Plasma Levels of Phospholipids in Patients With COVID-19; A Promising Simple Biochemical Parameter to Evaluate the Disease Severity

Abstract Background Cronavirus-19 (COVID-19) pandemic is a worldwide public health problem knowing in China recently from December 25, 2019. Phospholipids are structural components of mammalian cytoskeleton and cell membranes. Phospholipids is an anionic lipid found in mammalian membranes in low amounts (1–2%) of the total phospholipids. Also, it suppressed viral attachment to the plasma membrane and subsequent replication in lung cells. Aim: The present study was carried out to explain the correlation between the plasma phospholipids as well as secretory phospholipase-A2α2 (sPLA2α2) and cytokine storm; tumor necrosis factor (TNF)-α, interleukin--1β (IL-1β), interleukin-6 (IL)-6 and interleukin-13 (IL-13_ levels of patients with COVID-19 to assess the infection severity. Methods: Serum samples from enrolled 34 patients with mild, moderate, and acute COVID-19 infection. Complete blood picture (CBC), plasma d-dimer, ferritin, C-reactive protein (CRP), lipid profile, phospholipids, sPLA2α2 and TNF-α, IL-1β, IL-6 and IL-13 as well as lung computed tomography (CT) imaging.Results: CBC showed that the presence of leukopenia, lymphopenia, eosinopenia in patient with mild, moderate, and acute COVID-19 infection. Also, significant increase in plasma d-dimer, CRP, ferritin, triacyclglycerols, TNF-α, IL-1β, IL-6 and IL-13 levels as well as sPLA2α2 activity when compared to normal persons. However, plasma levels of phospholipids, cholesterol, HDL-C and LDL-C were decreased significantly in patient with acute COVID-19 infection only, when compared to normal persons. In addition, lung computed tomography (CT) scan showed that the presence of ground glass opacity (GGO), bronchial wall thickening, crazy paving sign as well as right, left, upper and lower lung predominant in patient with mild, moderate and acute COVID-19 infection. The levels of blood leukopenia, lymphopenia and eosinopenia as well as plasma phospholipids d-dimer, CRP, ferritin, cytokine storm and sPLA2α2 were pronounced in group of patients with acute COVID-19 infection more the mild and moderate one.Conclusion: The present study was showed that there is a correlation between plasma phospholipids depletion as well as elevation sPLA2α2 and cytokines storm with the severity of COVID-19 infection. Also, the plasma phospholipids levels can used to estimate COVID-19 infection severity and help to identify patients into three classes: mild, moderate and severe one.