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?:abstract
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Rationale: To evaluate hypertriglyceridemia (HTG) risk factors in adult hospitalized COVID patients treated with Parenteral Nutrition (PN) Methods: Patients starting PN from 03/16-04/15/2020 were selected Data collected: demographic, nutritional (indication, days of PN, PN composition (g/kg/d by adjusted body weight);COVID treatments and analytical In our COVID protocol, inflammatory state (IS) was considered with at least 2 of the next criteria: PCR>100mg/L, DD>1 000μ/L, LDH>400U/L, ferritin>1 000ng/ml and IL-6>70ng/L HTG was defined as triglycerides (TG)≥3 mmol/L Data expressed as median [IQR] T-student test to compare our results with a previous no-COVID cohort with PN at our center and TG at PN beginning and end Multivariate analysis to study TG at PN beginning and HTG risk factors Results: 54 patients, 72 2% men, 67 6 [13 4] years, 80 [19 3] kg, 29 8 [5 6] kg/m2, 61 1 % had dyslipidaemia PN lasted 5 [5] days 83 3% received PN for enteral intolerance PN composition (g/kg/d): 1 28 [0 05] nitrogen, 0 57 [0 78] lipids, 3 05 [1 53] glucose and 19 8 [7 1] kcal/kg/d No differences between TGC at PN beginning and ending (3,56 [1 01] vs 3 621[1 74], p: 0 89) 80% met IS, 79 6% critical or semicritical, and 50% died 81 5% received tocilizumab, 79 6% propofol and 12 9% tacrolimus TG before PN started were higher than our previous cohort (3 31[1 14] vs 2 24[1 19] mmol/L;p<0 001)and patients received lower lipid dose (0 52 [0 02] and 0 7[0 18] g/kg/d, respectively (p <0 001) Multivariate regression analysis showed a significant relationship between tocilizumab and initial TG (1 459 [0 342-2 576], r2=0 431), while IS, propofol, BMI, dylipidemia, tacrolimus, Lopinavir/r were not significant Conclusion: COVID patients may have an increased HTG risk, especially those with tocilizumab However, more studies must be conducted Despite reducing PN lipid dose, TG reduction was not observed References: Llop J, Sabin P, Garau M et al The importance of clinical factors in parenteral nutrition associated hypertriglyceridemia Clinical Nutrition (2003) 22(6): 577–583 Disclosure of Interest: None declared
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