Lipoprotein metabolism with a focus on COVID 19 kidney patients

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.