Aterojenik Plazma İndeksinin Uzamış COVİD Tanısındaki Rolü

Year 2022, Volume: 12 Issue: 4, 694 - 702, 28.12.2022

Mustafa Duran , Ercan Kurtipek , Mehmet Burak Özen

https://doi.org/10.31832/smj.1175430

Abstract

Amaç: Koronavirüs 2019 hastalığının (KOVİD-19) iyi bilinen uzun süreli etkilerinden biri, 'uzamış KOVİD' olarak bilinen solunum fonksiyonlarının kademeli kaybıdır. Mevcut durumun önemi nedeniyle, hastaneye yatış süresince ve hastaneden taburcu olduktan sonra uzamış KOVİD öngörücüleri üzerine çeşitli çalışmalar yapılmıştır. Yakın zamanda klinik kullanıma giren aterojenik plazma indeksi (APİ), diğer biyobelirteçlere kıyasla KOVİD-19 hastalarında advers olayların öngörülmesinde daha iyi bir prediktif değere sahiptir. Bu çalışmada, KOVİD-19 geçirmiş hastalarda gelişebilen uzamış KOVİD tahmininde APİ’nin rolünü araştırmayı amaçladık.
Gereç ve Yöntemler: Uzamış KOVİD tanısı almış 52 uygun hastayı ve geçirilmiş KOVİD-19 öyküsü olan 80 sağlıklı kontrol hastasının verilerini inceledik. Uzamış KOVİD teşhisini doğrulamak için tüm deneklere KOVİD-19 ile ilgili şikayetlerin varlığını veya yokluğunu değerlendiren standart bir anket uygulandı. Tüm katılımcıların geçmiş tıbbi kayıtları ile klinik ve demografik özellikleri tarandı ve kapsamlı fizik muayene ve ekokardiyografik değerlendirme yapıldı.
Bulgular: Çalışmamıza göre vücut yüzey alanı, Troponin T, NT-pro-BNP ve APİ, uzamış KOVİD’in bağımsız öngörücüleri olarak ön plana çıkmaktadır. APİ, mevcut parametreler arasında uzamış KOVİD’in en iyi prediktörü olarak ön plana çıkmaktadır (p=0,005). Uzamış KOVİD tahmini için APİ prediktif değerini belirlemek için alıcı çalışma karakteristiği (ROC) eğrisi çizildi ve Youden endeksi kullanılarak en iyi kesme değeri 0.113 olarak belirlendi (AUC:0.658, %95 CI:0.556). -0.760, P=0.002).
Sonuç: Verilerimiz, APİ'nin uzamış KOVİD’in bağımsız bir öngörücüsü olduğunu göstermektedir.

Keywords

Aterojenik plazma indeksi, KOVİD-19, Uzamış KOVİD

Supporting Institution

Yok

The Role of Atherogenic Index of Plasma in The Diagnosis Long COVID

Abstract

Objective: One of the well-known prolonged effects of coronavirus disease 2019 (COVID-19) is the gradual loss of pulmonary functions, known as ‘long COVID’. Due to the importance of this deleterious condition, several studies have been conducted to investigate predictors of long COVID throughout hospital admission and after hospital discharge. Recently introduced, the atherogenic index of plasma (AIP) has a better predictive value for the prediction of adverse events in COVID-19 patients compared to other biomarkers. This study aimed to explore the role of AIP in the prediction of long COVID among COVID-19 survivors.
Material and Methods: We evaluated 52 eligible patients with a diagnosis of long COVID and 80 healthy control subjects with a prior history of COVID-19. To confirm long COVID diagnosis, all subjects underwent a standardized questionnaire which recount the presence or absence of COVID-19-related complaints. All participants’ past medical records and clinical, and demographic characteristics were scanned and underwent comprehensive physical examination and echocardiographic assessment
Results: According to our study, body surface area, Troponin T, NT-pro-BNP, and AIP were the independent predictors of long COVID. AIP was the best predictor of long COVID among the aforementioned parameters (p=0.005). To determine the AIP cut-off value for predicting long COVID, the receiver operating characteristic (ROC) curve was drawn and the best cut-off value was determined as 0.113 by using the Youden index, (AUC:0.658, 95% CI:0.556-0.760, P=0.002).
Conclusion: Our data indicate that AIP is an independent predictor of long COVID.

