Accumulation of oxysterols in the erythrocytes of COVID-19 patients as a biomarker for case severity (preprint)

ABSTRACT

Background: Due to the high risk of COVID-19 patients to the formation of thrombosis in the circulating blood, atherosclerosis, and myocardial infarction, it was necessary to study the lipidomic of the erythrocytes. The aim of this work was to analyze the pathogenic oxysterols and acylcarnitines in the erythrocyte’s homogenate of COVID-19 patients and to estimate the case severity from the level of oxysterols. Methods: A linear ion trap mass spectrometry coupled with high-performance liquid chromatography was used to investigate the extract of erythrocytes homogenate. The toxic biomarkers that primarily induce the generation of dead red blood cells, were characterized, and quantified in the erythrocytes of COVID-19 patients and matched with healthy volunteers. Results: A total of 30 patients and 30 healthy volunteers were enrolled. The concentration of five oxysterols and six acylcarnitines in the erythrocyte’s homogenate of COVID-19 patients was significantly upregulated matching with healthy subjects at p <0.05. The average total concentration of oxysterols was 23.36 ± 13.47 μg/mL in the erythrocytes of COVID-19 patients, while samples of healthy volunteers showed a total concentration of 4.92 ± 1.61 μg/mL. The average concentration level of 7-ketocholesterol and 4-cholestenone in the COVID-19 patients was higher by five and ten-fold compared to the healthy subjects. Also, the average concentration of acylcarnitines in the erythrocyte's homogenate of COVID-19 patients was high by 2-to-4-fold in comparison with the healthy volunteers. Conclusions: The abnormally high levels of oxysterols and acylcarnitines found in the erythrocytes of COVID-19 patients were associated with the severity of the case's complications and substantial risk of thrombosis. The concentration of oxysterols in the erythrocyte homogenate could be useful as a diagnostic biomarker to stand on the COVID-19 case severity.