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Mehraeen E, Abbaspour F, Banach M, SeyedAlinaghi S, Zarebidoki A, Tamehri Zadeh SS. The prognostic significance of insulin resistance in COVID-19: a review. J Diabetes Metab Disord 2024; 23:305-322. [PMID: 38932824 PMCID: PMC11196450 DOI: 10.1007/s40200-024-01385-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 12/31/2023] [Indexed: 06/28/2024]
Abstract
Objectives Emerging publications indicate that diabetes predisposes patients with COVID-19 to more severe complications, which is partly attributed to inflammatory condition. In the current review, we reviewed recent published literature to provide evidence on the role of insulin resistance (IR) in diabetes, the association between diabetes and COVID-19 severity and mortality, the impact of COVID-19 infection on incident new-onset diabetes, mechanisms responsible for IR in COVID-19 patients, and the predictive value of different surrogates of IR in COVID-19. Method The literature search performs to find out studies that have assessed the association between IR surrogates and morbidity and mortality in patients with COVID-19. Results We showed that there is a bulk of evidence in support of the fact that diabetes is a potent risk factor for enhanced morbidity and mortality in COVID-19 patients. COVID-19 patients with diabetes are more prone to remarkable dysglycemia compared to those without diabetes, which is associated with an unfavourable prognosis. Furthermore, SARS-COV2 can make patients predispose to IR and diabetes via activating ISR, affecting RAAS signaling pathway, provoking inflammation, and changing the expression of PPARɣ and SREBP-1. Additionally, higher IR is associated with increased morbidity and mortality in COVID-19 patients and different surrogates of IR can be utilized as a prognostic biomarker for COVID-19 patients. Conclusion Different surrogates of IR can be utilized as predictors of COVID-19 complications and death.
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Affiliation(s)
- Esmaeil Mehraeen
- Department of Health Information Technology, Khalkhal University of Medical Sciences, Khalkhal, Iran
| | - Faeze Abbaspour
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Maciej Banach
- Department of Preventive Cardiology and Lipidology, Medical University of Lodz (MUL), 93338 Lodz, Poland
| | - SeyedAhmad SeyedAlinaghi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Ameneh Zarebidoki
- School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Seyed Saeed Tamehri Zadeh
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, No. 24, Parvaneh Street, Velenjak, P.O. Box 19395-4763, Tehran, Iran
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2
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Ochoa-Ramírez LA, De la Herrán Arita AK, Sanchez-Zazueta JG, Ríos-Burgueño E, Murillo-Llanes J, De Jesús-González LA, Farfan-Morales CN, Cordero-Rivera CD, Del Ángel RM, Romero-Utrilla A, Camberos-Barraza J, Valdez-Flores MA, Camacho-Zamora A, Batiz-Beltrán JC, Angulo-Rojo C, Guadrón-Llanos AM, Picos-Cárdenas VJ, Norzagaray-Valenzuela CD, Rábago-Monzón ÁR, Velarde-Félix JS, Reyes-Ruiz JM, Osuna-Ramos JF. Association between lipid profile and clinical outcomes in COVID-19 patients. Sci Rep 2024; 14:12139. [PMID: 38802549 PMCID: PMC11130121 DOI: 10.1038/s41598-024-62899-y] [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: 01/16/2024] [Accepted: 05/21/2024] [Indexed: 05/29/2024] Open
Abstract
High-density lipoprotein cholesterol (HDL-c) removes cholesterol, an essential component in lipid rafts, and this cholesterol removal can regulate protein attachment to lipid rafts, modulating their functionality in the immune cell response. Although severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can alter the lipid profile, there is little information on the role of HDL-c and other lipids in prognostic of the coronavirus disease 2019 (COVID-19) in Mexican population. This study aims to evaluate the predictive value of HDL-c and lipid profile on severity and survival of 102 patients infected with SARS-CoV-2 during the COVID-19 first wave. Our findings, derived from univariate and multivariate Cox proportional hazards regression models, highlighted age and hypertension as significant predictors of survival (HR = 1.04, p = 0.012; HR = 2.78, p = 0.027), while gender, diabetes, and obesity showed no significant impact. Triglycerides and HDL-c levels notably influenced mortality, with elevated triglycerides and lower HDL-c associated with higher mortality risk (p = 0.032). This study underscores the importance of lipid profiles alongside traditional risk factors in assessing COVID-19 risk and outcomes. It contributes to the understanding of COVID-19 patient management and emphasizes the need for further investigation into the role of dyslipidemia in influencing COVID-19 prognosis, potentially aiding in refined risk stratification and therapeutic strategies.
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Affiliation(s)
- Luis Antonio Ochoa-Ramírez
- Hospital General de Culiacán "Bernardo J. Gastelum", Servicios de Salud de Sinaloa, Culiacán, Sinaloa, Mexico
| | | | | | - Efrén Ríos-Burgueño
- Departamento de Anatomía Patológica, Centro de Investigación y Docencia en Ciencias de la Salud, Universidad Autónoma de Sinaloa, Hospital Civil de Culiacán, Culiacán, Mexico
| | - Joel Murillo-Llanes
- Departamento de Investigación del Hospital de la Mujer, Servicios de Salud de Sinaloa, Culiacán, Sinaloa, Mexico
| | | | - Carlos Noe Farfan-Morales
- Departamento de Ciencias Naturales, Universidad Autónoma Metropolitana, Unidad Cuajimalpa, Ciudad de México, Mexico
| | - Carlos Daniel Cordero-Rivera
- Departamento de Infectómica y Patogénesis Molecular, Centro de Investigación y de Estudios Avanzados del Instituto politécnico Nacional, Ciudad de México, Mexico
| | - Rosa María Del Ángel
- Departamento de Infectómica y Patogénesis Molecular, Centro de Investigación y de Estudios Avanzados del Instituto politécnico Nacional, Ciudad de México, Mexico
| | - Alejandra Romero-Utrilla
- Departamento de Anatomía Patológica, Instituto Mexicano del Seguro Social, Culiacán, Sinaloa, Mexico
| | | | | | | | | | - Carla Angulo-Rojo
- Facultad de Medicina, Universidad Autónoma de Sinaloa, Culiacán, Sinaloa, Mexico
| | | | | | | | | | - Jesús Salvador Velarde-Félix
- Hospital General de Culiacán "Bernardo J. Gastelum", Servicios de Salud de Sinaloa, Culiacán, Sinaloa, Mexico
- Facultad de Biología, Universidad Autónoma de Sinaloa, Culiacán, Sinaloa, Mexico
| | - José Manuel Reyes-Ruiz
- Departamento de Investigación en Salud, Unidad Médica de Alta Especialidad, Hospital de Especialidades No. 14, Centro Médico Nacional "Adolfo Ruiz Cortines", Instituto Mexicano del Seguro Social (IMSS), Veracruz, Mexico.
- Facultad de Medicina, Región Veracruz, Universidad Veracruzana (UV), Veracruz, Mexico.
