Alteration of lipid profile, kidney functions, D-dimer and some anti- inflammatory parameters in samples of Iraqi patients with Covid-19

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Noor Ghassan Elias
Raghda Shams Akram
Yassamen Samer Abd Aon


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Objective: The Aim of our research was to look into the association between various biochemical indicators and COVID-19 infection in Baghdad, Iraq.
Methods: From the 15th of March to the August 2022, a cohort of 45 people with positively COVID-19 and 45 healthy controls visited Al-Yarmouk Teaching Hospital in Baghdad, Iraq. All of the patients have been diagnosed with COVID-19 and are experiencing symptoms and indicators. Each of the patients and healthy controls had their whole blood samples taken to be analyzed for; Lipid profile (triglycerides, Total cholesterol, low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein (HDL) values) Kidney function test (Urea and Creatinine), by using an enzymatic method , Anti-inflammation parameters (INF-, TGF, Interleukin—12, and Interleukin 18), The (Biosours) ELISA kit was used to assess the results., and D-dimer was quantified using mini vidas kits donated by Bio Meriux-France.
Results: The results showed that The majority of COVID-19 patients showed elevated lipid profiles and kidney function tests, as well as the anti-inflammatory parameters with increase the levels of D-dimer compared to healthy controls.
Conclusion: The present study concludes that Covid-19 cause alteration in lipid profile, kidney functions, D-dimer and some anti- inflammatory parameters.

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1. D Benvenuto, M Giovanetti, A Ciccozzi, S Spoto, S Angeletti, M. Ciccozzi, (2020). The 2019-new coronavirus epidemic: evidence for virus evolution J Med Virol, 92, 455-459
2. M Abu-Farha, TA Thanaraj, MG Qaddoumi, A Hashem, J Abubaker, F. Al-Mulla , (2020). The role of lipid metabolism in COVID-19 virus infection and as a drug target Int J Mol Sci, 21, 3544.
3. E Kocar, T Rezen, D. Rozman , (2021). Cholesterol, lipoproteins, and COVID-19: basic concepts and clinical applications Biochim Biophys Acta Mol Cell Biol Lipids, 1866, Article 158849
4. Kato S, Chmielewski M, Honda H, Pecoits-Filho R, Matsuo S, Yuzawa Y, et al. (2008). Aspects of immune dysfunction in end-stage renal disease. Clinical journal of the American Society of Nephrology: CJASN.;3(5):1526–33. pmid:18701615
5. Chou CY, Wang SM, Liang CC, Chang CT, Liu JH, Wang IK, et al. ,(2014). Risk of pneumonia among patients with chronic kidney disease in outpatient and inpatient settings: a nationwide population-based study. Medicine.;93(27): 174.
6. Henry BM, Lippi G., (2020) .Chronic kidney disease is associated with severe coronavirus disease 2019 (COVID-19) infection. International urology and nephrology.;52(6):1193–4.
7. Chen YT, Shao SC, Lai EC, Hung MJ, Chen YC., (2020).Mortality rate of acute kidney injury in SARS, MERS, and COVID-19 infection: a systematic review and meta-analysis. Critical care. 24(1):439.
8. Gaffney PJ. (1980). Breakdown products of fibrin and fibrinogen: molecular mechanisms and clinical implications. J Clin Pathol.;14:10–17.
9. Halaby R, Popma CJ, Cohen A, et al., (2015). D-Dimer elevation and adverse outcomes. J Thromb Thromboly.;39(1):55–59.
10. De Monyé W, Sanson BJ, Mac Gillavry MR, et al., (2002). Embolus location affects the sensitivity of a rapid quantitative D-dimer assay in the diagnosis of pulmonary embolism. J Respir Crit Care Med.;165(3):345–348.
11. Schrecengost JE, LeGallo RD, Boyd JC, et al. (2003). Comparison of diagnostic accuracies in outpatients and hospitalized patients of D-dimer testing for the evaluation of suspected pulmonary embolism. Clin Chem.;49(9):1483–1490.
12. Cui S, Chen S, Li X, et al. (2020). Prevalence of venous thromboembolism in patients with severe novel coronavirus pneumonia. J Thromb Haemost.;18(6):1421–1424.
13. Zhang L, Feng X, Zhang D, et al. (2020). Deep vein thrombosis in hospitalized patients with coronavirus disease (COVID-19) in Wuhan, China: prevalence, risk factors, and outcome. Circulation.;142(2):114–128.
14. Klok FA, Kruip M, van der Meer NJM, et al , (2020). Incidence of thrombotic complications in critically ill ICU patients with COVID-19. Thromb Res.;191:145–147.
15. Zhang Y, Xiao M, Zhang S, et al. Coagulopathy and antiphospholipid antibodies in patients with Covid-19. N Engl J Med. 2020;382(17):e38.
