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Lipoprotein concentrations over time in the intensive care unit COVID-19 patients: Results from the ApoCOVID study.
Tanaka, Sébastien; De Tymowski, Christian; Assadi, Maksud; Zappella, Nathalie; Jean-Baptiste, Sylvain; Robert, Tiphaine; Peoc'h, Katell; Lortat-Jacob, Brice; Fontaine, Lauriane; Bouzid, Donia; Tran-Dinh, Alexy; Tashk, Parvine; Meilhac, Olivier; Montravers, Philippe.
  • Tanaka S; Assistance Publique-Hôpitaux de Paris (AP-HP), Department of Anesthesiology and Critical Care Medicine, Bichat-Claude Bernard Hospital, Paris, France.
  • De Tymowski C; Réunion Island University, French Institute of Health and Medical Research (INSERM), U1188 Diabetes atherothrombosis Réunion Indian Ocean (DéTROI), CYROI Plateform, Saint-Denis de La Réunion, Réunion, France.
  • Assadi M; Assistance Publique-Hôpitaux de Paris (AP-HP), Department of Anesthesiology and Critical Care Medicine, Bichat-Claude Bernard Hospital, Paris, France.
  • Zappella N; French Institute of Health and Medical Research (INSERM) U1149, Center for Research on Inflammation, Paris, France.
  • Jean-Baptiste S; University of Paris, UFR Denis Diderot, Paris, France.
  • Robert T; Assistance Publique-Hôpitaux de Paris (AP-HP), Department of Anesthesiology and Critical Care Medicine, Bichat-Claude Bernard Hospital, Paris, France.
  • Peoc'h K; University of Paris, UFR Denis Diderot, Paris, France.
  • Lortat-Jacob B; Assistance Publique-Hôpitaux de Paris (AP-HP), Department of Anesthesiology and Critical Care Medicine, Bichat-Claude Bernard Hospital, Paris, France.
  • Fontaine L; Assistance Publique-Hôpitaux de Paris (AP-HP), Department of Anesthesiology and Critical Care Medicine, Bichat-Claude Bernard Hospital, Paris, France.
  • Bouzid D; Assistance Publique-Hôpitaux de Paris (AP-HP), Biochemistry Department, Bichat-Claude Bernard Hospital, Paris, France.
  • Tran-Dinh A; French Institute of Health and Medical Research (INSERM) U1149, Center for Research on Inflammation, Paris, France.
  • Tashk P; University of Paris, UFR Denis Diderot, Paris, France.
  • Meilhac O; Assistance Publique-Hôpitaux de Paris (AP-HP), Biochemistry Department, Bichat-Claude Bernard Hospital, Paris, France.
  • Montravers P; Assistance Publique-Hôpitaux de Paris (AP-HP), Department of Anesthesiology and Critical Care Medicine, Bichat-Claude Bernard Hospital, Paris, France.
PLoS One ; 15(9): e0239573, 2020.
Article in English | MEDLINE | ID: covidwho-793642
Semantic information from SemMedBD (by NLM)
1. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
2. Patients LOCATION_OF Lipoproteins
Subject
Patients
Predicate
LOCATION_OF
Object
Lipoproteins
3. Poor outcome PROCESS_OF Patients
Subject
Poor outcome
Predicate
PROCESS_OF
Object
Patients
4. Pneumonia COEXISTS_WITH Superinfection
Subject
Pneumonia
Predicate
COEXISTS_WITH
Object
Superinfection
5. intensive care unit LOCATION_OF Prospective Studies
Subject
intensive care unit
Predicate
LOCATION_OF
Object
Prospective Studies
6. Cessation of life PROCESS_OF Patients
Subject
Cessation of life
Predicate
PROCESS_OF
Object
Patients
7. Low density lipoprotein cholesterol measurement DIAGNOSES Pneumoni
Subject
Low density lipoprotein cholesterol measurement
Predicate
DIAGNOSES
Object
Pneumoni
8. Pneumonia PROCESS_OF Patients
Subject
Pneumonia
Predicate
PROCESS_OF
Object
Patients
9. Superinfection COEXISTS_WITH Bacterial sepsis
Subject
Superinfection
Predicate
COEXISTS_WITH
Object
Bacterial sepsis
10. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
11. Patients LOCATION_OF Lipoproteins
Subject
Patients
Predicate
LOCATION_OF
Object
Lipoproteins
12. Poor outcome PROCESS_OF Patients
Subject
Poor outcome
Predicate
PROCESS_OF
Object
Patients
13. Pneumonia COEXISTS_WITH Superinfection
Subject
Pneumonia
Predicate
COEXISTS_WITH
Object
Superinfection
14. intensive care unit LOCATION_OF Prospective Studies
Subject
intensive care unit
Predicate
LOCATION_OF
Object
Prospective Studies
15. Cessation of life PROCESS_OF Patients
Subject
Cessation of life
Predicate
PROCESS_OF
Object
Patients
16. Low density lipoprotein cholesterol measurement DIAGNOSES Pneumonia, Ventilator-Associated
Subject
Low density lipoprotein cholesterol measurement
Predicate
DIAGNOSES
Object
Pneumonia, Ventilator-Associated
17. Pneumonia PROCESS_OF Patients
Subject
Pneumonia
Predicate
PROCESS_OF
Object
Patients
18. Superinfection COEXISTS_WITH Bacterial sepsis
Subject
Superinfection
Predicate
COEXISTS_WITH
Object
Bacterial sepsis
ABSTRACT