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Alqahtani TMM, Alghamdi MAA, Baig MR, Al-Abbasi FA, Sheikh RA, Almalki NAR, Hejazi MM, Alhayyani S, Asar TO, Kumar V, Anwar F. Recent Patterns and Assessment of Long-term Complications followi ngSARS-CoV-2 Infection and Vaccination in the Context of Diabet esPrevalence among Blood Donors. Curr Diabetes Rev 2024; 20:e110124225520. [PMID: 38415496 DOI: 10.2174/0115733998274390231110050809] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 10/02/2023] [Accepted: 10/13/2023] [Indexed: 02/29/2024]
Abstract
BACKGROUND Much increasing evidence has suggested that long-term complications post vaccination of SARS-CoV-2 experience a wide range of complication including diabetes. The risk and burden of type 1 diabetes is extensively reported, but type 2 diabetes mellitus (T2D) has yet to be characterized. To address this gap, we aimed to examine trends of long-term complications post SARS-CoV-2 infection and vaccination in diabetes incidence among the Saudi population. METHODS In this cross-sectional hospital-based study, we analyzed the blood profile of first-time blood donors from the University Hospital of King Abdulaziz University, Jeddah. Saudi Arabia. Various blood parameters, HbA1c was measured in the month of May 2023. All the donors were non-diabetic and were never diagnosed with T2D before the current blood donation. 203 healthy subjects donated their blood, out of which 104 had abnormally high HbA1c tending towards diagnosis of T2D and 99 had with blood profiles. The study followed the STROBE reporting guidelines. RESULTS Out of 203 donors 104 (male 50(48.1%), female 54(51.9%)) were diagnosed with increased HbA1c (8.24 in males) compared to 7.61 of HbA1c in females. 35.6% were above ˃65 years, with 52.9% with O+ from the ABO blood group. Liver functions indicated significant p˂0.05, 0.04, increased amount of GGT (46.47 U/L), Alkaline phosphatase (99.93 ±64.26 uL) respectively in HbA1c elevated donors KFT represented significant p˂0.05, 0.02 elevated levels of urea (6.73 ±5.51 mmol/L), creatinine (129.97 ±195.17 umol/L) respectively along with elevated values of Lactate dehydrogenase (LDH) (263.72± 196.70 uL) and triglycerides (1.66 ±0.74mmol/L) when compared to normal value of HbA1c donors. DISCUSSION In the present cross-sectional study, significant increase in HbA1c, trending towards increased cases of T2D post SARS-CoV-2 infection and vaccination. Males are much affected compared to females. Further maximum number of cases were from donors above the age of 65 years with altered partial LFT (GGT, Alkaline phosphatase), KFT (urea, creatinine), lipid profile (TG) and LDH in post SARS-CoV-2 and vaccination blood donors. CONCLUSION Increase in HbA1c in 50% of donors, irrespective of gender, is an alarming figure for health authorities, with altered LFT, KFT and LDH tests and, in the near future, may increase the incidence of T2D. Large-scale population-based studies are required to prevent future incidences of T2D in young children who will be vaccinated.
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Affiliation(s)
| | | | - Mirza Rafi Baig
- Department of Clinical Pharmacy & Pharmacotherapeutics, Dubai Pharmacy College for Girls. Dubai Medical University, Dubai, United Arab Emirates
| | - Fahad A Al-Abbasi
- Department of Biochemistry, Faculty of Science, King Abdul-Aziz University, Jeddah, 21589, Saudi Arabia
| | - Ryan Adnan Sheikh
- Department of Biochemistry, Faculty of Science, King Abdul-Aziz University, Jeddah, 21589, Saudi Arabia
| | - Naif A R Almalki
- Department of Biochemistry, Faculty of Science, King Abdul-Aziz University, Jeddah, 21589, Saudi Arabia
| | - Moayad Mustafa Hejazi
- Department of Biochemistry, Faculty of Science, King Abdul-Aziz University, Jeddah, 21589, Saudi Arabia
| | - Sultan Alhayyani
- Department of Chemistry, College of Sciences & Arts, Rabigh King Abdulaziz University, Jeddah, Saudi Arabia
| | - Turky Omar Asar
- Department of Biology, College of Science and Arts at Alkamil, University of Jeddah, Jeddah, Saudi Arabia
| | - Vikas Kumar
- Natural Product Discovery Laboratory, Department of Pharmaceutical Sciences, Sam Higginbottom Institute of Agriculture, SHUATS, Prayagraj, India
| | - Firoz Anwar
- Department of Biochemistry, Faculty of Science, King Abdul-Aziz University, Jeddah, 21589, Saudi Arabia
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Lumu W, Mutebi RK, Nakireka S, Muyanja D, Eleku S, Kaddu D, Nunda E, Kabugo D, Kinene H, Nambago S, Ninsiima C, Kifuba I, Edemaga D, Atwiine E, Mutebi B, Nandawula M, Nakigudde N, Kataike Z, Nakachwa J, Nakaayi C, Lukyamuzi P, Ssebuufu R, Mutumba R. Association of triglyceride-glucose index with vascular risk factors and clinical outcomes among COVID-19 patients: a retrospective cross-sectional study in Mengo Hospital, Kampala, Uganda. Pan Afr Med J 2023; 46:113. [PMID: 38465013 PMCID: PMC10924613 DOI: 10.11604/pamj.2023.46.113.41795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 12/06/2023] [Indexed: 03/12/2024] Open
Abstract
Introduction triglyceride-glucose (TyG) index is a reliable surrogate marker of insulin resistance. We assessed the association between triglyceride-glucose (TyG) index and vascular risk factors and clinical outcomes of critically ill adult COVID-19 patients. Methods data from the charts of all patients with a confirmed diagnosis of COVID-19 who were hospitalized at Mengo Hospital Uganda from December 2020 to August 2021 was used for this study. Data on demographics, past medical history, clinical presentation, laboratory findings and clinical outcomes within the first 10 days of admission was extracted. TyG index was calculated as Inverse (triglyceride (mg/dl) x fasting glucose level (mg/dl)/2 and defined vascular risk factors using standard methods. Bivariate and multivariate logistic regression was conducted to establish a significant association. Statistical significance was set at p< 0.05. Results out of 314 patients, 176 (56%) were females. The mean age ± SD was 58.2 years ± 16.82. The median TyG index was 9.76 (9.29-10.33). A high TyG index was found among 85.4% (n= 268, 95% CI: 0.809-0.889) of patients. Elevated total cholesterol was in 55.4% (n=174), triglycerides 70.7% (n=222), LDL 64.7% (n=203), blood glucose 80.6% (n=253), systolic blood pressure 43% (n=135) and 24.8% (n=78) diastolic blood pressure. The majority 49.7% ( n=156) were discharged, 22.0% (n=69) needed admission to the intensive care unit (ICU), 15.3% (n=48) died in the unit and 13.0% (n=41) had a composite outcome. The TyG index was significantly associated with glycated hemoglobin (AOR=1.029, 95%CI 0.561-1.496, p<0.001), low-density lipoprotein cholesterol (AOR=0.121,95%CI 0.023-0.219, p=0.016), high-density cholesterol (AOR=1.956, 95%CI 1.299-2.945, p=0.001), total cholesterol (AOR=2.177, 95%CI 1.5222-3.144, p<0.001, hospital death (AOR=0.778, 95%CI 0.623-0.972, p=0.028) and composite outcome (AOR=1.823, 95% CI 1.221-2.559, p=0.023). There was no association between hypertension and TyG index. Conclusion a high TyG index was associated with vascular risk factors and clinical outcomes.
