Abstract
The key role of inflammation in COVID-19 induced many authors to study the cytokine storm, whereas the role of other inflammatory mediators such as oxylipins is still poorly understood. IMPRECOVID was a monocentric retrospective observational pilot study with COVID-19 related pneumonia patients (n = 52) admitted to Pisa University Hospital between March and April 2020. Our MS-based analytical platform permitted the simultaneous determination of sixty plasma oxylipins in a single run at ppt levels for a comprehensive characterisation of the inflammatory cascade in COVID-19 patients. The datasets containing oxylipin and cytokine plasma levels were analysed by principal component analysis (PCA), computation of Fisher’s canonical variable, and a multivariate receiver operating characteristic (ROC) curve. Differently from cytokines, the panel of oxylipins clearly differentiated samples collected in COVID-19 wards (n = 43) and Intensive Care Units (ICUs) (n = 27), as shown by the PCA and the multivariate ROC curve with a resulting AUC equal to 0.92. ICU patients showed lower (down to two orders of magnitude) plasma concentrations of anti-inflammatory and pro-resolving lipid mediators, suggesting an impaired inflammation response as part of a prolonged and unsolvable pro-inflammatory status. In conclusion, our targeted oxylipidomics platform helped shedding new light in this field. Targeting the lipid mediator class switching is extremely important for a timely picture of a patient’s ability to respond to the viral attack. A prediction model exploiting selected lipid mediators as biomarkers seems to have good chances to classify patients at risk of severe COVID-19.
Keywords: COVID-19; Inflammation regulation; Lipid mediator class switching; Oxylipins; Severity predictors; UHPLC-MS/MS.
【저자키워드】 COVID-19, severity predictors, Inflammation regulation, Lipid mediator class switching, Oxylipins, UHPLC-MS/MS., 【초록키워드】 Inflammation, Biomarker, Cytokines, severe COVID-19, Anti-inflammatory, Pneumonia, intensive care unit, risk, cytokine, principal component analysis, ROC, Patient, plasma, dataset, characteristic, university, platform, COVID-19 patients, retrospective, Lipid, PCA, ROC Curve, AUC, computation, switching, plasma concentration, pilot study, ICUs, characterisation, Fisher, targeting, inflammation response, inflammatory cascade, ICU patient, lipid mediator, inflammatory mediator, selected, shown, resulting, collected, analysed, magnitude, respond, canonical, pro-inflammatory status, the cytokine storm, with COVID-19, 【제목키워드】 Inflammation, Regulation,