INTRODUCTION:

Severe acute respiratory syndrome coronavirus2 has caused a global pandemic of coronavirus disease 2019 (COVID-19). High-density lipoproteins (HDLs), particles chiefly known for their reverse cholesterol transport function, also display pleiotropic properties, including anti-inflammatory or antioxidant functions. HDLs and low-density lipoproteins (LDLs) can neutralize lipopolysaccharides and increase bacterial clearance. HDL cholesterol (HDL-C) and LDL cholesterol (LDL-C) decrease during bacterial sepsis, and an association has been reported between low lipoprotein levels and poor patient outcomes. The goal of this study was to characterize the lipoprotein profiles of severe ICU patients hospitalized for COVID-19 pneumonia and to assess their changes during bacterial ventilator-associated pneumonia (VAP) superinfection.

METHODS:

A prospective study was conducted in a university hospital ICU. All consecutive patients admitted for COVID-19 pneumonia were included. Lipoprotein levels were assessed at admission and daily thereafter. The assessed outcomes were survival at 28 days and the incidence of VAP.

RESULTS:

A total of 48 patients were included. Upon admission, lipoprotein concentrations were low, typically under the reference values ([HDL-C] = 0.7[0.5-0.9] mmol/L; [LDL-C] = 1.8[1.3-2.3] mmol/L). A statistically significant increase in HDL-C and LDL-C over time during the ICU stay was found. There was no relationship between HDL-C and LDL-C concentrations and mortality on day 28 (log-rank p = 0.554 and p = 0.083, respectively). A comparison of alive and dead patients on day 28 did not reveal any differences in HDL-C and LDL-C concentrations over time. Bacterial VAP was frequent (64%). An association was observed between HDL-C and LDL-C concentrations on the day of the first VAP diagnosis and mortality ([HDL-C] = 0.6[0.5-0.9] mmol/L in survivors vs. [HDL-C] = 0.5[0.3-0.6] mmol/L in nonsurvivors, p = 0.036; [LDL-C] = 2.2[1.9-3.0] mmol/L in survivors vs. [LDL-C] = 1.3[0.9-2.0] mmol/L in nonsurvivors, p = 0.006).

CONCLUSION:

HDL-C and LDL-C concentrations upon ICU admission are low in severe COVID-19 pneumonia patients but are not associated with poor outcomes. However, low lipoprotein concentrations in the case of bacterial superinfection during ICU hospitalization are associated with mortality, which reinforces the potential role of these particles during bacterial sepsis.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Superinfection / Coronavirus Infections / Pneumonia, Bacterial / Pneumonia, Ventilator-Associated / Cholesterol, HDL / Cholesterol, LDL Type of study: Cohort study / Observational study / Prognostic study Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2020 Document Type: Article Affiliation country: Journal.pone.0239573

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Superinfection / Coronavirus Infections / Pneumonia, Bacterial / Pneumonia, Ventilator-Associated / Cholesterol, HDL / Cholesterol, LDL Type of study: Cohort study / Observational study / Prognostic study Limits: Aged / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2020 Document Type: Article Affiliation country: Journal.pone.0239573