Sandra Parra , Mireia Saballs , Mark DiNubile , Mireia Feliu , Simona Iftimie , Laia Revuelta , Raul Pavón , Alba Àvila , Susan Levinson , Antoni Castro
{"title":"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","authors":"Sandra Parra , Mireia Saballs , Mark DiNubile , Mireia Feliu , Simona Iftimie , Laia Revuelta , Raul Pavón , Alba Àvila , Susan Levinson , Antoni Castro","doi":"10.1016/j.athplu.2023.01.002","DOIUrl":null,"url":null,"abstract":"<div><h3>Background and aims</h3><p>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.</p></div><div><h3>Methods</h3><p>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.</p></div><div><h3>Results</h3><p>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 (<em>p</em> < 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 (<em>r</em> = −0.333; <em>p</em> < 0.001), ferritin (<em>r</em> = −0.354; <em>p</em> < 0.001), D-dímer (<em>r</em> = −0.214; <em>p</em> < 0.001), LDH (<em>r</em> = −0.209; <em>p</em> < 0.001. LDL-c levels were significantly associated with CRP (<em>r</em> = −0.320; <em>p</em> < 0.001) and LDH (<em>r</em> = −0.269; <em>p</em> < 0.001). ROC curves showed that HDL [AUC = 0.737(0.586–0.887), <em>p</em> = 0.005] and lymphocytes [AUC = 0.672(0.497–0.847], <em>p</em> < 0.043] had the best prognostic accuracy to predict death. In a multivariate analysis, HDL-c (β = −0.146(0.770–0.971), <em>p</em> = 0.014) and urea (β = 0.029(1.003–1.057), <em>p</em> = 0.027) predicted mortality.</p></div><div><h3>Conclusion</h3><p>Hypolipidemia including HDL levels at admission identifies patients with a higher risk of death and worse clinical manifestations who may require more intensive care.</p></div>","PeriodicalId":72324,"journal":{"name":"Atherosclerosis plus","volume":null,"pages":null},"PeriodicalIF":1.4000,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9988188/pdf/","citationCount":"3","resultStr":"{\"title\":\"Low HDL-c levels at admission are associated with greater severity and worse clinical outcomes in patients with COVID-19 disease\",\"authors\":\"Sandra Parra , Mireia Saballs , Mark DiNubile , Mireia Feliu , Simona Iftimie , Laia Revuelta , Raul Pavón , Alba Àvila , Susan Levinson , Antoni Castro\",\"doi\":\"10.1016/j.athplu.2023.01.002\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background and aims</h3><p>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.</p></div><div><h3>Methods</h3><p>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.</p></div><div><h3>Results</h3><p>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 (<em>p</em> < 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 (<em>r</em> = −0.333; <em>p</em> < 0.001), ferritin (<em>r</em> = −0.354; <em>p</em> < 0.001), D-dímer (<em>r</em> = −0.214; <em>p</em> < 0.001), LDH (<em>r</em> = −0.209; <em>p</em> < 0.001. LDL-c levels were significantly associated with CRP (<em>r</em> = −0.320; <em>p</em> < 0.001) and LDH (<em>r</em> = −0.269; <em>p</em> < 0.001). ROC curves showed that HDL [AUC = 0.737(0.586–0.887), <em>p</em> = 0.005] and lymphocytes [AUC = 0.672(0.497–0.847], <em>p</em> < 0.043] had the best prognostic accuracy to predict death. In a multivariate analysis, HDL-c (β = −0.146(0.770–0.971), <em>p</em> = 0.014) and urea (β = 0.029(1.003–1.057), <em>p</em> = 0.027) predicted mortality.</p></div><div><h3>Conclusion</h3><p>Hypolipidemia including HDL levels at admission identifies patients with a higher risk of death and worse clinical manifestations who may require more intensive care.</p></div>\",\"PeriodicalId\":72324,\"journal\":{\"name\":\"Atherosclerosis plus\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.4000,\"publicationDate\":\"2023-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9988188/pdf/\",\"citationCount\":\"3\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Atherosclerosis plus\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2667089523000020\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"PERIPHERAL VASCULAR DISEASE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Atherosclerosis plus","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2667089523000020","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"PERIPHERAL VASCULAR DISEASE","Score":null,"Total":0}
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.