ABSTRACT
Background and Aims: At the moment COVID-19 is the most relevant global health problem. It seems that during SARS-CoV-2 infection total cholesterol (TC), LDL-C, and HDL-C values decrease. In our clinical practice we frequently observed alterations of the lipid profile in patients with COVID-19. This study aims to evaluate whether SARS-CoV-2 infection could be actually involved in the determining of lipid profile alterations, and to study the possible correlation of TC, LDL-C, HDL-C lowering and disease severity and/or clinical outcome. Methods: We performed a retrospective analysis of the 118 patients who required hospitalization to Internal Medicine Unit of Chieti University Hospital (Italy) for COVID-19 between March and May 2020. We compared pre-infection lipid values collected from our laboratory exams software (53 of the 118 patients enrolled) to those measured on admission. Results: Preliminary Median values showed on admission for COVID-19 were: TC 136.89±42.73 mg/dl, LDL-C 81.53±30.35 mg/dl, HDL-C 32,36±15.13 mg/dl and triglycerides 115±40.45 mg/dl (p=0.001, p<0.001 respectively). Median values of pre-infection total cholesterol and HDL-C were significantly higher than those measured on admission. C-reactive protein negatively correlated with LDL-C and HDL-C (p=0.036). No significant influence of lipid alterations on clinical outcome was highlighted. Conclusions: Such results pointed out the impact of SARS-CoV-2 infection on TC and HDL-C, with the lowest values of LDL-C and HDL-C that are more likely to be detected at the highest inflammatory state in COVID-19 patients. It remains to better define a possible role for lipid metabolism and eventually for statins in the clinical and therapeutic approach to COVID-19.
ABSTRACT
SARS-CoV-2 infection is characterized by extremely heterogeneous features, going from cases with few symptoms to severe respiratory failures. Chest Computed Tomography (CT) is currently the gold-standard imaging method, although burdened by the risk of exposure to ionizing radiation and management / organizational concerns. In particular, the critical patient undergoing ventilation (invasive or not) seems to be difficult to monitor by repeated CT scan over time. We report the case of a 55-year-old male patient subjected to Continuous Positive Airway Pressure (CPAP) and prone positioning, in which the use of ultrasound monitoring allowed to verify the effectiveness of the pressure support used in recruiting previously atelectasis lung areas. Lung ultrasound can guide pulmonary recruitment and pronation maneuvers in patients undergoing non-invasive ventilation. Ultrasound can identify atelectatic lung areas, which demonstrate an alveolar re-expansion following the setting of high PEEP values, as underlined by the reappearance of pleural/air interface.