Phospholipid remodeling and its derivatives are associated with COVID-19 severity.

BACKGROUND: Timely medical intervention in severe cases of coronavirus disease 2019 (COVID-19) and better understanding of the disease's pathogenesis are essential for reducing mortality, but early classification of severe cases and its progression is challenging. OBJECTIVE: We investigated the levels of circulating phospholipid metabolites and their relationship with COVID-19 severity, as well as the potential role of phospholipids in disease progression. METHODS: We performed nontargeted lipidomic analysis of plasma samples (n = 150) collected from COVID-19 patients (n = 46) with 3 levels of disease severity, healthy individuals, and subjects with metabolic disease. RESULTS: Phospholipid metabolism was significantly altered in COVID-19 patients. Results of a panel of phosphatidylcholine (PC) and lysophosphatidylcholine (LPC) and of phosphatidylethanolamine and lysophosphatidylethanolamine (LPE) ratios were significantly correlated with COVID-19 severity, in which 16 phospholipid ratios were shown to distinguish between patients with severe disease, mild disease, and healthy controls, 9 of which were at variance with those in subjects with metabolic disease. In particular, relatively lower ratios of circulating (PC16:1/22:6)/LPC 16:1 and (PE18:1/22:6)/LPE 18:1 were the most indicative of severe COVID-19. The elevation of levels of LPC 16:1 and LPE 18:1 contributed to the changes of related lipid ratios. An exploratory functional study of LPC 16:1 and LPE 18:1 demonstrated their ability in causing membrane perturbation, increased intracellular calcium, cytokines, and apoptosis in cellular models. CONCLUSION: Significant Lands cycle remodeling is present in patients with severe COVID-19, suggesting a potential utility of selective phospholipids with functional consequences in evaluating COVID-19's severity and pathogenesis.

Phospholipid remodeling and its derivatives are associated with the severity of COVID-19

Graphical Background Timely medical interventions in severe cases of COVID-19 and better understanding of the pathogenesis are essential for reducing the mortality, but early classification of severe cases and its progression is challenging. Objective To investigate the levels of circulating phospholipid metabolites and their relationship with the severity of COVID-19 and the potential role of phospholipids in the progression of the disease. Methods In this study, we performed non-targeted lipidomic analysis of plasma samples (n=150) collected from COVID-19 patients (N=46) with three levels of severity, healthy individuals and subjects with metabolic diseases. Results Results showed that phospholipid metabolism was significantly altered in COVID-19 patients. A panel of phosphatidylcholine (PC) and lysophosphatidylcholine (LPC) and of phosphatidylethanolamine (PE) and lysophosphatidylethanolamine (LPE) ratios were significantly correlated with the severity of COVID-19, in which 16 phospholipid ratios were shown to distinguish severe patients from mild cases and healthy controls, and 9 of which were at variance with those in subjects with metabolic diseases. In particular, relatively lower ratios of circulating (PC16:1/22:6)/LPC16:1 and (PE18:1/22:6)/LPE18:1 were the most indicative of severe COVID-19. The elevation of levels of LPC16:1 and LPE18:1 contributed to the changes of related lipid ratios. An exploratory functional study of LPC16:1 and LPE18:1 demonstrated their ability in causing membrane perturbation, increased intracellular calcium, cytokines, and apoptosis in cellular models. Conclusion These results demonstrate significant Lands cycle remodeling in patients with severe COVID-19, and suggest the potential utility of selective phospholipids with functional consequences in evaluating COVID-19 severity and its pathogenesis. Phospholipid ratio correlated with the severity of COVID-19, and the biological functions of phospholipid derivatives may be associated with exacerbation of the disease

The Association between Burnout, Social Support, and Psychological Capital among Primary Care Providers in Togo: A Cross-Sectional Study.

Background and Objectives: Job burnout is prevalent among primary care providers (PCPs) in different countries, and the factors that can alleviate burnout in these countries have been explored. However, no study has addressed the prevalence and the correlates of job burnout among Togolese PCPs. Therefore, we aimed to examine the prevalence of burnout and its association with social support and psychological capital among PCPs in Togo. Material and Methods: We conducted a cross-sectional study in Togo from 5 to 17 November 2020 among 279 PCPs of 28 peripheral care units (PCUs). Participants completed the Maslach Burnout Inventory, Job Content Questionnaire, and Psychological Capital Questionnaire. Data were analyzed using the Mann-Whitney U test, Kruskal-Wallis H test, Pearson correlation analysis, and multiple linear regression. Results: We received 279 responses, out of which 37.28% experienced a high level of emotional exhaustion (EE), 13.62% had a high level of depersonalization (DP), and 19.71% experienced low levels of personal accomplishment (PA). EE had a significant negative correlation with the supervisor's support. In contrast, self-efficacy, hope, optimism, and resilience had a significant negative correlation with DP and a significant positive correlation with PA. Furthermore, supervisors' support significantly predicted lower levels of EE. Optimism significantly predicted lower levels of DP and higher levels of PA. Conclusions: Burnout is common among Togolese PCPs, and self-efficacy, optimism, and supervisors' support significantly contribute to low levels of job burnout among Togolese PCPs. This study provided insight into intervention programs to prevent burnout among PCPs in Togo.