16. Li, M, Yeung, CHC and Schooling, CM ,(2021) .Circulating cytokines and coronavirus disease: a Bi-directional Mendelian randomization study. Frontiers in Genetics 12, 680646.
17. Kerner, G et al. (2021) Human ancient DNA analyses reveal the high burden of tuberculosis in Europeans over the last 2,000 years. American Journal of Human Genetics 108, 517–524.
18. The COVID-19 Host Genetics Initiative AG (2021) Mapping the human genetic architecture of COVID-19 by worldwide meta-analysis. medRxiv.
19. Lau, YL and Peiris, JS (2009). Association of cytokine and chemokine gene polymorphisms with severe acute respiratory syndrome. Hong Kong Medical Journal 15, 43–46.
20. Hayn, M et al. (2021) Systematic functional analysis of SARS-CoV-2 proteins uncovers viral innate immune antagonists and remaining vulnerabilities. Cell Reports 35, 109126.
21. Kaplanski, G (2018) Interleukin-18: biological properties and role in disease pathogenesis. Immunological Reviews 281, 138–153.
22. Vecchié, A et al. (2021) IL-18 and infections: is there a role for targeted therapies? Journal of Cellular Physiology 236, 1638–1657.
23. McGowan, LM et al. (2019) Integrating Mendelian randomization and multiple-trait colocalization to uncover cell-specific inflammatory drivers of autoimmune and atopic disease. Human Molecular Genetics 28, 3293–3300.
24. Simon C., Everitt H. & Kendrick T. (2005) Oxford Handbook of General Practice. 2nd Edition. Oxford University Press. Pp. 712-728.
25. Richmond W. (1992). Analytical reviews in clinical biochemistry: the quantitative analysis of cholesterol. Ann. Clin.Biochem. 29(26):577-597.
26. Larsen ,K.Clin.Chim. (1972) Acta.41:204.
27. Min Gao,Carmen Piernas, Astbury , Julia Hippisley-Cox, (2021), Associations between body-mass index and COVID-19 severity in 6·9 million people in England: a prospective,community-based, cohort study, FRCP , 9(6): 350-359.
28. Williamson EJ, Walker AJ , Bhaskaran K, et al. (2020) , Factors associated with COVID-19-related death using OpenSAFELY. Nature.; 584: 430-436.
29. Yates, T., Zaccardi, F., Islam, N. et al. (2021), Obesity, chronic disease, age, and in-hospital mortality in patients with covid-19: analysis of ISARIC clinical characterisation protocol UK cohort. BMC Infect Dis 21, 717.
30. Abu-Farha M., Thanaraj T.A., Qaddoumi M.G., Hashem A., Abubaker J., Al-Mulla F. (2020), The role of lipid metabolism in COVID-19 virus infection and as a drug target. Int J Mol Sci. 17; 21: 3544.
31. Wu Q., Zhou L., Sun X., Yan Z., Hu C., Wu J., et al.( 2017), Altered lipid metabolism in recovered SARS patients twelve years after infection. Sci Rep. 22; 7: 9110
32. Apostolou F., Gazi I.F., Lagos K., Tellis C.C., Tselepis A.D., Liberopoulos E.N., et al. (2010). Acute infection with Epstein-Barr virus is associated with atherogenic lipid changes, Atherosclerosis ; 212: 607-613
33. Cao W.J., Wang T.T., Gao Y.F., Wang Y.Q., Bao T., Zou G.Z.( 2019) Serum lipid metabolic derangement is associated with disease progression during chronic HBV infection. Clin Lab.1; 65
34. Baker J. Ayenew W. Quick H., Hullsiek K.H., Tracy R., Henry K., et al. (2010), High-density lipoprotein particles and markers of inflammation and thrombotic activity in patients with untreated HIV infection., J Infect Dis.15; 201: 285-292
35. Fleck-Derderian S., McClellan W., Wojcicki J.M. (2017), The association between cytomegalovirus infection, obesity, and metabolic syndrome in U.S. adult females. Obesity (Silver Spring); 25: 626-633
36. Lima W.G., Souza N.A., Fernandes S.O.A., Cardoso V.N., Godói I.P. (2019), Serum lipid profile as a predictor of dengue severity: a systematic review and meta-analysis. Rev Med Virol.; 29e2056
37. Kaysen G.A., Ye X., Raimann J.G., Wang Y., Topping A., Usvyat L.A., et al. (2018), Lipid levels are inversely associated with infectious and all-cause mortality: international MONDO study results. J Lipid.
38. Song S.Z., Liu H.Y., Shen H., Yuan B., Dong Z.N., Jia X.W., et al.(2004). Comparison of serum biochemical features between SARS and other viral pneumonias. Zhongguo Wei Zhong Bing Ji Jiu Yi Xue.; 16: 664-666.
