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Lipoprotein metabolism with a focus on COVID 19 kidney patients


International Journal of Family & Community Medicine
Anita LR Saldanha,1 Marileia Scartezini,2 Ana Paula Pantoja Margeotto,1 Abel  Pereira,1 André Luis Valera Gasparoto,3 Tania Leme da Rocha Martinez1

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Abstract

This  article  presents  the  role  of  lipids,  apoproteins  and  lipoproteins  and  their  metabolic  pathways. Definition and function of fatty acids, triglycerides, phospholipids, cholesterol, chylomicron,  VLDL,  LDL,  HDL,  IDL  and  Lp  (a)  are  described.  Both  exogenous  and  endogenous  cycles  of  lipids  and  their  metabolic  pathways  are  presented  and  the  roles  of  both lipoprotein lipase and hepatic lipase are included for means of better understanding. The  major  cardiovascular  risk  that  LDL  cholesterol  represents  is  outlined  as  well  as  its  atherogenic  role.  During  the  COVID  19  pandemic  there  are  alterations  in  the  lipid  profile that worsen the risk. There is the decrease in HDL and LDL cholesterol fractions acutely during the infection, pointing out that the main deleterious effects are due to lipid changes mainly to HDL cholesterol diminution. As seen in the HDL’s role description, its protagonism  in  the  reverse  transport  of  cholesterol  from  the  periphery  to  the  liver,  HDL  particles have affinity for binding and neutralization of pathogen associated lipids that mediate the excessive immune reaction in sepsis. It is important to emphasize its already mentioned  function  in  immunomodulation,  antithrombosis  and  antioxidation,  that  are  diminished  with  its  lowering.  Also  lipoprotein  lipase  activity  is  lessened  and  thus  VLDL  particles and consequently triglycerides are increased. COVID 19 added to chronic kidney disease  present  repercussions  and  higher  detrimental  effects,  not  to  mention  its  causative  action in acute kidney disease. Lipoprotein metabolic changes can signalize to COVID 19 aetiology in kidney diseases.

Keywords

lipids, lipoproteins, COVID 19, apoproteins, lipoprotein(a), metabolism, phospholipids, kidney disease

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