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Affiliation(s)
- William Lumu
- Department of Internal Medicine, Mengo Hospital, Kampala, Uganda
| | | | - Susan Nakireka
- Department of Internal Medicine, Mengo Hospital, Kampala, Uganda
| | - David Muyanja
- Department of Internal Medicine, Mengo Hospital, Kampala, Uganda
| | - Simon Eleku
- Department of Internal Medicine, Mengo Hospital, Kampala, Uganda
| | - Denis Kaddu
- Department of Internal Medicine, Mengo Hospital, Kampala, Uganda
| | - Ezra Nunda
- Department of Internal Medicine, Mengo Hospital, Kampala, Uganda
| | - Deus Kabugo
- Department of Internal Medicine, Mengo Hospital, Kampala, Uganda
| | - Henry Kinene
- Department of Internal Medicine, Mengo Hospital, Kampala, Uganda
| | - Simon Nambago
- Department of Internal Medicine, Mengo Hospital, Kampala, Uganda
| | | | - Isa Kifuba
- Department of Internal Medicine, Mengo Hospital, Kampala, Uganda
| | | | - Edgar Atwiine
- Department of Internal Medicine, Mengo Hospital, Kampala, Uganda
| | - Brian Mutebi
- Department of Internal Medicine, Mengo Hospital, Kampala, Uganda
| | | | | | - Zubeda Kataike
- Department of Internal Medicine, Mengo Hospital, Kampala, Uganda
| | | | | | - Paul Lukyamuzi
- Department of Internal Medicine, Mengo Hospital, Kampala, Uganda
| | | | - Rose Mutumba
- Department of Internal Medicine, Mengo Hospital, Kampala, Uganda
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Kočar E, Katz S, Pušnik Ž, Bogovič P, Turel G, Skubic C, Režen T, Strle F, Martins dos Santos VA, Mraz M, Moškon M, Rozman D. COVID-19 and cholesterol biosynthesis: Towards innovative decision support systems. iScience 2023; 26:107799. [PMID: 37720097 PMCID: PMC10502404 DOI: 10.1016/j.isci.2023.107799] [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] [Received: 04/18/2023] [Revised: 07/12/2023] [Accepted: 08/29/2023] [Indexed: 09/19/2023] Open
Abstract
With COVID-19 becoming endemic, there is a continuing need to find biomarkers characterizing the disease and aiding in patient stratification. We studied the relation between COVID-19 and cholesterol biosynthesis by comparing 10 intermediates of cholesterol biosynthesis during the hospitalization of 164 patients (admission, disease deterioration, discharge) admitted to the University Medical Center of Ljubljana. The concentrations of zymosterol, 24-dehydrolathosterol, desmosterol, and zymostenol were significantly altered in COVID-19 patients. We further developed a predictive model for disease severity based on clinical parameters alone and their combination with a subset of sterols. Our machine learning models applying 8 clinical parameters predicted disease severity with excellent accuracy (AUC = 0.96), showing substantial improvement over current clinical risk scores. After including sterols, model performance remained better than COVID-GRAM. This is the first study to examine cholesterol biosynthesis during COVID-19 and shows that a subset of cholesterol-related sterols is associated with the severity of COVID-19.
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Affiliation(s)
- Eva Kočar
- Centre for Functional Genomics and Bio-Chips, Institute of Biochemistry and Molecular Genetics, Faculty of Medicine, University of Ljubljana, Zaloška cesta 4, SI-1000 Ljubljana, Slovenia
| | - Sonja Katz
- LifeGlimmer GmbH, Markelstraße 38, 12163 Berlin, Germany
- Biomanufacturing and Digital Twins Group, Bioprocess Engineering Laboratory, Wageningen University and Research, Droevendaalsesteeg 1, 6708PB Wageningen, the Netherlands
| | - Žiga Pušnik
- Faculty of Computer and Information Science, University of Ljubljana, Večna pot 113, SI-1000 Ljubljana, Slovenia
| | - Petra Bogovič
- Department of Infectious Diseases, University Medical Centre Ljubljana, Japljeva ulica 2, SI-1000 Ljubljana, Slovenia
| | - Gabriele Turel
- Department of Infectious Diseases, University Medical Centre Ljubljana, Japljeva ulica 2, SI-1000 Ljubljana, Slovenia
| | - Cene Skubic
- Centre for Functional Genomics and Bio-Chips, Institute of Biochemistry and Molecular Genetics, Faculty of Medicine, University of Ljubljana, Zaloška cesta 4, SI-1000 Ljubljana, Slovenia
| | - Tadeja Režen
- Centre for Functional Genomics and Bio-Chips, Institute of Biochemistry and Molecular Genetics, Faculty of Medicine, University of Ljubljana, Zaloška cesta 4, SI-1000 Ljubljana, Slovenia
| | - Franc Strle
- Department of Infectious Diseases, University Medical Centre Ljubljana, Japljeva ulica 2, SI-1000 Ljubljana, Slovenia
| | - Vitor A.P. Martins dos Santos
- LifeGlimmer GmbH, Markelstraße 38, 12163 Berlin, Germany
- Biomanufacturing and Digital Twins Group, Bioprocess Engineering Laboratory, Wageningen University and Research, Droevendaalsesteeg 1, 6708PB Wageningen, the Netherlands
| | - Miha Mraz
- Faculty of Computer and Information Science, University of Ljubljana, Večna pot 113, SI-1000 Ljubljana, Slovenia
| | - Miha Moškon
- Faculty of Computer and Information Science, University of Ljubljana, Večna pot 113, SI-1000 Ljubljana, Slovenia
| | - Damjana Rozman
- Centre for Functional Genomics and Bio-Chips, Institute of Biochemistry and Molecular Genetics, Faculty of Medicine, University of Ljubljana, Zaloška cesta 4, SI-1000 Ljubljana, Slovenia
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Beydoun HA, Ng TKS, Beydoun MA, Shadyab AH, Jung SY, Costanian C, Saquib N, Ikramuddin FS, Pan K, Zonderman AB, Manson JE. Biomarkers of glucose homeostasis as mediators of the relationship of body mass index and waist circumference with COVID-19 outcomes among postmenopausal women: The Women's Health Initiative. Clin Nutr 2023; 42:1690-1700. [PMID: 37523800 PMCID: PMC10529929 DOI: 10.1016/j.clnu.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 05/01/2023] [Accepted: 07/07/2023] [Indexed: 08/02/2023]
Abstract
BACKGROUND & AIMS Systematic reviews, meta-analyses and Mendelian randomization studies suggest that cardiometabolic diseases may be associated with COVID-19 risk and prognosis, with evidence implicating insulin resistance (IR) as a common biological mechanism. As driving factors for IR, we examined body mass index (BMI) and waist circumference (WC) among postmenopausal women in association with COVID-19 outcomes (positivity and hospitalization), and the role of glucose homeostasis as a mediator of this relationship. METHODS Associations of BMI and WC at baseline (1993-1998) with COVID-19 outcomes collected at Survey 1 (June-December, 2020) and/or Survey 2 (September-December, 2021) were evaluated among 42,770 Women's Health Initiative (WHI) participants (baseline age: 59.36 years) of whom 16,526 self-reported having taken ≥1 COVID-19 test, with 1242 reporting ≥1 positive COVID-19 test and 362 reporting ≥1 COVID-19 hospitalization. We applied logistic regression and causal mediation analyses to sub-samples with available fasting biomarkers of glucose homeostasis (glucose, insulin, Homeostatic Model Assessment for Insulin Resistance, Homeostasis Model Assessment for β-cell function, Quantitative Insulin-sensitivity Check Index, Triglyceride-Glucose index (TyG)) at baseline, whereby 57 of 759 reported COVID-19 test positivity and 23 of 1896 reported COVID-19 hospitalization. RESULTS In fully adjusted models, higher BMI, WC and TyG were associated with COVID-19 test positivity and hospitalization. Glucose concentrations mediated associations of BMI and WC with COVID-19 positivity, whereas TyG mediated BMI and WC's associations with COVID-19 hospitalization. CONCLUSIONS Obesity and central obesity markers collected an average of 24 years prior were associated with COVID-19 outcomes among postmenopausal women. Glucose concentration and TyG partly mediated these associations.