39. Han C.Y., Chiba T., Campbell J.S., Fausto N., Chaisson M., Orasanu G., et al., (2006). Reciprocal and coordinate regulation of serum amyloid A versus apolipoprotein A-I and paraoxonase-1 by inflammation in murine hepatocytes., Arterioscler Thromb Vasc Biol.; 26: 1806-1813.
40. Han C.Y., Tang C.,Guevara M.E., Wei H., Wietecha T., Shao B., et al., (2016). Serum amyloid A impairs the antiinflammatory properties of HDL., J Clin Invest.; 126: 266-281
41. Khovidhunkit W., Shigenaga J.K., Moser A.H., Feingold K.R., Grunfeld C., (2001). Cholesterol efflux by acute-phase high density lipoprotein: role of lecithin: cholesterol acyltransferase., J Lipid Res.; 42: 967-975
42. Light R.W. Macgregor M.I., Luchsinger P.C.,Ball Jr., W.C., (1972). Pleural effusions: the diagnostic, separation of transudates and exudates., Ann Intern Med.; 77: 507-513.
43. Hwang D.M., Chamberlain D.W., Poutanen S.M., Low D.E., Asa S.L., Butany J., (2005). Pulmonary pathology of severe acute respiratory syndrome in Toronto., Mod Pathol.; 18: 1-10
44. Pei F., Zheng J., Gao Z.F., Zhong Y.F., Fang W.G.. Gong E.C.. et al. (2005). Lung pathology and pathogenesis of severe acute respiratory syndrome: a report of six full autopsies. Zhonghua Bing Li Xue Za Zhi.; 34 (PMID: 16536279): 656-660.
45. Tian S., Hu W., Niu L., Liu H., Xu H., Xiao S.Y. (2020). Pulmonary pathology of early-phase 2019 novel coronavirus (COVID-19) pneumonia in two patients with lung cancer., J Thorac Oncol.; 15: 700-704
46. Zidar D.A., Juchnowski S.,Ferrari B., Clagett B., Pilch-Cooper H.A., Rose S., et al.,( 2015). Oxidized LDL levels are increased in HIV infection and may drive monocyte activation.. J Acquir Immune Defic Syndr. 1; 69: 154-160
47. Gierens H., Nauck M., Roth M., Schinker R., Schürmann C., Scharnagl H., et al.,( 2000). Interleukin-6 stimulates LDL receptor gene expression via activation of sterol-responsive and Sp1 binding elements., Arterioscler Thromb Vasc Biol.; 20: 1777-1783
48. Chiarla C., Giovannini I., Giuliante F., Zadak Z., Vellone M., Ardito F., et al. (2010). Severe hypocholesterolemia in surgical patients, sepsis, and critical illness., J Crit Care ; 25 (361.e7-361.e12)
49. Sun J.T., Chen Z., Nie P., Ge H., Shen L., Yang F., et al., (2020). Lipid profile features and their associations with disease severity and mortality in patients with COVID-19. Front Cardiovasc Med.; 7: 584987
50. Tanaka S., De Tymowski C., Assadi M., Zappella N., Jean-Baptiste S., Robert T., et al. (2020). Lipoprotein concentrations over time in the intensive care unit COVID-19 patients: results from the ApoCOVID study. PloS One.; 15 ,0239573.
51. Xia, T., Zhang, W., Xu, Y. et al. (2021). Early kidney injury predicts disease progression in patients with COVID-19: a cohort study. BMC Infect Dis 21, 1012.
52. Pan XW, Xu D, Zhang H, Zhou W, Wang LH, Cui XG. (2020). Identification of a potential mechanism of acute kidney injury during the COVID-19 outbreak: a study based on single-cell transcriptome analysis. Intensive Care Med.;46:1114–6.
53. Rabaan AA, Al-Ahmed SH, Haque S, Sah R, Tiwari R, Malik YS, et al. (2020). SARS-CoV-2, SARS-CoV, and MERS-COV: a comparative overview. Infez Med.;28:174–84.
54. Su H, Yang M, Wan C, Yi LX, Tang F, Zhu HY, et al (2020). Renal histopathological analysis of 26 postmortem findings of patients with COVID-19 in China. Kidney Int.;98:219–27.
55. Mohsen and Al-Mossawi , (2021). Dynamic relationship between D-dimer and COVID-19 severity, A report Submitted to the Council of Institute of Genetic Engineering and Biotechnology for Post Graduate Studies – University of Baghdad as a Partial Fulfillment of the Requirements for the Degree of Higher Diploma in Genetic Engineering and Biotechnology.
