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Lipoprotein concentrations over time in the intensive care unit COVID-19 patients: Results from the ApoCOVID study
- Source :
- PLOS ONE, 15(9):e0239573, PLoS ONE, PLoS ONE, Vol 15, Iss 9, p e0239573 (2020)
- Publication Year :
- 2020
-
Abstract
- IntroductionSevere acute respiratory syndrome coronavirus2 has caused a global pandemic of coronavirus disease 2019 (COVID-19). High-density lipoproteins (HDLs), particles chiefly known for their reverse cholesterol transport function, also display pleiotropic properties, including anti-inflammatory or antioxidant functions. HDLs and low-density lipoproteins (LDLs) can neutralize lipopolysaccharides and increase bacterial clearance. HDL cholesterol (HDL-C) and LDL cholesterol (LDL-C) decrease during bacterial sepsis, and an association has been reported between low lipoprotein levels and poor patient outcomes. The goal of this study was to characterize the lipoprotein profiles of severe ICU patients hospitalized for COVID-19 pneumonia and to assess their changes during bacterial ventilator-associated pneumonia (VAP) superinfection.MethodsA prospective study was conducted in a university hospital ICU. All consecutive patients admitted for COVID-19 pneumonia were included. Lipoprotein levels were assessed at admission and daily thereafter. The assessed outcomes were survival at 28 days and the incidence of VAP.ResultsA total of 48 patients were included. Upon admission, lipoprotein concentrations were low, typically under the reference values ([HDL-C] = 0.7[0.5-0.9] mmol/L; [LDL-C] = 1.8[1.3-2.3] mmol/L). A statistically significant increase in HDL-C and LDL-C over time during the ICU stay was found. There was no relationship between HDL-C and LDL-C concentrations and mortality on day 28 (log-rank p = 0.554 and p = 0.083, respectively). A comparison of alive and dead patients on day 28 did not reveal any differences in HDL-C and LDL-C concentrations over time. Bacterial VAP was frequent (64%). An association was observed between HDL-C and LDL-C concentrations on the day of the first VAP diagnosis and mortality ([HDL-C] = 0.6[0.5-0.9] mmol/L in survivors vs. [HDL-C] = 0.5[0.3-0.6] mmol/L in nonsurvivors, p = 0.036; [LDL-C] = 2.2[1.9-3.0] mmol/L in survivors vs. [LDL-C] = 1.3[0.9-2.0] mmol/L in nonsurvivors, p = 0.006).ConclusionHDL-C and LDL-C concentrations upon ICU admission are low in severe COVID-19 pneumonia patients but are not associated with poor outcomes. However, low lipoprotein concentrations in the case of bacterial superinfection during ICU hospitalization are associated with mortality, which reinforces the potential role of these particles during bacterial sepsis.
- Subjects :
- 0301 basic medicine
Male
Viral Diseases
Pulmonology
030204 cardiovascular system & hematology
medicine.disease_cause
Gastroenterology
Biochemistry
law.invention
Hospitals, University
chemistry.chemical_compound
0302 clinical medicine
Medical Conditions
COVID-19
Lipoproteins
Lipid profiles
Intensive care units
Sepsis
Lipids
Pneumonia
Cholesterol
law
Medicine and Health Sciences
Prospective Studies
Prospective cohort study
Multidisciplinary
Incidence (epidemiology)
Reverse cholesterol transport
Pneumonia, Ventilator-Associated
Middle Aged
Intensive care unit
Lipid Profiles
Hospitals
Intensive Care Units
Infectious Diseases
Superinfection
Medicine
Female
lipids (amino acids, peptides, and proteins)
France
Coronavirus Infections
Research Article
medicine.medical_specialty
Science
Pneumonia, Viral
03 medical and health sciences
Betacoronavirus
Signs and Symptoms
Internal medicine
medicine
Pneumonia, Bacterial
Humans
Pandemics
Aged
business.industry
SARS-CoV-2
Cholesterol, HDL
Biology and Life Sciences
Proteins
Covid 19
Cholesterol, LDL
medicine.disease
Health Care
030104 developmental biology
chemistry
Health Care Facilities
Clinical Medicine
business
Lipoprotein
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Journal :
- PLOS ONE, 15(9):e0239573, PLoS ONE, PLoS ONE, Vol 15, Iss 9, p e0239573 (2020)
- Accession number :
- edsair.doi.dedup.....8e9f708175b234840515bf5d80e941af