their metabolic pathways in E. histolytica; highlighting the mechanisms used by trophozoites to dispose lipids involved in the virulence processes.
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Affiliation(s)
- Silvia Castellanos-Castro
- College of Sciences and Humanities, Autonomous University of Mexico City, Mexico City, Mexico.,BioImage Analysis Unit, Pasteur Institute, Paris, France
| | - Jeni Bolaños
- Department of Infectomics and Molecular Pathogenesis, Center for Research and Advanced Studies of the National Polytechnic Institute, Mexico City, Mexico.,Centro Multidisciplinario de Estudios en Biotecnología, FMVZ, Universidad Michoacana de San Nnicolás Hidalgo, Morelia, Mexico
| | - Esther Orozco
- Department of Infectomics and Molecular Pathogenesis, Center for Research and Advanced Studies of the National Polytechnic Institute, Mexico City, Mexico
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Martínez CR, Ruiz CJ. Alterations in Host Lipid Metabolism Produced During Visceral Leishmaniasis Infections. CURRENT TROPICAL MEDICINE REPORTS 2019. [DOI: 10.1007/s40475-019-00187-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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35
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The impact of bacteremia on lipoprotein concentrations and patient's outcome: a retrospective analysis. Eur J Clin Microbiol Infect Dis 2019; 38:1279-1286. [PMID: 30982158 PMCID: PMC6570662 DOI: 10.1007/s10096-019-03543-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 03/18/2019] [Indexed: 01/05/2023]
Abstract
Bacteremia is a major clinical challenge requiring early treatment. Metabolic alterations occur during bacteremia, and accordingly plasma concentrations of lipoproteins LDL-C and HDL-C are substantially changed. We questioned whether bacteremia with Gram-negative versus Gram-positive bacteria causes contrasting changes of lipoprotein levels in order to differentiate between the 2-g stain types and if there is a relation with outcome parameters namely ICU-admission, 30-day mortality, duration of hospitalization. This is a retrospective dual-center cross-sectional study, including 258 patients with bacteremia. Plasma lipid levels were analyzed within 48 h to positive blood culture. Upon admission, HDL-C, LDL-C, and total cholesterol (p = 0.99) in plasma did not significantly differ between patients with Gram-negative and Gram-positive bacteremia, while significantly higher triglyceride concentrations were found in Gram-negative bacteremia (p < 0.05). 30-day mortality and ICU admission were associated with lower LDL-C and HDL-C concentrations as compared to survivors and non-ICU patients, and patients with HDL-C < 20 mg dl-1 and LDL-C < 55 mg dl-1 had a relative risk (RR) of 2.85 for ICU therapy requirement and RR = 2 of death within 30 days. Reduced HDL-C and LDL-C concentrations were associated with adverse patient's outcome in bacteremia. Discrimination between Gram-negative and Gram-positive pathogens upon lipoprotein patterns is unlikely.
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36
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Eldarov CM, Nikitina IV, Kirtbaya AR, Chagovets VV, Ionov OV, Bobrov MY. Blood Lipids Profiling of Preterm Neonates in the First Day of Life for Identification of Early Biomarkers of Sepsis and Pneumonia. RUSSIAN JOURNAL OF BIOORGANIC CHEMISTRY 2019. [DOI: 10.1134/s1068162019020031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Tsimihodimos V, Kei A, Apostolou F, Elisaf M. Diagnostic lipid changes in patients with visceral leishmaniasis. Hosp Pract (1995) 2018; 46:229-232. [PMID: 29848097 DOI: 10.1080/21548331.2018.1483171] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 05/29/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Visceral leishmaniasis (VL) has been associated with the increase in triglyceride (TG) levels and the decrease in high-density lipoprotein cholesterol (HDL-C) concentration. The aim of the study was to evaluate whether there is a diagnostic cut-off point in these lipid profile changes. MATERIALS AND METHODS We included 100 patients with febrile infections. Analytically, 22 patients with VL, 18 patients with leptospirosis, 20 patients with Brucella melitensis, and 40 age- and sex-matched patients with fever and proven bacteremia (endocarditis and pyelonephritis). The lipid parameters were assessed for their diagnostic accuracy using logistic regression and receiver operating characteristic statistics. RESULTS It was observed that coexistence of HDL-C < 15 mg/dL and ΤG > 180 mg/dL had 100% sensitivity and 67.5% specificity for the confirmation of VL. The corresponding positive and negative predictive values were 59.4% and 100%, respectively. CONCLUSION Coexistence of high TGs and low HDL-C values may suggest VL infection in a febrile patient.
