Declined serum high density lipoprotein cholesterol is associated with the severity of COVID-19 infection.
TL;DR: The lipid profile of a severe patient showed that serum cholesterol concentration significantly decreased in the early stage and returned to be normal in the recovery period, and decreased serum HDL-cholesterol is associated with the severity of COVID-19 infection.
About: This article is published in Clinica Chimica Acta.The article was published on 2020-11-01 and is currently open access. It has received 119 citations till now. The article focuses on the topics: Lipid profile.
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TL;DR: Clotting pathologies in both acute COVID-19 infection and in Long COVID/PASC might therefore benefit from following a regime of continued anticlotting therapy to support the fibrinolytic system function.
Abstract: Severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2)-induced infection, the cause of coronavirus disease 2019 (COVID-19), is characterized by acute clinical pathologies, including various coagulopathies that may be accompanied by hypercoagulation and platelet hyperactivation. Recently, a new COVID-19 phenotype has been noted in patients after they have ostensibly recovered from acute COVID-19 symptoms. This new syndrome is commonly termed Long COVID/Post-Acute Sequelae of COVID-19 (PASC). Here we refer to it as Long COVID/PASC. Lingering symptoms persist for as much as 6 months (or longer) after acute infection, where COVID-19 survivors complain of recurring fatigue or muscle weakness, being out of breath, sleep difficulties, and anxiety or depression. Given that blood clots can block microcapillaries and thereby inhibit oxygen exchange, we here investigate if the lingering symptoms that individuals with Long COVID/PASC manifest might be due to the presence of persistent circulating plasma clots that are resistant to fibrinolysis. We use techniques including proteomics and fluorescence microscopy to study plasma samples from healthy individuals, individuals with Type 2 Diabetes Mellitus (T2DM), with acute COVID-19, and those with Long COVID/PASC symptoms. We show that plasma samples from Long COVID/PASC still contain large anomalous (amyloid) deposits. We also show that these anomalous deposits in both acute COVID-19 and Long COVID/PASC plasma samples are resistant to fibrinolysis (compared to plasma from controls and T2DM), even after trypsinisation. After a second trypsinization, the persistent pellet deposits were solubilized. We detected various inflammatory molecules that are substantially increased in both the supernatant and trapped in the solubilized pellet deposits of acute COVID-19 and Long COVID/PASC, versus the equivalent volume of fully digested fluid of the control samples. Of particular interest was a substantial increase in α(2)-antiplasmin (α2AP), various fibrinogen chains, as well as Serum Amyloid A (SAA) that were trapped in the solubilized fibrinolytic-resistant pellet deposits. Clotting pathologies in both acute COVID-19 infection and in Long COVID/PASC might therefore benefit from following a regime of continued anticlotting therapy to support the fibrinolytic system function.
168 citations
Cites background from "Declined serum high density lipopro..."
...Compared with the healthy controls, the patients have sharply decreased concentrations of total cholesterol, HDL-cholesterol and LDLcholesterol (Hu et al., 2020)....
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TL;DR: In this article, the authors used proteomics and fluorescence microscopy to study plasma samples from healthy individuals, individuals with Type 2 Diabetes Mellitus (T2DM), with acute COVID-19, and those with Long COVID/PASC symptoms.
Abstract: BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2)-induced infection, the cause of coronavirus disease 2019 (COVID-19), is characterized by acute clinical pathologies, including various coagulopathies that may be accompanied by hypercoagulation and platelet hyperactivation. Recently, a new COVID-19 phenotype has been noted in patients after they have ostensibly recovered from acute COVID-19 symptoms. This new syndrome is commonly termed Long COVID/Post-Acute Sequelae of COVID-19 (PASC). Here we refer to it as Long COVID/PASC. Lingering symptoms persist for as much as 6 months (or longer) after acute infection, where COVID-19 survivors complain of recurring fatigue or muscle weakness, being out of breath, sleep difficulties, and anxiety or depression. Given that blood clots can block microcapillaries and thereby inhibit oxygen exchange, we here investigate if the lingering symptoms that individuals with Long COVID/PASC manifest might be due to the presence of persistent circulating plasma microclots that are resistant to fibrinolysis. METHODS: We use techniques including proteomics and fluorescence microscopy to study plasma samples from healthy individuals, individuals with Type 2 Diabetes Mellitus (T2DM), with acute COVID-19, and those with Long COVID/PASC symptoms. RESULTS: We show that plasma samples from Long COVID/PASC still contain large anomalous (amyloid) deposits (microclots). We also show that these microclots in both acute COVID-19 and Long COVID/PASC plasma samples are resistant to fibrinolysis (compared to plasma from controls and T2DM), even after trypsinisation. After a second trypsinization, the persistent pellet deposits (microclots) were solubilized. We detected various inflammatory molecules that are substantially increased in both the supernatant and trapped in the solubilized pellet deposits of acute COVID-19 and Long COVID/PASC, versus the equivalent volume of fully digested fluid of the control samples and T2DM. Of particular interest was a substantial increase in α(2)-antiplasmin (α2AP), various fibrinogen chains, as well as Serum Amyloid A (SAA) that were trapped in the solubilized fibrinolytic-resistant pellet deposits. CONCLUSIONS: Clotting pathologies in both acute COVID-19 infection and in Long COVID/PASC might benefit from following a regime of continued anticlotting therapy to support the fibrinolytic system function.
