入院时低HDL-c水平与COVID-19疾病患者更严重和更差的临床结果相关

IF 1.4 Q3 PERIPHERAL VASCULAR DISEASE Atherosclerosis plus Pub Date : 2023-06-01 DOI:10.1016/j.athplu.2023.01.002
Sandra Parra , Mireia Saballs , Mark DiNubile , Mireia Feliu , Simona Iftimie , Laia Revuelta , Raul Pavón , Alba Àvila , Susan Levinson , Antoni Castro
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引用次数: 3

摘要

背景和目的高密度脂蛋白颗粒可能起到缓冲宿主细胞免受过度炎症介质影响的作用。本研究的目的是调查脂质概况是否为新冠肺炎结果提供了预后生物标志物。方法对125例成年新冠肺炎患者的特征进行前瞻性研究,并对其入院当天的血脂状况进行临床结果分析。结果77例(61.2%)患者为男性,平均年龄66.3(15.6)岁。54.1%为双侧肺炎。住院期间的全因死亡率为20.8%。我们发现,世界卫生组织分类评估的更严重的疾病、入住重症监护室与更明显的淋巴细胞减少症、更高水平的CRP、铁蛋白(p<0.001)、D-Dímer和乳酸脱氢酶(LDH)死亡之间存在直接关联,所有这些都具有统计学意义。HDL-c和LDL-c水平较低也与更差的世界卫生组织分类、入住ICU和死亡相关,。HDL-c水平与炎症标志物CRP(r=−0.333;p<;0.001)、铁蛋白(r=–0.354;p&llt;0.001。LDL-c水平与CRP(r=-0.320;p<;0.001)和LDH(r=-0.269;p&llt;0.001)显著相关。ROC曲线显示,HDL[AUC=0.737(0.586–0.887),p=0.005]和淋巴细胞[AUC=0.672(0.497–0.847],p<;0.043]具有预测死亡的最佳预后准确性。在多变量分析中,HDL-c(β=−0.146(0.770–0.971),p=0.014)和尿素(β=0.029(1.003-1.057),p=0.027)预测死亡率。结论入院时的低脂血症(包括高密度脂蛋白水平)可识别出死亡风险更高、临床表现更差的患者,这些患者可能需要更多的重症监护。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Low HDL-c levels at admission are associated with greater severity and worse clinical outcomes in patients with COVID-19 disease

Background and aims

HDL particles may act to buffer host cells from excessive inflammatory mediators. The aim of this study is to investigate if the lipid profile provides a prognostic biomarker for COVID-19 outcomes.

Methods

This was a prospective study of the characteristics of 125 adult COVID-19 patients with a lipid profile performed on the day of admission analyzed with regard to clinical outcomes.

Results

Seventy-seven patients (61.2%) were men, with a mean age of 66.3 (15.6) years. 54.1% had bilateral pneumonia. The all-cause mortality rate during hospitalization was 20.8%. We found a direct association between more severe disease assessed by the WHO classification, admission to the ICU and death with more pronounced lymphopenia, higher levels of CRP, ferritin (p < 0.001), D-dímer and lactate dehydrogenase (LDH) all statistically significant. Lower leves of HDL-c and LDL-c were also associated with a worse WHO classification, ICU admission, and death,. HDL-c levels were inversely correlated with inflammatory markers CRP (r = −0.333; p < 0.001), ferritin (r = −0.354; p < 0.001), D-dímer (r = −0.214; p < 0.001), LDH (r = −0.209; p < 0.001. LDL-c levels were significantly associated with CRP (r = −0.320; p < 0.001) and LDH (r = −0.269; p < 0.001). ROC curves showed that HDL [AUC = 0.737(0.586–0.887), p = 0.005] and lymphocytes [AUC = 0.672(0.497–0.847], p < 0.043] had the best prognostic accuracy to predict death. In a multivariate analysis, HDL-c (β = −0.146(0.770–0.971), p = 0.014) and urea (β = 0.029(1.003–1.057), p = 0.027) predicted mortality.

Conclusion

Hypolipidemia including HDL levels at admission identifies patients with a higher risk of death and worse clinical manifestations who may require more intensive care.

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来源期刊
Atherosclerosis plus
Atherosclerosis plus Cardiology and Cardiovascular Medicine
CiteScore
2.60
自引率
0.00%
发文量
0
审稿时长
66 days
期刊最新文献
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