COVID-19 Outcome Relates With Circulating BDNF, According to Patient Adiposity and Age

Luciele Guerra Minuzzi; Marília Seelaender; Bruna Spolador De Alencar Silva; Eduardo Del Bosco Brunetti Cunha; Marina De Castro Deus; Franciane Thais Falcão Vasconcellos; Luis Felipe Beltrão Marqueze; Ana Carolina Gadotti; Cristina Pellegrino Baena; Telmo Pereira; Karsten Krüger; Andréa Novais Moreno Amaral; Ricardo Aurino Pinho; Fábio Santos Lira

doi:10.3389/fnut.2021.784429

COVID-19 Outcome Relates With Circulating BDNF, According to Patient Adiposity and Age

Front Nutr. 2021 Dec 10:8:784429. doi: 10.3389/fnut.2021.784429. eCollection 2021.

Authors

Luciele Guerra Minuzzi¹, Marília Seelaender², Bruna Spolador De Alencar Silva¹, Eduardo Del Bosco Brunetti Cunha³, Marina De Castro Deus³, Franciane Thais Falcão Vasconcellos³, Luis Felipe Beltrão Marqueze³, Ana Carolina Gadotti³, Cristina Pellegrino Baena³, Telmo Pereira^{4

5}, Karsten Krüger⁶, Andréa Novais Moreno Amaral³, Ricardo Aurino Pinho³, Fábio Santos Lira¹

Affiliations

¹ Exercise and Immunometabolism Research Group, Postgraduation Program in Movement Sciences, Department of Physical Education, Universidade Estadual Paulista (UNESP), Presidente Prudente, Brazil.
² Cancer Metabolism Research Group, LIM26-HC, FMUSP, University of São Paulo, São Paulo, Brazil.
³ Graduate Program in Health Sciences, School of Medicine, Pontificia Universidade Catolica do Parana, Curitiba, Brazil.
⁴ Polytechnic Institute of Coimbra, Coimbra Health School, Coimbra, Portugal.
⁵ Laboratory for Applied Health Research (LabinSaúde), Coimbra, Portugal.
⁶ Department of Exercise Physiology and Sports Therapy, Institute of Sports Science, Justus-Liebig-University Giessen, Giessen, Germany.

Abstract

Background and Aims: We evaluated adipose tissue-derived hormones, body composition, serum metabolic profile, levels of brain-derived neurotrophic factor (BDNF), and the association of these parameters with the clinical outcome in patients with COVID-19. We sought to examine whether obesity, sex, and age influence the adipose tissue endocrine response to the disease. Methods: This prospective study investigated 145 hospitalized patients with COVID-19. Patients were categorized based on their body mass index (BMI), sex and age, and were also classified regarding their outcome after hospitalization as: (a) Non-ICU: patients hospitalized who did not receive intensive care; (b) ICU-survivor: patients admitted to the intensive care unit and discharged; (c) ICU-death: patients who died. Blood samples were collected by the hospital staff between the first and third day of hospitalization. Serum leptin, adiponectin and BDNF concentrations, triglycerides, total cholesterol and cholesterol fractions were performed following the manufacturer's guidelines. Results: We demonstrate that BDNF levels predict intensive care (IC) need (p < 0.01). This association was found to be stronger in patients >60y (p = 0.026). Neither leptin nor adiponectin concentration was associated with IC requirement or with patient's outcome, while the BDNF/adiponectin ratio was closely associated with worsened outcomes (p < 0.01). BDNF concentration was similar between sexes, however tended to be lower in male patients (p = 0.023). In older patients, BDNF concentration was lower than that of younger patients (p = 0.020). These age and sex-specific differences should be considered when employing these potential markers for prognosis assessment. While appetite and body composition regulating hormones secreted by the white adipose tissue are not reliable predictors of disease severity, the ratio BDNF/adiponectin was indicative of patient status. Conclusion: Thus, we propose that serum BDNF content and BDNF/adiponectin ratio may serve as tools predicting worsened prognosis in COVID-19, especially for male patients.

Keywords: BDNF; COVID-19 severity; adiponectin; adipose tissue hormones; leptin.