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Affiliation(s)
- Vasilis Tsimihodimos
- a Department of Internal Medicine , Medical School, University of Ioannina , Ioannina , Greece
| | - Anastazia Kei
- a Department of Internal Medicine , Medical School, University of Ioannina , Ioannina , Greece
| | - Fotini Apostolou
- a Department of Internal Medicine , Medical School, University of Ioannina , Ioannina , Greece
| | - Moses Elisaf
- a Department of Internal Medicine , Medical School, University of Ioannina , Ioannina , Greece
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Dual antiretroviral therapy with tenofovir (TDF) and darunavir/ritonavir (DRV/RTV) in an HIV-1 positive patient: a case report, review, and meta-analysis of the literature on dual treatment strategies using protease inhibitors in combination with an NRTI. Infection 2018; 46:599-605. [PMID: 29961209 DOI: 10.1007/s15010-018-1171-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 06/27/2018] [Indexed: 01/05/2023]
Abstract
BACKGROUND Here, we report the case of an HIV positive patient under a dual antiretroviral drug regimen with tenofovir disoproxil and darunavir/ritonavir with stable clinical, virological, and immunological response over 126 weeks. Dual antiretroviral therapy has the advantage of reduced toxicity and lower health care costs, treatment failure and fostering drug resistance are perceived risks. Optimal drug combinations and indication criteria for dual treatment remain controversial. Nevertheless, first clinical trials indicate non-inferiority for combinations of nucleoside reverse transcriptase inhibitors and protease inhibitors. This case presents the combination of tenofovir disoproxil in combination with a protease inhibitor as a new potential dual treatment regimen. METHOD We performed a systematic literature search and meta-analysis of trials comparing dual to triple ART. RESULTS Literature review revealed nine studies in which dual therapy with a protease inhibitor and an NRTI was compared to triple therapy. We performed a meta-analysis of six trials that reported a 48-week follow-up. In treatment-naïve patients as well when ART switch was assessed, there was no difference in the treatment success in patients with dual ART versus triple. CONCLUSION We conclude that dual therapy with a protease inhibitor and NRTI is safe and effective. The use of tenofovir in dual treatment as described in our case needs to be assessed in future clinical trials.
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Eisfeld AJ, Halfmann PJ, Wendler JP, Kyle JE, Burnum-Johnson KE, Peralta Z, Maemura T, Walters KB, Watanabe T, Fukuyama S, Yamashita M, Jacobs JM, Kim YM, Casey CP, Stratton KG, Webb-Robertson BJM, Gritsenko MA, Monroe ME, Weitz KK, Shukla AK, Tian M, Neumann G, Reed JL, van Bakel H, Metz TO, Smith RD, Waters KM, N'jai A, Sahr F, Kawaoka Y. Multi-platform 'Omics Analysis of Human Ebola Virus Disease Pathogenesis. Cell Host Microbe 2017; 22:817-829.e8. [PMID: 29154144 DOI: 10.1016/j.chom.2017.10.011] [Citation(s) in RCA: 80] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Revised: 06/13/2017] [Accepted: 09/20/2017] [Indexed: 12/11/2022]
Abstract
The pathogenesis of human Ebola virus disease (EVD) is complex. EVD is characterized by high levels of virus replication and dissemination, dysregulated immune responses, extensive virus- and host-mediated tissue damage, and disordered coagulation. To clarify how host responses contribute to EVD pathophysiology, we performed multi-platform 'omics analysis of peripheral blood mononuclear cells and plasma from EVD patients. Our results indicate that EVD molecular signatures overlap with those of sepsis, imply that pancreatic enzymes contribute to tissue damage in fatal EVD, and suggest that Ebola virus infection may induce aberrant neutrophils whose activity could explain hallmarks of fatal EVD. Moreover, integrated biomarker prediction identified putative biomarkers from different data platforms that differentiated survivors and fatalities early after infection. This work reveals insight into EVD pathogenesis, suggests an effective approach for biomarker identification, and provides an important community resource for further analysis of human EVD severity.