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Affiliation(s)
- Hind A Beydoun
- Department of Research Programs, Fort Belvoir Community Hospital, Fort Belvoir, VA, USA.
| | - Ted K S Ng
- Department of Internal Medicine & Rush Institute of Healthy Aging, Rush University Medical Center, Chicago, IL, USA
| | - May A Beydoun
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging Intramural Research Program, Baltimore, MD, USA
| | - Aladdin H Shadyab
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, USA
| | - Su Yon Jung
- Translational Sciences Section, Jonsson Comprehensive Cancer Center, School of Nursing, University of California Los Angeles, Los Angeles, CA, USA
| | - Christy Costanian
- Center for Global Child Health, The Hospital for Sick Children (SickKids), Toronto, ON, USA
| | - Nazmus Saquib
- College of Medicine, Sulaiman AlRajhi University, Al Bukairiyah, Kingdom of Saudi Arabia
| | - Farha S Ikramuddin
- Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Kathy Pan
- School of Medicine, University of California San Diego, San Diego, CA, USA
| | - Alan B Zonderman
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging Intramural Research Program, Baltimore, MD, USA
| | - JoAnn E Manson
- Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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Petrakis V, Panagopoulos P, Trypsianis G, Papazoglou D, Papanas N. Fasting Plasma Glucose Increase and Neutrophil-to-Lymphocyte Ratio as Risk Predictors of Clinical Outcome of COVID-19 Pneumonia in Type 2 Diabetes Mellitus. Exp Clin Endocrinol Diabetes 2023; 131:194-197. [PMID: 36623835 DOI: 10.1055/a-2009-6937] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
AIM OF THE STUDY To evaluate fasting plasma glucose (FPG) increase and neutrophil-to-lymphocyte ratio (NLR) as risk predictors of severe clinical outcome of COVID-19 pneumonia in type 2 diabetes mellitus (T2DM) hospitalised patients. PATIENTS AND METHODS Type 2 diabetes mellitus (T2DM) patients hospitalised between March 2020 and February 2021 were studied retrospectively. The NLR ratio at admission and FPG increase (day 7, day with maximal FPG) were evaluated in association with the clinical progression of SARS-CoV-2 infection. RESULTS Three hundred patients (165 men, 135 women) were included in the study. The mean age was 67.17±8.65 years. Severe COVID-19 pneumonia was diagnosed in 170 patients (56.7%). Fifty-four patients (18%) were intubated and 49 (16.3%) died. Greater increase in FPG (79.5 vs. 44.5 mg/dL for day 1-7, p<0.001; and 113.5 vs. 75 mg/dL for day 1-day with maximum glucose value, p<0.001) and higher NLR at admission (10.65 vs. 6.85) were seen in patients with need of high-flow oxygen compared to those without need, and they were associated with a higher probability of intubation and death. CONCLUSION FPG increase and NLR could be significant risk predictors of severe COVID-19 pneumonia in T2DM hospitalised patients.
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Affiliation(s)
- Vasilios Petrakis
- Department of Infectious Diseases, Second Department of Internal Medicine, Democritus University of Thrace, University Hospital of Alexandroupolis, Greece
| | - Periklis Panagopoulos
- Department of Infectious Diseases, Second Department of Internal Medicine, Democritus University of Thrace, University Hospital of Alexandroupolis, Greece
| | - Grigorios Trypsianis
- Department of Medical Statistics, Medical School, Democritus University of Thrace
| | - Dimitrios Papazoglou
- Department of Infectious Diseases, Second Department of Internal Medicine, Democritus University of Thrace, University Hospital of Alexandroupolis, Greece
| | - Nikolaos Papanas
- Diabetes Centre, Second Department of Internal Medicine, Democritus University of Thrace, University Hospital of Alexandroupolis, Greece
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8
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Mateos ER, Zarate PB, Gonzalez FB, Perez-Mendez MJ, Dávila-Gonzalez E, Garduno-Gutierrez A, Sotelo-Salas R, Juan CMJ, Horacio SC, Francisco LMP, Villanueva C. Angiotensin Converting Enzyme 1 Polymorphisms and Lipid Profile in Mexican Patients With COVID-19. In Vivo 2023; 37:433-439. [PMID: 36593047 PMCID: PMC9843789 DOI: 10.21873/invivo.13096] [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: 11/10/2022] [Revised: 11/26/2022] [Accepted: 11/28/2022] [Indexed: 01/04/2023]
Abstract
BACKGROUND/AIM Renin-angiotensin system (RAS) is present in a diverse type of cells and plays an important role in lung physiology and pathophysiology. Angiotensin converting enzymes (ACE) are part of the RAS system. There are still controversies about the association of I/D polymorphisms of ACE1 with COVID-19 severity. The goal of the study was to determine whether there is an association of the I/D polymorphism with severity of COVID-19 in Mexican patients. PATIENTS AND METHODS The study included voluntary participants: 53 healthy individuals negative to RT-PCR COVID-19 (control), and 165 patients positive to COVID-19. Severity was defined by the need of hospitalization, invasive ventilation, shock, or multiple organ failure. The patient group consisted of 28 asymptomatic, 82 with mild, and 55 with severe COVID-19. I/D polymorphism was determined by PCR. Rutinary laboratory tests were performed in all the participants. RESULTS DD polymorphism was significantly associated with severe COVID-19, independently of comorbidities, or any other variable. Receiver operator characteristic curves demonstrated association of low total cholesterol, low high-density lipoproteins, and high c-reactive protein with severity of COVID-19. CONCLUSION The DD polymorphism was associated with the course of the infection and severity of COVID-19 in a sample of Mexican patients.