Keywords

Atherogenic index of plasma, COVID-19, Long COVID

References

• 1. Bourgonje AR, Abdulle AE, Timens W, Hillebrands JL, Navis GJ, Gordijn SJ, et al. Angiotensin-converting enzyme 2 (ACE2), SARS-CoV-2 and the pathophysiology of coronavirus disease 2019 (COVID-19). J Pathol. 2020;251:228–48. doi: 10.1002/path.5471.
• 2. Carfì A, Bernabei R, Landi F. Persistent symptoms in patients after acute COVID-19. J Am Med Assoc. 2020;324:603–605. doi: 10.1001/jama.2020.12603.
• 3. Raveendran AV, Jayadevan R, Sashidharan S. Long COVID: An overview. Diabetes Metab Syndr. 2021;15:869-875. doi: 10.1016/j.dsx.2021.04.007.
• 4. Hui DS, Joynt GM, Wong KT, Gomersall CD, Li TS, Antonio G, et al. Impact of severe acute respiratory syndrome (SARS) on pulmonary function, functional capacity and quality of life in a cohort of survivors. Thorax. 2005;60:401–409. doi: 10.1136/thx.2004.030205.
• 5. Spagnolo P, Balestro E, Aliberti S, Cocconcelli E, Biondini D, Della Casa G, et al. Pulmonary fibrosis secondary to COVID-19: a call to arms? Lancet Respir Med. 2020;8:750–752. doi: 10.1016/S2213-2600(20)30222-8.
• 6. Guzik TJ, Mohiddin SA, Dimarco A, Patel V, Savvatis K, Marelli-Berg FM, et al. COVID-19 and the cardiovascular system: implications for risk assessment, diagnosis, and treatment options. Cardiovasc Res. 2020;116:1666–1687. doi: 10.1093/cvr/cvaa106.
• 7. McDonald LT. Healing after COVID-19: are survivors at risk for pulmonary fibrosis? Am J Physiol Lung Cell Mol Physiol. 2021;320:L257-L265. doi: 10.1152/ajplung.00238.2020.
• 8. Onat A, Can G, Kaya H, Hergenç G. Atherogenic index of plasma" (log10 triglyceride/high-density lipoprotein-cholesterol) predicts high blood pressure, diabetes, and vascular events. J Clin Lipidol. 2010;4:89–98. doi: 10.1016/j.jacl.2010.02.005.
• 9. Dobiásová M, Frohlich J, Sedová M, Cheung MC, Brown BG. Cholesterol esterification and atherogenic index of plasma correlate with lipoprotein size and findings on coronary angiography. J Lipid Res. 2011;52:566–571. doi: 10.1194/jlr.P011668.
• 10. Gunay S, Sariaydın M, Acay A. New Predictor of Atherosclerosis in Subjects With COPD: Atherogenic Indices. Respir Care. 2016;61:1481-1487. doi: 10.4187/respcare.04796.
• 11. Akbas EM, Timuroglu A, Ozcicek A, Ozcicek F, Demirtas L, Gungor A, et al. Association of uric acid, atherogenic index of plasma and albuminuria in diabetes mellitus. Int J Clin Exp Med. 2014;7:5737-5743.
• 12. Essiarab F, Taki H, Lebrazi H, Sabri M, Saïle R. Usefulness of lipid ratios and atherogenic index of plasma in obese Moroccan women with or without metabolic syndrome. Ethn Dis. 2014;24:207-212.
• 13. Yıldırım TÖ, Kaya Ş. Heart Lung. 2021;50:329-333. doi: 10.1016/j.hrtlng.2021.01.016.
• 14. Masana L, Correig E, Ibarretxe D, Anoro E, Arroyo JA, Jericó C, et al. Low HDL and high triglycerides predict COVID-19 severity. Sci Rep. 2021;11:7217. doi: 10.1038/s41598-021-86747-5.
• 15. Quinones MA, Otto CM, Stoddard M, Waggoner A, Zoghbi WA. Recommendations for quantification of Doppler echocardiography. J Am SocEchocardiogr. 2002;15:167–84. doi: 10.1067/mje.2002.120202.