162 citations
TL;DR: In this article, HDL-C was found to be less protective in endothelial cells stiumalted by TNFα (permeability, VE-cadherin disorganization and apoptosis).
Abstract: Coronavirus disease 2019 (COVID-19) pandemic is affecting millions of patients worldwide. The consequences of initial exposure to SARS-CoV-2 go beyond pulmonary damage, with a particular impact on lipid metabolism. Decreased levels in HDL-C were reported in COVID-19 patients. Since HDL particles display antioxidant, anti-inflammatory and potential anti-infectious properties, we aimed at characterizing HDL proteome and functionality during COVID-19 relative to healthy subjects. HDLs were isolated from plasma of 8 severe COVID-19 patients sampled at admission to intensive care unit (Day 1, D1) at D3 and D7, and from 16 sex- and age-matched healthy subjects. Proteomic analysis was performed by LC-MS/MS. The relative amounts of proteins identified in HDLs were compared between COVID-19 and controls. apolipoprotein A-I and paraoxonase 1 were confirmed by Western-blot analysis to be less abundant in COVID-19 versus controls, whereas serum amyloid A and alpha-1 antitrypsin were higher. HDLs from patients were less protective in endothelial cells stiumalted by TNFα (permeability, VE-cadherin disorganization and apoptosis). In these conditions, HDL inhibition of apoptosis was blunted in COVID-19 relative to controls. In conclusion, we show major changes in HDL proteome and decreased functionality in severe COVID-19 patients.
68 citations
References
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TL;DR: The epidemiological, clinical, laboratory, and radiological characteristics and treatment and clinical outcomes of patients with laboratory-confirmed 2019-nCoV infection in Wuhan, China, were reported.
36,578 citations
Journal Article•
28,685 citations
TL;DR: Characteristics of patients who died were in line with the MuLBSTA score, an early warning model for predicting mortality in viral pneumonia, and further investigation is needed to explore the applicability of the Mu LBSTA scores in predicting the risk of mortality in 2019-nCoV infection.
16,282 citations
01 Jan 2015
12,972 citations
"Declined serum high density lipopro..." refers background in this paper
...Laboratory tests detection indicated that declined white blood cells and lymphocytes level in the patients [1,2]....
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TL;DR: Changes in serum cholesterol levels associated with HIV infection and antiretroviral medication exposure, and 1-time assessment of triglyceride levels post-HAART initiation are described to represent a return to preinfection serum lipid levels after accounting for expected age-related changes.
Abstract: ContextAlterations in serum lipid values have been widely reported among persons
infected with human immunodeficiency virus (HIV) type 1 treated with highly
active antiretroviral therapy (HAART), but no data have yet been reported
on changes from preseroconversion lipid values.ObjectiveTo describe changes in serum cholesterol levels associated with HIV
infection and antiretroviral medication exposure, and 1-time assessment of
triglyceride levels post-HAART initiation.Design, Setting, and ParticipantsThe Multicenter AIDS Cohort Study, a prospective study in which homosexual
and bisexual men were enrolled and from which 50 of 517 HIV seroconverters
were drawn for the analysis herein, who later initiated HAART, involving measurements
of stored serum samples obtained between 1984 and 2002.Main Outcome MeasuresChanges in levels of total cholesterol (TC), high-density lipoprotein
cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) at 6
time points during an average of 12 years; 1-time assessment of triglyceride
levels from the third post-HAART clinic visit.ResultsAmong the 50 men, notable declines in mean serum TC (–30 mg/dL
[−0.78 mmol/L]), HDL-C (–12 mg/dL [−0.31 mmol/L]), and LDL-C
values (–22 mg/dL [−0.57 mmol/L]) were observed after HIV infection.
Following HAART initiation, there were large increases in mean TC and LDL-C
values (50 and 21 mg/dL [1.30 and 0.54 mmol/L], respectively); however, the
mean changes from the preseroconversion values were 20 mg/dL (0.52 mmol/L)
(95% confidence interval [CI], –1 to 41) and –1 mg/dL (−0.03
mmol/L) (95% CI, –25 to 22), respectively. Mean HDL-C remained below
baseline levels throughout follow-up. The median value (interquartile range)
of triglycerides was 225 mg/dL (2.54 mmol/L) (147-331 mg/dL).ConclusionsBefore treatment, HIV infection results in substantial decreases in
serum TC, HDL-C, and LDL-C levels. Subsequent HAART initiation is associated
with increases in TC and LDL-C but little change in HDL-C. Increases in TC
and LDL-C observed after about 3 years of HAART possibly represent a return
to preinfection serum lipid levels after accounting for expected age-related
changes.
609 citations