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Affiliation(s)
- Evelyn Romero Mateos
- Department of Postgraduate Studies, Medical School, National Polytechnic Institute, Mexico City, Mexico
| | - Paola Berenice Zarate
- Department of Postgraduate Studies, Medical School, National Polytechnic Institute, Mexico City, Mexico
| | | | - Maria Jose Perez-Mendez
- Department of Postgraduate Studies, Medical School, National Polytechnic Institute, Mexico City, Mexico
- Molecular Biology Laboratory, Public Health Laboratory of Mexico State, Toluca, Mexico
| | | | | | - Rosalva Sotelo-Salas
- Department of Epidemiology, Tlalnepantla Health Jurisdiction, Tlalnepantla, Mexico
| | | | | | | | - Cleva Villanueva
- Department of Postgraduate Studies, Medical School, National Polytechnic Institute, Mexico City, Mexico;
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9
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Barazzoni R, Breda J, Cuerda C, Schneider S, Deutz NE, Wickramasinghe K. COVID-19: Lessons on malnutrition, nutritional care and public health from the ESPEN-WHO Europe call for papers. Clin Nutr 2022; 41:2858-2868. [PMID: 36075815 PMCID: PMC9365508 DOI: 10.1016/j.clnu.2022.07.033] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 07/22/2022] [Indexed: 01/27/2023]
Abstract
With prolonged pandemic conditions, and emerging evidence but persisting low awareness of the importance of nutritional derangements, ESPEN has promoted in close collaboration with World Health Organization-Europe a call for papers on all aspects relating COVID-19 and nutrition as well as nutritional care, in the Society Journals Clinical Nutrition and Clinical Nutrition ESPEN. Although more COVID-related papers are being submitted and continue to be evaluated, ESPEN and WHO present the current editorial to summarize the many published findings supporting major interactions between nutritional status and COVID-19. These include 1) high risk of developing the disease and high risk of severe disease in the presence of pre-existing undernutrition (malnutrition) including micronutrient deficiencies; 2) high risk of developing malnutrition during the course of COVID-19, with substantial impact on long-term sequelae and risk of long COVID; 3) persons with obesity are also prone to develop or worsen malnutrition and its negative consequences during the course of COVID-19; 4) malnutrition screening and implementation of nutritional care may improve disease outcomes; 5) social and public health determinants contribute to the interaction between nutritional status and COVID-19, including negative impact of lockdown and social limitations on nutrition quality and nutritional status. We believe the evidence supports the need to consider COVID-19 as (also) a case of malnutrition-enhanced disease and disease-related malnutrition, with added risk for persons both with and without obesity. Similarities with many other disease conditions further support recommendations to implement standard nutritional screening and care in COVID-19 patients, and they underscore the relevance of appropriate nutritional and lifestyle prevention policies to limit infection risk and mitigate the negative health impact of acute pandemic bouts.
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Affiliation(s)
- Rocco Barazzoni
- Department of Medical, Surgical and Health Sciences, University of Trieste, Italy.
| | - Joao Breda
- World Health Organization (WHO) Regional Office for Europe, Athens, Greece
| | - Cristina Cuerda
- Departamento de Medicina, Universidad Complutense de Madrid, Nutrition Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Stephane Schneider
- Gastroenterology and Nutrition, Nice University Hospital, Université Côte d'Azur, Nice, France
| | - Nicolaas E Deutz
- Center for Translational Research in Aging and Longevity, Texas A&M University, College Station, TX, USA
| | - Kremlin Wickramasinghe
- World Health Organization European Office for the Prevention and Control of Noncommunicable Diseases, Moscow, Russian Federation
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10
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Fabre B, Fernandez Machulsky N, Olano C, Jacobsen D, Gómez ME, Perazzi B, Zago V, Zopatti D, Ferrero A, Schreier L, Berg G. Remnant cholesterol levels are associated with severity and death in COVID-19 patients. Sci Rep 2022; 12:17584. [PMID: 36266451 PMCID: PMC9584251 DOI: 10.1038/s41598-022-21177-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 09/23/2022] [Indexed: 01/13/2023] Open
Abstract
Coronavirus disease-19 (COVID-19) patients with severe complications present comorbidities like cardiovascular-disease, hypertension and type-2 diabetes mellitus (DM), sharing metabolic alterations like insulin resistance (IR) and dyslipidemia. Our objective was to evaluate the association among different components of the lipid-lipoprotein profile, such as remnant lipoprotein (RLP)-cholesterol, in patients with COVID-19, and to analyze their associations with the severity of the disease and death. We studied 193 patients (68 (29-96) years; 49.7% male) hospitalized for COVID-19 and 200 controls (46 (18-79) years; 52.5% male). Lipoprotein profile, glucose and procalcitonin were assessed. Patients presented higher glucose, TG, TG/HDL-cholesterol and RLP-cholesterol levels, but lower total, LDL, HDL and no-HDL-cholesterol levels (p < 0.001). When a binary logistic regression was performed, age, non-HDL-cholesterol, and RLP-cholesterol were associated with death (p = 0.005). As the COVID-19 condition worsened, according to procalcitonin tertiles, a decrease in all the cholesterol fractions (p < 0.03) was observed with no differences in TG, while levels of RLP-cholesterol and TG/HDL-cholesterol increased (p < 0.001). Lower levels of all the cholesterol fractions were related with the presence and severity of COVID-19, except for RLP-cholesterol levels and TG/HDL-cholesterol index. These alterations indicate a lipid metabolic disorder, characteristic of IR states in COVID-19 patients. RLP-cholesterol levels predicted severity and death in these patients.
