Distinct Plasma LPC Signatures Differentiate COVID-19 Sepsis from Other Sepsis Aetiologies.

Area of Science:

• Biochemistry
• Clinical Diagnostics
• Infectious Disease Research

Background:

• Low blood lysophosphatidylcholine (LPC) levels are potential sepsis diagnostic markers.
• SARS-CoV-2 infection, a cause of sepsis, presents unique features compared to non-SARS-CoV-2 sepsis.
• Previous research indicated higher plasma cholesteryl ester levels in SARS-CoV-2 patients.

Purpose of the Study:

• To investigate differences in plasma lysophosphatidylcholine (LPC) species between SARS-CoV-2 sepsis and other forms of sepsis.
• To determine if LPC levels can serve as biomarkers to differentiate between sepsis types.

Main Methods:

• Plasma levels of 13 LPC species were quantified using flow injection analysis tandem mass spectrometry (FIA-MS/MS).
• Analysis was performed on 157 patients with systemic inflammatory response syndrome (SIRS), sepsis, or septic shock, including 24 with SARS-CoV-2 infection.
• Patients with liver cirrhosis or SIRS were excluded from further analysis due to altered LPC profiles.

Main Results:

• Patients with SIRS showed higher levels of LPC 15:0 and 22:4 compared to sepsis/septic shock patients.
• SARS-CoV-2 infection was associated with significantly higher plasma levels of ten individual LPC species and total LPC concentration compared to non-COVID-19 sepsis.
• LPC levels correlated negatively with procalcitonin and interleukin-6, and positively with gamma-glutamyltransferase and cholesteryl ester in sepsis/septic shock patients.

Conclusions:

• Differential plasma lysophosphatidylcholine (LPC) profiles can distinguish SARS-CoV-2 sepsis from other sepsis types, even with similar disease severity.
• These distinct LPC levels may function as valuable metabolic biomarkers.
• Identifying specific sepsis types through biomarkers can inform more targeted therapeutic strategies.