Association of low HDL-c levels with severe symptoms and poor clinical prognosis in patients with severe fever and thrombocytopenia syndrome

Abstract

BackgroundSevere fever with thrombocytopenia syndrome (SFTS) is an acute infectious disease caused by a novel bunyavirus, characterized by high fever, thrombocytopenia, and multiple organ damage. Disturbances in lipid metabolism often occur during viral infections, but the changes and clinical significance of lipid profiles in SFTS patients remain unclear. This study aimed to investigate the alterations in lipid profiles and their clinical significance in SFTS patients.MethodsA total of 157 SFTS patients and 157 healthy controls were enrolled in this study. Serum lipid levels were collected and analyzed among different groups and prognosis categories. Receiver operating characteristic (ROC) curve analysis was performed to assess the ability of lipid levels in distinguishing between severe and mild cases, as well as surviving and non-surviving patients. Pearson correlation analysis was used to examine the associations between lipid levels and clinical laboratory parameters.ResultsSFTS patients exhibited significantly lower levels of HDL-c, LDL-c, cholesterol, APoAI, and ApoB compared to healthy controls, while triglyceride levels were significantly higher. Serum HDL-c and ApoAI demonstrated good performance as indicators for distinguishing between survivors and non-survivors (AUC of 0.87 and 0.85, respectively). Multivariate regression analysis indicated that HDL-c independently acts as a protective factor in patients with SFTS. HDL-c levels showed decline in non-survivors but recovered in survivors. Moreover, HDL-c exhibited significant correlations with various clinical laboratory parameters (IL-6, CRP, AST, TT, APTT, PLT, ALB, and CD4).ConclusionThis study identified abnormalities in serum lipid metabolism among SFTS patients. HDL-c and ApoAI levels hold potential as biomarkers for distinguishing survivors from non-survivors. Additionally, HDL-c and ApoAI may serve as therapeutic targets for the management of SFTS patients.

Adenosine Deaminase as a Potential Diagnostic and Prognostic Biomarker for Severe Fever with Thrombocytopenia Syndrome

“…In most SFTS patients, there is a notable decrease in the platelet count, more so in severe cases. , Our findings reveal a significant negative correlation between serum ADA activity and the platelet count, indicating that ADA activity reflects disease severity. Previous studies have shown abnormal lipid metabolism in SFTS patients, with decreased HDL levels correlating with poor prognosis . HDL is known for its anti-inflammatory effects. , In our study, a negative correlation was found between ADA activity and HDL levels, suggesting a link between elevated levels of ADA and excessive inflammation in SFTS patients.…”

“…Previous studies have shown abnormal lipid metabolism in SFTS patients, with decreased HDL levels correlating with poor prognosis. 26 HDL is known for its anti-inflammatory effects. 27 , 28 In our study, a negative correlation was found between ADA activity and HDL levels, suggesting a link between elevated levels of ADA and excessive inflammation in SFTS patients.…”

Lower serum LDL-C levels are associated with poor prognosis in severe fever with thrombocytopenia syndrome: a single-center retrospective cohort study

“…In a study using machine learning methods, Zheng et al reported that serum cholesterol may be a relevant indicator of mortality in patients with SFTS ( Zheng et al, 2023 ). Huang et al suggested an association between low serum HDL-C levels and adverse outcomes in SFTS ( Huang et al, 2023 ). However, our findings suggest a relationship between low LDL-C levels and poor prognosis in SFTS.…”