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Article

Acute Hypertriglyceridemia in Patients with COVID-19 Receiving Parenteral Nutrition

1
Clinical Nutrition Unit, Department of Endocrinology and Nutrition, Hospital Universitario 12 de Octubre, Avenida de Córdoba, s/n, 28041 Madrid, Spain
2
Department of Pharmacy, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain
*
Author to whom correspondence should be addressed.
Academic Editors: Roberto Iacone and Roland N. Dickerson
Nutrients 2021, 13(7), 2287; https://doi.org/10.3390/nu13072287
Received: 21 April 2021 / Revised: 23 June 2021 / Accepted: 28 June 2021 / Published: 1 July 2021
(This article belongs to the Section Clinical Nutrition)
Hypertriglyceridemia is a metabolic complication associated with parenteral nutrition (PN). It is unknown if patients with acute respiratory distress syndrome (ARDS) secondary to COVID-19 are more at risk. Our aim was to describe the incidence, risk factors and clinical impact of hypertriglyceridemia in critically ill patients with ARDS-COVID-19 receiving PN. We designed a cohort study of patients with ARDS-COVID-19 infection that required admission to critical care units and nutritional support with PN. Individual PN prescriptions for macronutrients and insulin were provided. Lipid emulsion contained fish oil (SMOFlipid® or Lipoplus®). Hypertriglyceridemia was defined as plasma levels above 400 mg/dL. Eighty-seven patients, 66.6% men, 60.1 ± 10.8 years old, BMI 29.1 ± 5.6 kg/m2, 71% of whom received lopinavir/ritonavir, 56% received Propofol and 55% received Tocilizumab were included. The incidence of hypertriglyceridemia was 37 × 100 patient-days with PN. This complication was more frequent in obese patients (OR 3.34; 95% CI, 2.35–4.33) and in those treated with lopinavir/ritonavir (OR 4.98; 95% CI, 3.60–6.29) or Propofol (OR 2.45; 95% CI, 1.55–3.35). Total mortality was 33.3%, similar between the type of lipid emulsion (p = 0.478). On average, patients with hypertriglyceridemia had a longer requirement of PN compared to the group without elevated triglycerides (TG), probably because of their longer survival (p = 0.001). TG higher than 400 mg/dL was not a protective factor for mortality (OR 0.31; 95% CI, 0.01–1.30). In conclusion, the incidence of hypertriglyceridemia was 37 × 100 patient-days with PN. The risk of this complication is associated with obesity and the use of lopinavir/ritonavir or Propofol. View Full-Text
Keywords: COVID-19; acute respiratory distress syndrome; hypertriglyceridemia; fatty acids; lipidic emulsions; parenteral nutrition COVID-19; acute respiratory distress syndrome; hypertriglyceridemia; fatty acids; lipidic emulsions; parenteral nutrition
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MDPI and ACS Style

Villa López, G.; Valero Zanuy, M.A.; González Barrios, I.; Maíz Jiménez, M.; Gomis Muñóz, P.; León Sanz, M. Acute Hypertriglyceridemia in Patients with COVID-19 Receiving Parenteral Nutrition. Nutrients 2021, 13, 2287. https://doi.org/10.3390/nu13072287

AMA Style

Villa López G, Valero Zanuy MA, González Barrios I, Maíz Jiménez M, Gomis Muñóz P, León Sanz M. Acute Hypertriglyceridemia in Patients with COVID-19 Receiving Parenteral Nutrition. Nutrients. 2021; 13(7):2287. https://doi.org/10.3390/nu13072287

Chicago/Turabian Style

Villa López, Gema, Maria Angeles Valero Zanuy, Ivan González Barrios, Maria Maíz Jiménez, Pilar Gomis Muñóz, and Miguel León Sanz. 2021. "Acute Hypertriglyceridemia in Patients with COVID-19 Receiving Parenteral Nutrition" Nutrients 13, no. 7: 2287. https://doi.org/10.3390/nu13072287

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