Associação do perfil lipídico com os níveis de Interleucina 18 em pacientes com COVID-19

Abstract

COVID-19, a multi-organ disease, can cause substantial respiratory problems but also severe extrapulmonary manifestations. In addition to respiratory symptoms, many patients experience cardiovascular symptoms, such as heart palpitations and chest tightness/pain, as an initial clinical manifestation of COVID-19. The virus responsible for the disease, SARS-CoV-2, can attack the cardiovascular system also by indirect mechanisms due to the dysregulation of the renin-angiotensin pathway, leading to endothelial dysfunction and also inflammation. IL-18, besides being associated with exacerbation of inflammation and tissue damage, has been reported as a predictor of the seriousness of the infection. This study aimed to associate lipid profile with interleukin 18 levels in patients with COVID-19. The present study is an observational, analytical and cross-sectional study that evaluated a sample composed of 260 patients. The COVID-19 group was composed of patients who tested positive in the RT-qPCR test and the control group is formed by patients treated in outpatient clinics with a negative condition for COVID-19. Serum samples were used for the measurement of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-c) and triglycerides (TG) by colorimetric method, apolipoproteins A-I and B by immunoturbidimetric method and IL-18 by enzyme immunoassay. For statistical analysis, p < 0.05 was considered. Comparing the distribution of values of lipid parameters and IL-18, it was observed that the total cholesterol value of the control group compared to the COVID-19 group is different, the same is observed with the apo B value in both groups. When correlating lipid parameters and IL-18, a negative correlation was observed between HDL-C and IL-18 in both the control group and the COVID-19 group. In the case of triglycerides and apo B, it correlates only in the control group in a positive way. It was also found that for HDL-c the patients in the COVID-19 group had more often values outside the reference range, while in the case of LDL-c, it was the opposite, the patients in the control group had more often values outside the reference range. A correlation was found between IL-18 mediated inflammatory response. In addition, COVID-19 was associated with low HDL-c levels, which may be a risk for individuals with atherosclerotic plaques.