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Affiliation(s)
- Bibiana Fabre
- grid.7345.50000 0001 0056 1981Departamento de Bioquímica Clínica, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Cátedra de Bioquímica Clínica I, Junín 956 (C1113AAD), Buenos Aires, Argentina ,grid.7345.50000 0001 0056 1981Facultad de Farmacia y Bioquímica, Instituto de Fisiopatología y Bioquímica Clínica (INFIBIOC), Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Nahuel Fernandez Machulsky
- grid.7345.50000 0001 0056 1981Departamento de Bioquímica Clínica, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Cátedra de Bioquímica Clínica I, Junín 956 (C1113AAD), Buenos Aires, Argentina ,grid.7345.50000 0001 0056 1981Facultad de Farmacia y Bioquímica, Instituto de Fisiopatología y Bioquímica Clínica (INFIBIOC), Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Carolina Olano
- grid.7345.50000 0001 0056 1981Departamento de Bioquímica Clínica, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Cátedra de Bioquímica Clínica I, Junín 956 (C1113AAD), Buenos Aires, Argentina ,grid.7345.50000 0001 0056 1981Facultad de Farmacia y Bioquímica, Instituto de Fisiopatología y Bioquímica Clínica (INFIBIOC), Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Darío Jacobsen
- grid.7345.50000 0001 0056 1981Departamento de Bioquímica Clínica, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Cátedra de Bioquímica Clínica I, Junín 956 (C1113AAD), Buenos Aires, Argentina
| | - María Eugenia Gómez
- grid.7345.50000 0001 0056 1981Departamento de Bioquímica Clínica, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Cátedra de Bioquímica Clínica I, Junín 956 (C1113AAD), Buenos Aires, Argentina
| | - Beatriz Perazzi
- grid.7345.50000 0001 0056 1981Departamento de Bioquímica Clínica, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Cátedra de Bioquímica Clínica I, Junín 956 (C1113AAD), Buenos Aires, Argentina ,grid.7345.50000 0001 0056 1981Facultad de Farmacia y Bioquímica, Instituto de Fisiopatología y Bioquímica Clínica (INFIBIOC), Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Valeria Zago
- grid.7345.50000 0001 0056 1981Departamento de Bioquímica Clínica, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Cátedra de Bioquímica Clínica I, Junín 956 (C1113AAD), Buenos Aires, Argentina ,grid.7345.50000 0001 0056 1981Facultad de Farmacia y Bioquímica, Instituto de Fisiopatología y Bioquímica Clínica (INFIBIOC), Universidad de Buenos Aires, Buenos Aires, Argentina ,grid.7345.50000 0001 0056 1981Facultad de Farmacia y Bioquímica, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Damián Zopatti
- grid.7345.50000 0001 0056 1981Facultad de Medicina, Dirección de Estadística y Archivo Médico, Hospital de Clínicas José de San Martin, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Andrés Ferrero
- grid.7345.50000 0001 0056 1981Facultad de Medicina, Director Adjunto Hospital de Clínicas José de San Martin, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Laura Schreier
- grid.7345.50000 0001 0056 1981Departamento de Bioquímica Clínica, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Cátedra de Bioquímica Clínica I, Junín 956 (C1113AAD), Buenos Aires, Argentina ,grid.7345.50000 0001 0056 1981Facultad de Farmacia y Bioquímica, Instituto de Fisiopatología y Bioquímica Clínica (INFIBIOC), Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Gabriela Berg
- grid.7345.50000 0001 0056 1981Departamento de Bioquímica Clínica, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Cátedra de Bioquímica Clínica I, Junín 956 (C1113AAD), Buenos Aires, Argentina ,grid.7345.50000 0001 0056 1981Facultad de Farmacia y Bioquímica, Instituto de Fisiopatología y Bioquímica Clínica (INFIBIOC), Universidad de Buenos Aires, Buenos Aires, Argentina ,grid.7345.50000 0001 0056 1981Facultad de Farmacia y Bioquímica, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Universidad de Buenos Aires, Buenos Aires, Argentina
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11
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Association of triglyceride-glucose index with prognosis of COVID-19: A population-based study. J Infect Public Health 2022; 15:837-844. [PMID: 35779467 PMCID: PMC9225941 DOI: 10.1016/j.jiph.2022.06.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 06/17/2022] [Accepted: 06/21/2022] [Indexed: 11/22/2022] Open
Abstract
Background Triglyceride-glucose (TyG) index is a simple and reliable surrogate marker for insulin resistance. Epidemiology studies have shown that insulin resistance is a risk factor for various infectious diseases. We evaluated the prognostic value of TyG index measured before the COVID-19 infection in COVID-19 infected patients. Methods From a nationwide COVID-19 cohort dataset in Korea, we included COVID-19 patients diagnosed between Jan and Jun 2020. Based on the nationwide health screening data between 2015 and 2018, TyG index was calculated as ln [triglyceride (mg/dL) × fasting glucose level (mg/dL)/2]. Primary outcome is development of severe complications of COVID-19 defined as composite of mechanical ventilation, intensive care unit care, high-flow oxygen therapy, and mortality within two months after the diagnosis of COVID-19. Results This study included 3887 patients with COVID-19 confirmed by reverse transcription polymerase chain reaction. Mean ± standard deviation of TyG index was 8.54 ± 0.61. Severe complications of COVID-19 were noted in 289 (7.44%) patients. In the multivariate logistic regression, TyG index was positively associated with severe complications of COVID-19 (adjusted odds ratio: 1.42, 95% confidence interval [1.12–1.79]). Conclusions In COVID-19 infected patients, high TyG index was associated with increased risk for severe complications. TyG index might be useful predictor for the severity of COVID-19 infection.
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12
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Taha EM, Mohialdeen Taha M, Al-Obaidy SK, Faris Hasan B, Rahim SM. Association between Atherogenic Index and Cholesterol to HDL Ratio in COVID-19 Patients During the Initial Phase of Infection. ARCHIVES OF RAZI INSTITUTE 2022; 77:1311-1318. [PMID: 36618288 PMCID: PMC9759214 DOI: 10.22092/ari.2022.357527.2057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 04/01/2022] [Indexed: 01/10/2023]
Abstract
This case-control study aimed to assess pathologic alteration in the serum levels of the atherogenic index, cholesterol to high-density lipoprotein (HDL) ratio, HDL cholesterol, total cholesterol, triglyceride, HbA1c, and glucose in 158 COVID-19 patients who were hospitalized in Erbil international hospital, Erbil, Iraq, between January and May 2020, in the early stage of infection. The patients were confirmed for SARS-CoV-2 on admission. The laboratory test results were compared between this group and a group of healthy individuals (n=158). A statistically significant difference was found between the studied factors in healthy controls and COVID-19 patients, except for low-density lipoprotein (LDL) cholesterol (P=0.13). In the case of COVID-19 patients, total levels of cholesterol and HDL cholesterol were significantly lower than controls (P<0.003). Triglyceride, VLDL cholesterol, atherogenic index, and total cholesterol to HDL ratio were found to be significantly higher in COVID-19 patients, compared to controls (P<0.005). Atherogenic index were found to be positively correlated with triglyceride (r=0.88, P=0.00), HbA1C (r=0.6, P=0.05), and glucose index (r= 0.62, P= 0.05), and the ratio of cholesterol to HDL (r=0.64, P=0.04). In contrast, no correlation was found between atherogenic index and cholesterol to HDL ratio in controls. The results of the current study indicated that risk factors for the cardiovascular disease increased in patients with COVID-19 infection, which included atherogenic index, cholesterol to HDL ratio, as well as the association between atherogenic index, and all were organized in one cluster. Therefore, lipids can perform a vital physiological function in patients infected with COVID-19.
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Affiliation(s)
- E. M Taha
- Department of Chemistry, College of Science for Women, University of Baghdad, Baghdad, Iraq
| | | | - S. K Al-Obaidy
- University of Baghdad, College of Agriculture, Baghdad, Iraq
| | - B Faris Hasan
- Department of Chemistry, College of Science for Women, University of Baghdad, Baghdad, Iraq
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13
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Pei G, Qin A, Dong L, Wang S, Liu X, Yang D, Tan J, Zhou X, Tang Y, Qin W. Prognostic Value of Triglyceride to High-Density Lipoprotein Cholesterol Ratio (TG/HDL-C) in IgA Nephropathy Patients. Front Endocrinol (Lausanne) 2022; 13:877794. [PMID: 35795149 PMCID: PMC9251124 DOI: 10.3389/fendo.2022.877794] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 05/17/2022] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND The triglycerides to high-density lipoprotein cholesterol (TG/HDL-C) ratio is an easy-to-use atherogenic and prognostic marker which has attracted increasing attention these days. However, whether TG/HDL-C correlate with outcomes in IgA nephropathy (IgAN) patients remains unknown. To clarify these issues, we conducted this study. METHODS A total of 1146 patients from West China Hospital of Sichuan University were retrospectively analysed between 2008 and 2018.The demographic, clinical and pathological data of all patients at the time of biopsy were collected. Then, patients were divided into the high TG/HDL group (TG/HDL ≥ 1.495, N=382) and the low TG/HDL group (TG/HDL-C < 1.495, N=764) based on the optimal cut-off value of the TG/HDL-C using receive operating curve. Cox proportional hazard models and Kaplan-Meier curves were used to evaluate the renal outcomes of IgAN. RESULTS The median age of the patients was 33 (26-42) years, and 44.5% were men. By correlation analysis, we found that the TG/HDL-C ratio was negatively correlated with the eGFR (r = 0.250, P < 0.001) but positively correlated with proteinuria (r = 0.230, P< 0.001), BMI (r=0.380, P<0.001) and serum uric (r =0.308, P< 0.001). Patients with a higher TG/HDL-C ratio tended to have hypertension [odds ratio (OR), 1.987; 95% CI, 1.527-2.587; P<0.001] and more severe pathologic lesions with tubular atrophy/interstitial fibrosis (OR, 1.610; 95% CI, 1.203-2.154; P=0.001). During a median follow-up period of 54.1 (35.6-73.2) months, a high TG/HDL ratio was strongly associated with worse renal survival in IgAN patients (log-rank: P <0.001). Multivariate Cox analysis demonstrated that a high TG/HDL-C ratio (HR 1.775, 95% CI 1.056-2.798; P=0.029) was an independent predictive marker to ESRD. CONCLUSION In this study, we addressed the importance of TG/HDL-C ratio as a predictive marker for IgAN progression.
