Lipoprotein(a) during COVID-19 hospitalization: Thrombosis, inflammation, and mortality

Kaltoft, Mikkel; Glavind, Kathrine; Nielsen, Sune F.; Langsted, Anne; Iversen, Kasper; Nordestgaard, Børge G.; Kamstrup, Pia R.

doi:10.1016/j.atherosclerosis.2022.07.015

Cited by 10 publications

(8 citation statements)

References 33 publications

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“…In conclusion, further studies are needed to elucidate how IKBKE regulates the pathogenesis of SLE, including the role of IKBKE in microglia and other cells. Lp(a) levels among individuals hospitalized due to COVID-19 have been shown to significantly correlate with higher thrombotic risk, as marked by increased D-dimer levels (2). Interestingly, the researchers of this study, which was conducted prior to widespread vaccination against COVID-19, found that elevated Lp(a) level was not associated with increased risk for in-hospital death (2).…”

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confidence: 72%

“…Huang and Xu pointed out that several single-nucleotide polymorphisms around IKBKE have been detected as SLE-risk alleles in genome-wide association studies. A previous study showed that the SLE-risk allele G of rs2297550 was associated with decreased expression of IKBKE in peripheral blood mononuclear cells (PBMCs) from healthy controls (2). In general, the effect of expression quantitative trait loci (eQTL) is cell-type specific and context-dependent.…”

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confidence: 99%

“…Lp(a) levels among individuals hospitalized due to COVID-19 have been shown to significantly correlate with higher thrombotic risk, as marked by increased D-dimer levels (2). Interestingly, the researchers of this study, which was conducted prior to widespread vaccination against COVID-19, found that elevated Lp(a) level was not associated with increased risk for in-hospital death (2). On the contrary, another retrospective analysis of patients hospitalized with COVID-19 demonstrated that elevated Lp(a) level was associated with prolonged duration of hospitalization, more severe course of disease, and significantly increased mortality rate (3).…”

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confidence: 99%

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Karino

Kono

Kanda

et al. 2023

Arthritis & Rheumatology

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confidence: 72%

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confidence: 99%

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confidence: 99%

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Karino

Kono

Kanda

et al. 2023

Arthritis & Rheumatology

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“…Nonetheless, no significant effects of ESS were found on the rates of mortality [ 19 ]. In another study, particularly interleukin-6 and procalcitonin were robustly associated with an increased risk of death during hospitalization and reduced hospital discharge [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

What Is the Place of Intermediate Care Unit in Patients with COVID-19? A Single Center Experience

Bülbül

Hakim

Ceylan

et al. 2023

International Journal of Clinical Practice

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Introduction. COVID-19 pandemic has led to an increased rate of intensive care unit (ICU) stays. Intermediate care units (IMCUs) are a useful resource for the management of patients with severe COVID-19 that do not require ICU admission. In this research, we aimed to determine survival outcomes and parameters predicting mortality in patients who have been admitted to IMCU. Materials and Methods. Patients who were admitted to IMCU between April 2019 and January 2021 were analyzed retrospectively. Sociodemographics, clinical characteristics, and blood parameters on admission were compared between the patients who died in IMCU and the others. Blood parameters at discharge were compared between survived and deceased individuals. Survival analysis was performed via Kaplan–Meier analysis. Blood parameters predicting mortality were determined by univariate and multivariate Cox regression analysis. Results. A total of 140 patients were included within the scope of this study. The median age was 72.5 years, and 77 (55%) of them were male and 63 (45%) of them were female. A total of 37 (26.4%) patients deceased in IMCU, and 40 patients (28.5%) were transferred to ICU. Higher platelet count (HR 3.454; 95% CI 1.383–8.625; p = 0.008 ), procalcitonin levels (HR 3.083; 95% CI 1.158–8.206; p = 0.024 ), and lower oxygen saturation (HR 4.121; 95% CI 2.018–8.414; p < 0.001 ) were associated with an increased risk of mortality in IMCU. At discharge from IMCU, higher procalcitonin levels (HR 2.809; 95% CI 1.216–6.487; p = 0.016 ), lower platelet count (HR 2.269; 95% CI 1.012–5.085; p = 0.047 ), and noninvasive mechanic ventilation requirement (HR 2.363; 95% CI 1.201–4.651; p = 0.013 ) were associated with an increased risk of mortality. Median OS was found as 41 days. The overall survival rate was found 40% while the IMCU survival rate was 73.6%. Conclusions. IMCU seems to have a positive effect on survival in patients with severe COVID-19 infection. Close monitoring of these parameters and early intervention may improve survival rates and outcomes.

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“…Furthermore, serum Lp(a) levels (which are often high in HeFH patients) increase further during and post COVID -19 as the LPA gene encoding for Lp (a) contains an interleukin-(IL-6) response element, which is upregulated by elevated IL-6 levels during the acute phase of COVID-19 infection [26]. Hyperactivation of the humoral immune system is also linked to D-dimer elevation reflecting increased thrombotic activity, as shown in a study of 211 hospitalized COVID-19 patients [27].…”

Section: Endothelial Dysfunctionmentioning

confidence: 99%

Familial hypercholesterolemia: The nexus of endothelial dysfunction and lipoprotein metabolism in COVID-19

Vuorio

Raal

Kovanen

2023

Current Opinion in Lipidology

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Purpose of reviewPatients with heterozygous familial hypercholesterolemia (HeFH) are at increased risk for COVID-19 cardiovascular complications in the acute phase of the infection. Elevated levels of LDL-C and often lipoprotein(a) are present from birth and lead to endothelial dysfunction, which is aggravated by a direct viral attack of the endothelial cells and their exposure to the toxic levels of circulating proinflammatory and prothrombotic mediators during the hyperinflammatory reaction typical of COVID-19. Recent findingsEvidence to date shows the benefit of lipid-lowering therapy in patients with COVID-19. In HeFH patients who are at much higher cardiovascular risk, the focus should, therefore, be on the effective lowering of LDL-C levels, the root cause of the greater cardiovascular vulnerability to COVID-19 infection in these patients. The ongoing use of statins and other lipid-lowering therapies should be encouraged during the ongoing COVID pandemic to mitigate the risk of cardiovascular complications from COVID-19, particularly in HeFH patients. SummaryEpidemiologic registry data show that the incidence of myocardial infarction is increased in SARS-CoV-2infected HeFH patients. There is a need to study whether the risk for acute cardiovascular events is increased in the long-term and if there are changes in lipid metabolism after SARS-CoV infection(s) in patients with HeFH.

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Lipoprotein(a) during COVID-19 hospitalization: Thrombosis, inflammation, and mortality

Cited by 10 publications

References 33 publications

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What Is the Place of Intermediate Care Unit in Patients with COVID-19? A Single Center Experience

Familial hypercholesterolemia: The nexus of endothelial dysfunction and lipoprotein metabolism in COVID-19

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