56. Ackermann, M.; Verleden, S. E.; Kuehnel, M.; Haverich, A.; Welte, T.; Laenger, F. et al. (2020). Pulmonary vascular endothelialitis, thrombosis, and angiogenesis in Covid-19. New England Journal of Medicine, 383(2):120-128.
57. Han, H.; Yang, L.; Liu, R.; Liu, F.; Wu, K. L.; Li, J. et al. (2020). Prominent changes in blood coagulation of patients with SARS-CoV-2 infection. Clinical Chemistry and Laboratory Medicine (CCLM), 58(7): 1116-1120.
58. Xiaoneng MO, Wenhua J, Zhuquan S, Mu C, Hui P, Ping P, et al. (2020). Abnormal pulmonary function in COVID-19 patients at time of hospital discharge. Eur Respir J. 55:2001217
59. Petrosillo N, Viceconte G, Ergonul O, Ippolito G, Petersen, E. . (2020). COVID-19, SARS and MERS: are they closely related? Clin Microbiol Infect26:729–34.
60. Netea MG, Giamarellos-Bourboulis EJ, Domínguez-Andrés J, Curtis N, van Crevel R, van de Veerdonk FL, et al. (2020). Trained immunity: a tool for reducing susceptibility to and the severity of SARS-CoV-2 infection. Cell. 181:969–77.
61. Sungnak W, Huang N, Becavin C, Berg M, Queen R, Litvinukova M, et al. . (2020). SARS-CoV-2 entry factors are highly expressed in nasal epithelial cells together with innate immune genes. Nat Med: 26:681–7.
62. Cao, X. COVID-19: (2020) . Immunopathology and its implications for therapy. Nat Rev Immunol. 20:269–70.
63. Meng XM, Nikolic-Paterson DJ, Lan, HY. TGF- β: (2016) the master regulator of fibrosis. Nat Rev Nephrol. 12:325–38.
64. Hu ZJ, Xu J, Yin JM, Li L, Hou W, Zhang LL, Zhou Z, Yu YZ, Li HJ, Feng YM and Jin RH (2020) Lower Circulating Interferon-Gamma Is a Risk Factor for Lung Fibrosis in COVID-19 Patients. Front. Immunol. 11:585647.
65. Trinchieri, G.(2003). Interleukin-12 and the regulation of innate resistance and adaptive immunity. Nat. Rev. Immunol.3:133-146.
66. Orange, J. S., and C. A. Biron.(1996). An absolute and restricted requirement for IL-12 in natural killer cell IFN-gamma production and antiviral defense: studies of natural killer and T-cell responses in contrasting viral infections. J. Immunol.156:1138-1142.
67. Monteiro, J. M., C. Harvey, and G. Trinchieri.(1998). Role of interleukin-12 in primary influenza virus infection. J. Virol.72:4825-4831.
68. Cousens, L. P., R. Peterson, S. Hsu, A. Dorner, J. D. Altman, R. Ahmed, and C. A. Biron.(1999). Two roads diverged: interferon alpha/beta- and interleukin 12-mediated pathways in promoting T-cell interferon gamma responses during viral infection. J. Exp. Med.189:1315-1328.
69. Galván-Peña S et al. (2021) Profound treg perturbations correlate with COVID-19 severity. Proceedings of the National Academy of Sciences of the USA 118, , 2111315118.
70. Zhang Y et al. (2021) Identification of monocytes associated with severe COVID-19 in the PBMCs of severely infected patients through single-cell transcriptome sequencing. Engineering (Beijing). PubMed
71. Fujioka N et al. (1999) Interleukin-18 protects mice against acute herpes simplex virus type 1 infection. Journal of Virology 73, 2401–2409.
72. Barr DP et al. (2007) A role for plasmacytoid dendritic cells in the rapid IL-18-dependent activation of NK cells following HSV-1 infection. European Journal of Immunology 37, 1334–1342.
73. Reading PC et al. (2007) IL-18, but not IL-12, regulates NK cell activity following intranasal herpes simplex virus type 1 infection. The Journal of Immunology 179, 3214–3221.
74. Zalinger ZB, Elliott R and Weiss SR (2017) Role of the inflammasome-related cytokines Il-1 and Il-18 during infection with murine coronavirus. Journal of NeuroVirology 23, 845–854.
75. Zhang B et al. (2014) Viral infection. Prevention and cure of rotavirus infection via TLR5/NLRC4-mediated production of IL-22 and IL-18. Science (New York, NY) 346, 861–865.
76. McGowan LM et al. (2019) Integrating Mendelian randomization and multiple-trait colocalization to uncover cell-specific inflammatory drivers of autoimmune and atopic disease. Human Molecular Genetics 28, 3293–3300.
77. Yeung, S. L. (2021). Interleukin-18 and COVID-19. Epidemiology and infection, 150, e14.

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