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EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-314890


The COVID-19 pandemic has led governments to instate a large number of restrictions on and recommendations for citizens’ behavior. One of our best tools for measuring compliance with these strictures are nationally representative surveys that ask citizens to self-report their behavior. But if respondents’ avoid disclosing socially undesirable behaviors, such as not complying with government strictures in a public health crisis, estimates of compliance will be biased upwards. To assess the magnitude of this problem, this study compares measures of compliance from direct questions to those estimated from list-experiments - a response technique that allows respondents to report illicit behaviors without individual-level detection. Implementing the list-experiment in two separate surveys of Danish citizens (n>5,000), we find no evidence that citizens under-report non-compliant behavior. We therefore conclude that survey estimates of compliance with COVID-19 regulations do not suffer from social desirability bias

J Clin Lipidol ; 15(6): 796-804, 2021.
Article in English | MEDLINE | ID: covidwho-1487791


BACKGROUND: Besides the well-accepted role in lipid metabolism, high-density lipoprotein (HDL) also seems to participate in host immune response against infectious diseases. OBJECTIVE: We used a quantitative proteomic approach to test the hypothesis that alterations in HDL proteome associate with severity of Coronavirus disease 2019 (COVID-19). METHODS: Based on clinical criteria, subjects (n=41) diagnosed with COVID-19 were divided into two groups: a group of subjects presenting mild symptoms and a second group displaying severe symptoms and requiring hospitalization. Using a proteomic approach, we quantified the levels of 29 proteins in HDL particles derived from these subjects. RESULTS: We showed that the levels of serum amyloid A 1 and 2 (SAA1 and SAA2, respectively), pulmonary surfactant-associated protein B (SFTPB), apolipoprotein F (APOF), and inter-alpha-trypsin inhibitor heavy chain H4 (ITIH4) were increased by more than 50% in hospitalized patients, independently of sex, HDL-C or triglycerides when comparing with subjects presenting only mild symptoms. Altered HDL proteins were able to classify COVID-19 subjects according to the severity of the disease (error rate 4.9%). Moreover, apolipoprotein M (APOM) in HDL was inversely associated with odds of death due to COVID-19 complications (odds ratio [OR] per 1-SD increase in APOM was 0.27, with 95% confidence interval [CI] of 0.07 to 0.72, P=0.007). CONCLUSION: Our results point to a profound inflammatory remodeling of HDL proteome tracking with severity of COVID-19 infection. They also raise the possibility that HDL particles could play an important role in infectious diseases.

COVID-19/blood , COVID-19/pathology , Lipoproteins, HDL/blood , Adult , Apolipoproteins/blood , Cholesterol, HDL/blood , Female , Humans , Male , Mass Spectrometry , Middle Aged , Proteomics , Serum Amyloid A Protein/metabolism , Triglycerides/blood
Front Cell Infect Microbiol ; 11: 709893, 2021.
Article in English | MEDLINE | ID: covidwho-1403459


Highlights: Innate immune activation during Covid-19 infection is associated with pernicious clinical outcome. Background: Coronavirus disease 2019 (Covid-19) is a worldwide threat that has already caused more than 3 000 000 deaths. It is characterized by different patterns of disease evolution depending on host factors among which old-age and pre-existing comorbidities play a detrimental role. Previous coronavirus epidemics, notably SARS-CoV, were associated with increased serum neopterin levels, which can be interpreted as a sign of acute innate immunity in response to viral infection. Here we hypothesize that neopterin may serve as a biomarker of SARS-CoV-2 viral infection and Covid-19 disease severity. Methods: We measured neopterin blood levels by ELISA. Seric concentration was quantified from 256 healthy donors and 374 Covid-19 patients at hospital admission. Enrolled Covid-19 patients were all symptomatic and displayed a large spectrum of comorbidities. Patients were followed until disease resolution or death. Results: Severe and critically ill SARS-CoV-2 infected patients were characterized by a profound exacerbation of immune activation characterized by elevated neopterin blood levels. Systemic neopterin levels above 19nM stratified healthy individuals from Covid-19 patients with 87% specificity and 100% sensitivity. Moreover, systemic neopterin levels above 53nM differentiated non-survivors from survivors with 64% specificity and 100% sensitivity. Conclusion: We propose that neopterin concentration measured at arrival to hospital is a hallmark of severe Covid-19 and identifies a high-risk population of pernicious clinical outcome with a need for special medical care.

COVID-19 , Neopterin , Critical Illness , Humans