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Affiliation(s)
- Gaiqin Pei
- West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
- Department of Rehabilitation Medicine Center, West China Hospital, Sichuan University, Sichuan, China
| | - Aiya Qin
- West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
- Department of Nephrology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Lingqiu Dong
- West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
- Department of Nephrology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Siqing Wang
- West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
- Department of Nephrology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Xiang Liu
- West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
- Department of Nephrology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Dandan Yang
- West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
- Department of Nephrology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Jiaxing Tan
- Department of Nephrology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Xiaoyuan Zhou
- West China School of Public Health, West China Forth Hospital of Sichuan University, Chengdu, China
| | - Yi Tang
- Department of Nephrology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Wei Qin
- Department of Nephrology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
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14
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Rahimibashar F, Sedighi L, Shahriary A, Reiner Z, Pourhoseingholi MA, Mirmomeni G, Jouzdani AF, Vahedian-Azimi A, Jamialahmadi T, Sahebkar A. Is there any association between plasma lipid profile and severity of COVID-19? Clin Nutr ESPEN 2022; 49:191-196. [PMID: 35623812 PMCID: PMC9047402 DOI: 10.1016/j.clnesp.2022.04.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 04/20/2022] [Accepted: 04/25/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND COVID-19 is an infectious disease which caused a pandemic with many diseases and fatalities. This new variant of coronavirus called SARS-CoV-2 and is primarily characterized by respiratory symptoms. There are some data indicating that LDL-cholesterol (LDL-C) as well as HDL-cholesterol (HDL-C) levels are inversely correlated to disease severity and could act as a predictor for disease progression and unfavorable prognosis. However, the results of some other studies do not confirm this. This current study aimed to provide an answer to this question. METHODS This prospective, single-center study analyzed 367 confirmed COVID-19 patients to find whether there are any differences in plasma lipoproteins between survivors and non-survivors patients or between the patients with a "duration of ≤10 days intensive unit care (ICU) stay" and patients with a "duration of >10 days ICU stay". RESULTS No association between any lipid/lipoprotein parameter and the severity of COVID-19 could be found but survivors and non-survivors did differ concerning total cholesterol and LDL-C levels. CONCLUSION Multivariate cox regression analysis could not prove any association between lipids/lipoproteins and severe events in COVID-19 patients. Significantly less non-survivors with COVID-19 were taking atorvastatin than survivors which is consistent with the majority of previous findings.
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Affiliation(s)
- Farshid Rahimibashar
- Department of Anesthesiology and Critical Care, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Ladan Sedighi
- Department of Medical and Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Alireza Shahriary
- Chemical Injuries Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Zeljko Reiner
- Department of Internal Diseases, University Hospital Center Zagreb School of Medicine, Zagreb University, Zagreb, Croatia
| | - Mohamad Amin Pourhoseingholi
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Golshan Mirmomeni
- Hearing Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Ali Fathi Jouzdani
- Student Research Committee, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Amir Vahedian-Azimi
- Trauma Research Center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran.
| | - Tannaz Jamialahmadi
- Surgical Oncology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amirhossein Sahebkar
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Biotechnology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.
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15
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Battaglini D, Lopes-Pacheco M, Castro-Faria-Neto HC, Pelosi P, Rocco PRM. Laboratory Biomarkers for Diagnosis and Prognosis in COVID-19. Front Immunol 2022; 13:857573. [PMID: 35572561 PMCID: PMC9091347 DOI: 10.3389/fimmu.2022.857573] [Citation(s) in RCA: 108] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 03/31/2022] [Indexed: 01/08/2023] Open
Abstract
Severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) causes a wide spectrum of clinical manifestations, with progression to multiorgan failure in the most severe cases. Several biomarkers can be altered in coronavirus disease 2019 (COVID-19), and they can be associated with diagnosis, prognosis, and outcomes. The most used biomarkers in COVID-19 include several proinflammatory cytokines, neuron-specific enolase (NSE), lactate dehydrogenase (LDH), aspartate transaminase (AST), neutrophil count, neutrophils-to-lymphocytes ratio, troponins, creatine kinase (MB), myoglobin, D-dimer, brain natriuretic peptide (BNP), and its N-terminal pro-hormone (NT-proBNP). Some of these biomarkers can be readily used to predict disease severity, hospitalization, intensive care unit (ICU) admission, and mortality, while others, such as metabolomic and proteomic analysis, have not yet translated to clinical practice. This narrative review aims to identify laboratory biomarkers that have shown significant diagnostic and prognostic value for risk stratification in COVID-19 and discuss the possible clinical application of novel analytic strategies, like metabolomics and proteomics. Future research should focus on identifying a limited but essential number of laboratory biomarkers to easily predict prognosis and outcome in severe COVID-19.