• 16. Dobiásová M., Frohlich J. The plasma parameter log (TG/HDL-C) as an atherogenic index: Correlation with lipoprotein particle size and esterification rate in apoB-lipoprotein-depleted plasma (FER(HDL)) Clin. Biochem. 2001;34:583–588. doi: 10.1016/S0009-9120(01)00263-6.
• 17. Helms J, Tacquard C, Severac F, Leonard-Lorant I, Ohana M, Delabranche X, et al. CRICS TRIGGERSEP Group . High risk of thrombosis in patients with severe SARS-CoV-2 infection: A multicenter prospective cohort study. Intensive Care Med. 2020;46:1089–98. doi: 10.1007/s00134-020-06062-x
• 18. George PM, Wells AU, Jenkins RG. Pulmonary fibrosis and COVID-19: The potential role for antifibrotic therapy. Lancet Respir Med. 2020;8:807–15.
• 19. Wiersinga WJ, Rhodes A, Cheng AC, Peacock SJ, Prescott HC. Pathophysiology, transmission, diagnosis, and treatment of coronavirus disease 2019 (COVID-19): A review. JAMA. 2020;324:782–793. doi: 10.1001/jama.2020.12839.
• 20. Abu-Farha M, Thanaraj TA, Qaddoumi MG, Hashem A, Abubaker J, Al-Mulla F. The role of lipid metabolism in COVID-19 virus infection and as a drug target. Int J Mol Sci. 2020;21:3544–3555. doi: 10.3390/ijms21103544.
• 21. Lee W, Ahn JH, Park HH, Kim HN, Kim H, Yoo Y, et al. COVID-19-activated SREBP2 disturbs cholesterol biosynthesis and leads to cytokine storm. Signal Transduct Target Ther. 2020;5:186–197. doi: 10.1038/s41392-020-00292-7.
• 22. Nguemaïm NF, Mbuagbaw J, Nkoa T, Alemnji G, Teto G, Fanhi TC, et al. Serum lipid profile in highly active antiretroviral therapy-naïve HIV-infected patients in Cameroon: a case-control study. HIV Med. 2010;11:353–359. doi: 10.1111/j.1468-1293.2009.00784.x.
• 23. Constans J, Pellegrin JL, Peuchant E, Dumon MF, Pellegrin I, Sergeant C, et al. Plasma lipids in HIV-infected patients: a prospective study in 95 patients. Eur J Clin Invest. 1994;24:416–420. doi: 10.1111/j.1365-2362.1994.tb02185.x.
• 24. Grunfeld C, Pang M, Doerrler W, Shigenaga JK, Jensen P, Feingold KR. Lipids, lipoproteins, triglyceride clearance, and cytokines in human immunodeficiency virus infection and the acquired immunodeficiencysyndrome. JClinEndocrinolMetab. 1992;74:1045–1052. doi: 10.1210/jcem.74.5.1373735.
• 25. Teto G, Kanmogne GD, Torimiro JN, Alemnji G, Nguemaim FN, Takou D, et al. Lipid peroxidation and total cholesterol in HAART-naïve patients infected with circulating recombinant forms of human immunodeficiency virus type-1 in Cameroon. PLoS One. 2013;8:e65126. doi: 10.1371/journal.pone.0065126.
• 26. Cheng VC, Hung IF, Tang BS, Chu M, Wong ML, Chan KH, et al. Viral replication in the nasop-harynx is associated with diarrhea in patients with severe acute respiratory syndrome. Clin Infect Dis. 2004;38:467–475. doi: 10.1086/382681.
• 27. Ng EK, Hui DS, Chan KC, Hung CW, Chiu WK, Lee N, et al. Quantitative analysis and prognostic implication of SARS coronavirus RNA in the plasma and serum of patients with severe acute respira-tory syndrome. Clin Chem. 2003;49:1976–1980. doi: 10.1373/clinchem.2003.024125.
• 28. Chu CM, Poon LL, Cheng VC, Chan KS, Hung FN, Wong ML, et al. Initial viral load and the out-comes of SARS. CMAJ. 2004;171:1349–1352. doi: 10.1503/cmaj.1040398rao.