Plasma Phospholipids: A Promising Simple Biochemical Parameter to Evaluate COVID-19 Infection Severity

Mohammed Abdalla Hussein; Noor Eldin Mohamed Ismail; Ahmed H Mohamed; Rita M Borik; Ali Abdelaziz Ali; Yasser O Mosaad

doi:10.1177/11779322211055891

Plasma Phospholipids: A Promising Simple Biochemical Parameter to Evaluate COVID-19 Infection Severity

Bioinform Biol Insights. 2021 Nov 18:15:11779322211055891. doi: 10.1177/11779322211055891. eCollection 2021.

Authors

Mohammed Abdalla Hussein¹, Noor Eldin Mohamed Ismail², Ahmed H Mohamed³, Rita M Borik⁴, Ali Abdelaziz Ali⁵, Yasser O Mosaad⁶

Affiliations

¹ Department of Biochemistry, Faculty of Applied Medical Science, October 6 University, 6th of October City, Egypt.
² Consultant in hest chronic diseases, Shobra Health Insurance Hospital, Shobra, Egypt.
³ Department of Radiology and Medical Imaging, Faculty of Applied Medical Science, October 6 University, 6th of October City, Egypt.
⁴ Chemistry Department, Faculty of Science (Female Section), Jazan University, Jazan, Saudi Arabia.
⁵ October 6 University, 6th of October City, Egypt.
⁶ Faculty of Pharmacy, Department of Pharmacology, Toxicology, and Biochemistry, Future University, New Cairo, Egypt.

Abstract

Background: Coronavirus-19 (COVID-19) pandemic is a worldwide public health problem that has been known in China since December 25, 2019. Phospholipids are structural components of the mammalian cytoskeleton and cell membranes. They suppress viral attachment to the plasma membrane and subsequent replication in lung cells. In the virus-infected lung, phospholipids are highly prone to oxidation by reactive oxygen species, leading to the production of oxidized phospholipids (OxPLs).

Objective: This study was carried out to explain the correlation between the level of plasma phospholipids in patients with COVID-19 infection and the levels of cytokine storms to assess the severity of the disease.

Methods: Plasma samples from 34 enrolled patients with mild, moderate, and severe COVID-19 infection were collected. Complete blood count (CBC), plasma levels of D-dimer, ferritin, C-reactive protein (CRP), cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), phospholipids, secretory phospholipase A2 (sPLA2)α2, and cytokine storms were estimated, and lung computed tomography (CT) imaging was detected.

Results: The CBC picture showed the presence of leukopenia, lymphopenia, and eosinopenia in patients with COVID-19 infection. Furthermore, a significant increase was found in plasma levels of D-dimer, CRP, ferritin, tumor necrosis factor (TNF)-α, interleukin (IL)-1β, IL-6, and IL-13 as well as sPLA2α2 activity compared to normal persons. However, plasma levels of phospholipids decreased in patients with moderate and severe COVID-19 infection, as well as significantly decreased in levels of triacylglycerols and HDL-C in plasma from patients with severe infection only, compared to normal persons. Furthermore, a lung CT scan showed the presence of inflammation in a patient with mild, moderate, and severe COVID-19 infection.

Conclusions: This study shows that there is a correlation between plasma phospholipid depletion and elevated cytokine storm in patients with COVID-19 infection. Depletion of plasma phospholipid levels in patients with COVID-19 infection is due to oxidative stress, induction of cytokine storm, and systemic inflammatory response after endothelial cell damage promote coagulation. According to current knowledge, patients with COVID-19 infection may need to administer surfactant replacement therapy and sPLA2 inhibitors to treat respiratory distress syndrome, which helps them to maintain the interconnected surfactant structures.

Keywords: COVID-19 pandemic; OxPLs; cytokine storm; phospholipids; pulmonary surfactant; sPA2.