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Affiliation(s)
- Denise Battaglini
- Anesthesia and Intensive Care, San Martino Policlinico Hospital, Instituto di Ricovero e Cura a Carattere Scientifico (IRCCS) for Oncology and Neuroscience, Genoa, Italy.,Department of Surgical Science and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy.,Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Miquéias Lopes-Pacheco
- Laboratory of Pulmonary Investigation, Carlos Chagas Filho Biophysics Institute, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Paolo Pelosi
- Anesthesia and Intensive Care, San Martino Policlinico Hospital, Instituto di Ricovero e Cura a Carattere Scientifico (IRCCS) for Oncology and Neuroscience, Genoa, Italy.,Department of Surgical Science and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy
| | - Patricia R M Rocco
- Laboratory of Pulmonary Investigation, Carlos Chagas Filho Biophysics Institute, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.,COVID-19 Virus Network from Brazilian Council for Scientific and Technological Development, Brasília, Brazil.,COVID-19 Virus Network from Foundation Carlos Chagas Filho Research Support of the State of Rio de Janeiro, Rio de Janeiro, Brazil
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16
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Peng F, Lei S, Zhang Q, Zhong Y, Wu S. Triglyceride/High-Density Lipoprotein Cholesterol Ratio is Associated with the Mortality of COVID-19: A Retrospective Study in China. Int J Gen Med 2022; 15:985-996. [PMID: 35136352 PMCID: PMC8815778 DOI: 10.2147/ijgm.s346690] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 01/14/2022] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Triglyceride to high density lipoprotein cholesterol ratio (TG/HDL-c) is crucial when researching metabolic and vascular diseases, and its involvement in COVID-19 was sparsely elaborated on. The purpose of the study was to explore the inflammatory associations between the TG/HDL-c ratio and COVID-19 prognosis. METHODS A total of 262 COVID-19 patients consisting of 244 survivors and 18 non-survivors were retrospectively investigated. The clinical features and baseline hematological parameters were recorded and analyzed. The receiver operating characteristic curve (ROC) was used to explore the role of TG/HDL-c in predicting the mortality of COVID-19, the Spearman's rank correlation coefficients were used to measure the correlation between TG/HDL-c and inflammatory indicators, and the Kaplan-Meier (KM) curve was used to estimate the survival of COVID-19 patients with high and low TG/HDL-c ratio. Logistic regression analyses were performed to investigate the role of TG/HDL-c ratio on mortality of COVID-19 with no underlying diseases. RESULTS Compared with the survivors, the non-survivors of COVID-19 had significantly higher levels of white blood cells (4.7 vs 13.0 × 109/L; P < 0.001), neutrophils (3.0 vs 11.6 × 109/L; P < 0.001), C-reactive proteins (15.7 vs 76.7 mg/L; P < 0.001) and TG/HDL-c ratio (1.4 vs 2.5; P = 0.001). The ROC curve [area under the curve (AUC), 0.731; 95% confidence interval (CI), 0.609-0.853; P = 0.001] suggested that the TG/HDL-c ratio could predict the mortality of COVID-19. The TG/HDL-c ratio was positively correlated with white blood cells (r = 0.255, P < 0.001), neutrophils (r = 0.243, P < 0.001) and C-reactive proteins (r = 0.170, P < 0.006). Patients with high TG/HDL-c ratio showed a worse survival compared with those with low TG/HDL-c ratio (Log rank P = 0.003). Moreover, TG/HDL-c ratio was an independent factor in predicting the mortality of COVID-19 patients with no underlying diseases. CONCLUSION Our study demonstrated that TG/HDL-c ratio might potentially be a predictive marker for mortality in COVID-19 patients.
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Affiliation(s)
- Fei Peng
- Department of Respiratory Medicine, The Second Xiangya Hospital of Central South University, Changsha, People’s Republic of China
| | - Si Lei
- Department of Respiratory Medicine, The Second Xiangya Hospital of Central South University, Changsha, People’s Republic of China
| | - Quan Zhang
- Department of Respiratory Medicine, The Second Xiangya Hospital of Central South University, Changsha, People’s Republic of China
| | - Yanjun Zhong
- Department of Critical Care Medicine, The Second Xiangya Hospital of Central South University, Changsha, People’s Republic of China
| | - Shangjie Wu
- Department of Respiratory Medicine, The Second Xiangya Hospital of Central South University, Changsha, People’s Republic of China
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Stoian AP, Kempler P, Stulnig T, Rizvi AA, Rizzo M. Diabetes and COVID-19: What 2 Years of the Pandemic Has Taught Us. Metab Syndr Relat Disord 2021; 20:137-140. [PMID: 34967689 DOI: 10.1089/met.2021.0133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
As the world enters its third year of the COVID-19 pandemic, individuals with diabetes have faced particular challenges from the virus. A deleterious bidirectional relationship exists between the two disorders, with heightened inflammatory, immunologic, and cellular mechanisms leading to a more severe illness and increased morbidity and mortality. Tight glucose control, though necessary, is hampered by physical restrictions and difficulty accessing health care. Novel glucose-lowering medications may provide unique benefits in this regard. It is imperative that multi-pronged efforts be prioritized in order to reduce adverse outcomes in patients with diabetes at risk for COVID-19.
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Affiliation(s)
- Anca Pantea Stoian
- Department of Diabetes, Nutrition and Metabolic Diseases, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.,National Institute of Diabetes, Nutrition and Metabolic Diseases "Prof N.C. Paulescu," Bucharest, Romania
| | - Peter Kempler
- Department of Medicine and Oncology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Thomas Stulnig
- Department of Medicine III and Karl Landsteiner institute for Metabolic Diseases and Nephrology, Clinic Hietzing, Vienna Healthcare Group, Vienna, Austria
| | - Ali A Rizvi
- Department of Medicine, University of Central Florida College of Medicine, Orlando, Florida, USA.,Division of Endocrinology, Diabetes and Metabolism, University of South Carolina School of Medicine, Columbia, South Carolina, USA
| | - Manfredi Rizzo
- Department of Diabetes, Nutrition and Metabolic Diseases, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.,Division of Endocrinology, Diabetes and Metabolism, University of South Carolina School of Medicine, Columbia, South Carolina, USA.,Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (Promise), University of Palermo, Palermo, Italy
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18
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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: 3.0] [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
| | - 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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Gangadharan C, Ahluwalia R, Sigamani A. Diabetes and COVID-19: Role of insulin resistance as a risk factor for COVID-19 severity. World J Diabetes 2021; 12:1550-1562. [PMID: 34630907 PMCID: PMC8472493 DOI: 10.4239/wjd.v12.i9.1550] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 06/11/2021] [Accepted: 07/30/2021] [Indexed: 02/06/2023] Open
Abstract
Patients with diabetes are more susceptible to coronavirus disease 2019 (COVID-19), and as a consequence, develop more severe form of disease. This is partly due to a systemic inflammatory state and pro thrombotic milieu seen in metabolic syndrome. In this review, we attempt to explore the pathogenetic links between insulin resistance and COVID-19 disease severity. Insulin resistance is an underlying condition for metabolic syndromes, including type 2 diabetes, which impairs insulin signaling pathways affecting metabolic and cardiovascular homeostasis. A high concentration of circulating insulin shifts the balance to mitogen activated protein kinase (MAPK)-dependent signaling and causes endothelial cell damage. The phosphatidylinositol 3 kinase and MAPK dependent signaling pathways maintain a balance between nitric oxide-dependent vasodilator and endothelin-1 dependent vasoconstriction actions of insulin. Vascular smooth muscle cell dysfunction is responsible for inflammation and blood coagulation leading to microvascular and macrovascular complications in diabetes. Hyperactivity in renin-angiotensin system is implicated in development of islet oxidative stress and subsequent β-cell dysfunction, as it alters the islet blood flow. These deleterious effects of insulin resistance involving altered blood pressure, vascular dysfunction, and inflammation could be associated with increased severity in COVID-19 patients. We conclude that clinical and/or biochemical markers of insulin resistance should be included as prognostic markers in assessment of acute COVID-19 disease.
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Affiliation(s)
- Charitha Gangadharan
- Department of Clinical Research, Narayana Hrudayalaya Limited, Bangalore 560099, Karnataka, India
| | - Rupa Ahluwalia
- Consultant in Diabetes and Endocrinology, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich NR4 7UY, United Kingdom
| | - Alben Sigamani
- Chief Scientific Officer, Numen Health, Bangalore 560095, Karnataka, India
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