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Affiliation(s)
- Amie J Eisfeld
- Department of Pathobiological Sciences, University of Wisconsin - Madison (UW-Madison), Madison, WI 53706, USA
| | - Peter J Halfmann
- Department of Pathobiological Sciences, University of Wisconsin - Madison (UW-Madison), Madison, WI 53706, USA
| | - Jason P Wendler
- Biological Sciences Division, Earth and Biological Sciences Directorate, Pacific Northwest National Laboratory (PNNL), Richland, WA 99352, USA
| | - Jennifer E Kyle
- Biological Sciences Division, Earth and Biological Sciences Directorate, Pacific Northwest National Laboratory (PNNL), Richland, WA 99352, USA
| | - Kristin E Burnum-Johnson
- Biological Sciences Division, Earth and Biological Sciences Directorate, Pacific Northwest National Laboratory (PNNL), Richland, WA 99352, USA
| | - Zuleyma Peralta
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai (ISMMS), New York City, NY 10029, USA
| | - Tadashi Maemura
- Division of Virology, Department of Microbiology and Immunology, Institute of Medical Science (IMS), University of Tokyo, Tokyo 108-8639, Japan
| | - Kevin B Walters
- Department of Pathobiological Sciences, University of Wisconsin - Madison (UW-Madison), Madison, WI 53706, USA
| | - Tokiko Watanabe
- Division of Virology, Department of Microbiology and Immunology, Institute of Medical Science (IMS), University of Tokyo, Tokyo 108-8639, Japan
| | - Satoshi Fukuyama
- Division of Virology, Department of Microbiology and Immunology, Institute of Medical Science (IMS), University of Tokyo, Tokyo 108-8639, Japan
| | - Makoto Yamashita
- Division of Virology, Department of Microbiology and Immunology, Institute of Medical Science (IMS), University of Tokyo, Tokyo 108-8639, Japan
| | - Jon M Jacobs
- Biological Sciences Division, Earth and Biological Sciences Directorate, Pacific Northwest National Laboratory (PNNL), Richland, WA 99352, USA
| | - Young-Mo Kim
- Biological Sciences Division, Earth and Biological Sciences Directorate, Pacific Northwest National Laboratory (PNNL), Richland, WA 99352, USA
| | - Cameron P Casey
- Biological Sciences Division, Earth and Biological Sciences Directorate, Pacific Northwest National Laboratory (PNNL), Richland, WA 99352, USA
| | - Kelly G Stratton
- Computing and Analytics Division, National Security Directorate, PNNL, Richland, WA 99352, USA
| | | | - Marina A Gritsenko
- Biological Sciences Division, Earth and Biological Sciences Directorate, Pacific Northwest National Laboratory (PNNL), Richland, WA 99352, USA
| | - Matthew E Monroe
- Biological Sciences Division, Earth and Biological Sciences Directorate, Pacific Northwest National Laboratory (PNNL), Richland, WA 99352, USA
| | - Karl K Weitz
- Biological Sciences Division, Earth and Biological Sciences Directorate, Pacific Northwest National Laboratory (PNNL), Richland, WA 99352, USA
| | - Anil K Shukla
- Biological Sciences Division, Earth and Biological Sciences Directorate, Pacific Northwest National Laboratory (PNNL), Richland, WA 99352, USA
| | - Mingyuan Tian
- Department of Chemical and Biological Engineering, UW-Madison, Madison, WI 53706, USA
| | - Gabriele Neumann
- Department of Pathobiological Sciences, University of Wisconsin - Madison (UW-Madison), Madison, WI 53706, USA
| | - Jennifer L Reed
- Department of Chemical and Biological Engineering, UW-Madison, Madison, WI 53706, USA
| | - Harm van Bakel
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai (ISMMS), New York City, NY 10029, USA; Icahn Institute for Genomics and Multiscale Biology, ISMMS, New York City, NY 10029, USA.
| | - Thomas O Metz
- Biological Sciences Division, Earth and Biological Sciences Directorate, Pacific Northwest National Laboratory (PNNL), Richland, WA 99352, USA.
| | - Richard D Smith
- Biological Sciences Division, Earth and Biological Sciences Directorate, Pacific Northwest National Laboratory (PNNL), Richland, WA 99352, USA.
| | - Katrina M Waters
- Biological Sciences Division, Earth and Biological Sciences Directorate, Pacific Northwest National Laboratory (PNNL), Richland, WA 99352, USA.
| | - Alhaji N'jai
- Department of Pathobiological Sciences, University of Wisconsin - Madison (UW-Madison), Madison, WI 53706, USA; Department of Biological Sciences, Fourah Bay College, College of Medicine & Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Foday Sahr
- 34(th) Regimental Military Hospital at Wilberforce, Freetown, Sierra Leone.
| | - Yoshihiro Kawaoka
- Department of Pathobiological Sciences, University of Wisconsin - Madison (UW-Madison), Madison, WI 53706, USA; Division of Virology, Department of Microbiology and Immunology, Institute of Medical Science (IMS), University of Tokyo, Tokyo 108-8639, Japan; International Research Center for Infectious Diseases, IMS, University of Tokyo, Tokyo 108-8639, Japan.
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