Marcos Luis A, Vorkas Charles Kyriakos, Mann Inderjit, Garry Evan, Lamba Pooja, Pham Sophia K, Spector Rachel, Papamanoli Aikaterini, Krivacsy Sara, Lum Michael, Zahra Aleena, Hou Wei, Spitzer Eric D
Division of Infectious Diseases, Department of Internal Medicine, Stony Brook University, Stony Brook, NY 11794, USA.
Department of Microbiology and Immunology, Stony Brook University, Stony Brook, NY 11794, USA.
Pathogens. 2023 Apr 18;12(4):613. doi: 10.3390/pathogens12040613.
Babesiosis, an intra-erythrocytic protozoan disease, is an emerging zoonotic parasitic disease worldwide. Cholesterol levels are correlated with severe infections, such as sepsis and COVID-19, and anecdotal reports suggest that high-density lipoprotein (HDL) cholesterol declines during acute babesiosis. Our aim was to describe the cholesterol levels in patients with acute babesiosis diagnosed in an endemic area in New York, hypothesizing that HDL levels correlate with the severity of infection.
We reviewed the medical records of adult patients with babesiosis diagnosed by identification of parasites on a thin blood smear and confirmed by polymerase chain reaction from 2013 to 2018, who also had available a lipid profile drawn at the time of clinical presentation. Additional lipid profile levels were considered as "baseline" if they were drawn within 2 months before or after the infection as part of routine care.
A total of 39 patients with babesiosis had a lipid profile drawn on presentation. The patients were divided into two groups for comparison based on the treating physician's clinical decision: 33 patients who were admitted to the hospital and 8 patients who were evaluated as outpatients. A history of hypertension was more common in admitted patients (37% vs. 17%, = 0.02). The median levels of low-density lipoprotein (LDL) and HDL were significantly reduced in admitted patients compared to non-admitted patients (46 vs. 76 mg/dL, = 0.04; and 9 vs. 28.5 mg/dL, = 0.03, respectively). In addition, LDL and HDL levels returned to baseline values following resolution of acute babesiosis.
LDL and HDL levels are significantly reduced during acute babesiosis, suggesting that cholesterol depletion may predict disease severity. Pathogen and host factors may contribute to a reduction in serum cholesterol levels during acute babesiosis.
巴贝斯虫病是一种红细胞内原虫病，是全球范围内一种新出现的人畜共患寄生虫病。胆固醇水平与严重感染相关，如败血症和新冠肺炎，且有传闻称急性巴贝斯虫病期间高密度脂蛋白（HDL）胆固醇会下降。我们的目的是描述在纽约一个流行地区诊断出的急性巴贝斯虫病患者的胆固醇水平，推测HDL水平与感染严重程度相关。
我们回顾了2013年至2018年通过薄血涂片鉴定寄生虫并经聚合酶链反应确认诊断为巴贝斯虫病的成年患者的病历，这些患者在临床表现时也有血脂谱检查结果。如果在感染前或感染后2个月内作为常规护理的一部分进行血脂谱检查，则将其视为“基线”水平。
共有39例巴贝斯虫病患者在就诊时进行了血脂谱检查。根据主治医生的临床判断，将患者分为两组进行比较：33例住院患者和8例门诊评估患者。住院患者中高血压病史更为常见（37%对17%，P = 0.02）。与非住院患者相比，住院患者的低密度脂蛋白（LDL）和HDL中位数水平显著降低（分别为46对76mg/dL，P = 0.04；9对28.5mg/dL，P = 0.03）。此外，急性巴贝斯虫病缓解后，LDL和HDL水平恢复到基线值。
急性巴贝斯虫病期间LDL和HDL水平显著降低，提示胆固醇消耗可能预示疾病严重程度。病原体和宿主因素可能导致急性巴贝斯虫病期间血清胆固醇水平降低。
