Background Coronavirus disease 2019 (COVID-19) has become a global health threat, and thus, an early and effective set of predictors is needed to manage the course of the disease. Objectives We aim to determine the effect of SARS-CoV-2 on lipid profile and to evaluate whether the atherogenic index of plasma (AIP) could be used to predict in-hospital mortality in COVID-19 patients. Methods In this retrospective chart review study, a total of 139 confirmed COVID-19 patients, whose diagnoses are confirmed by PCR and computerized tomography results, are enrolled. The study population is divided into two groups: the deceased patient group and the survivor group. For each patient, fasting total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and the triglyceride values are obtained from the laboratory tests required at the admission to hospital. Finally, the AIP is calculated as the base 10 logarithm of the triglyceride to HDL-C ratio. Distributional normality of the data is checked and depending on the normality of the data, either T test or Mann Whithey U test is employed to compare the two aforementioned study groups. Results Mean age of the study population is 49.2±20.8 and 61.2% (n=85) is male. Out of the 139 patients 26 have deceased and the remaining 113 patients survived the disease. Mean age of the deceased patients was 71.8±8.9 and mean age of the survivor patients is 44.0±19.2 (p<0.001). The deceased group had more patients with hypertension (50.0% vs. 23.0, p=0.006), diabetes mellitus (35.6% vs. 10.6%, p=0.002), cardiovascular diseases (23.1% vs. 4.4%, p=0.001), chronic renal insufficiency (11.5% vs. 0.9%, p=0.003) and atrial fibrillation (7.7% vs 0%, p=0.003). The AIP values in the deceased group are found to be statistically higher (p<0.001) than the survivor group. As a measure of mortality, the area under the operating characteristic curve for the AIP is calculated as 0.850 (95% confidence interval: 0.772-0.928) along with the optimal cut-off value of 0.6285 (78.6% sensitivity and 80.5% specificity). Furthermore, the AIP value is observed to be elevated in patients with pneumonia, intubation history, and intensive care admission during hospital stay (p=0.002, p<0.001 and p<0.001, respectively). Finally, compared to the survivor group, total cholesterol, HDL-C, LDL-C values are lower (p=0.004, p<0.001 and p<0.001, respectively) and triglyceride levels are higher (p<0.001) in deceased patients. Conclusion In this study, we show that the AIP levels higher than 0.6285 can predict in-hospital mortality for COVID-19 patients. Moreover, the AIP emerges as a good candidate to be used as an early biomarker to predict pneumonia, intubation and intensive care need. Hence, regular check of the AIP levels in COVID-19 patients can improve management of these patients and prevent deterioration of the disease.

中文翻译：

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血浆致动脉粥样硬化指数作为 COVID-19 患者死亡率的预测因子


背景 2019 年冠状病毒病 (COVID-19) 已成为全球健康威胁，因此需要一套早期有效的预测因子来管理该疾病的病程。目的 我们的目的是确定 SARS-CoV-2 对血脂谱的影响，并评估血浆动脉粥样硬化指数 (AIP) 是否可用于预测 COVID-19 患者的院内死亡率。方法 在这项回顾性图表审查研究中，共有 139 名确诊的 COVID-19 患者入组，其诊断均通过 PCR 和计算机断层扫描结果确诊。研究人群分为两组：已故患者组和幸存者组。对于每位患者，空腹总胆固醇、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）和甘油三酯值是通过入院时所需的实验室测试获得的。最后，AIP 计算为甘油三酯与 HDL-C 比率的以 10 为底的对数。检查数据的分布正态性，并根据数据的正态性，采用T检验或Mann Whithey U检验来比较上述两个研究组。结果 研究人群的平均年龄为 49.2±20.8 岁，其中 61.2% (n=85) 为男性。 139 名患者中，26 人死亡，其余 113 名患者幸存。死亡患者的平均年龄为 71.8±8.9 岁，幸存者患者的平均年龄为 44.0±19.2 岁 (p<0.001)。死亡组中患有高血压（50.0% vs. 23.0，p=0.006）、糖尿病（35.6% vs. 10.6%，p=0.002）、心血管疾病（23.1% vs. 4.4%，p=0.001）的患者较多，慢性肾功能不全（11.5% vs. 0.9%，p=0.003）和心房颤动（7.7% vs 0%，p=0.003）。 死亡组的 AIP 值在统计上高于幸存者组 (p<0.001)。作为死亡率的衡量标准，AIP 操作特征曲线下面积计算为 0.850（95% 置信区间：0.772-0.928），最佳截止值为 0.6285（78.6% 敏感性和 80.5% 特异性）。此外，观察到有肺炎、插管史和住院期间入住重症监护病房的患者的 AIP 值升高（分别为 p=0.002、p<0.001 和 p<0.001）。最后，与幸存者组相比，总胆固醇、HDL-C、LDL-C 值较低（分别为 p=0.004、p<0.001 和 p<0.001），甘油三酯水平较高（p<0.001）。 001）已故患者。结论 在本研究中，我们表明 AIP 水平高于 0.6285 可以预测 COVID-19 患者的院内死亡率。此外，AIP 成为预测肺炎、插管和重症监护需求的早期生物标志物的良好候选者。因此，定期检查 COVID-19 患者的 AIP 水平可以改善对这些患者的管理并防止疾病恶化。