Evaluation of oxidative stress markers in hospitalized patients with moderate and severe COVID-19

Abstract

Background: Clinical evidence suggests increased oxidative stress in COVID-19 patients and this worsened redox status could potentially contribute to the progression of the disease. Objectives: To investigate the oxidative stress we have measured oxidative stress parameters, namely, PAT (total antioxidant power, iron reducing) and d-ROMs (plasma peroxides). Additionally we have investigated their correlation with the most frequently used clinical parameters CRP, LDH, and NLR in serum from moderate and severe COVID-19 patients hospitalized in a tertiary hospital. Methods: PAT and d-ROMs were determined by analytical photometric metric method in serum from 50 hospitalized patients. For each of them, two samples were collected and analyzed immediately after collection seven days apart. Results: All patients at admission had a much higher value for plasma peroxides and a significant correlation between oxidative stress parameters and CRP, LDH, and NLR. (p<0.05), except for OS index (OSI) vs CRP in the severe group. At discharge, plasma peroxides were reduced and OSI was improved in the moderate group. Conclusion: We consider that using OSI at the beginning of COVID-19 disease presents a valuable starting point for the general assessment of oxidative stress and hence enabling a better triage of the patients in terms of disease severity.

Redox Status Is the Mainstay of SARS-CoV-2 and Host for Producing Therapeutic Opportunities

“…Regarding SARS-CoV-2, an observational study showed an increase in antioxidant capacity by inducing SOD and CAT in COVID-19 patients [ 42 ]. However, this was inconsistent with other COVID-19 patients [ 43 ]. This warrants additional studies to establish the link between SARS-CoV-2 and the host antioxidant system’s activation.…”

Molecular Mechanisms Related to Responses to Oxidative Stress and Antioxidative Therapies in COVID-19: A Systematic Review

“…Levels of oxidative stress depend on COVID-19 severity [ 30 ] and change during the disease [ 82 ], so both factors should be considered when comparing results from different studies. Levels of superoxide anion increased substantially with increased disease severity, while hydrogen peroxide levels were similar in all hospitalized patients, independent of disease severity [ 83 ].…”

“…However, depending on the outcome, oxidative stress levels changed between admission and seven days after admission. In severe COVID-19 patients with fatal consequences, increased oxidative stress was observed, while in surviving patients, oxidative stress was decreased during this period [ 82 ]. Karkhanei et al found that total oxidant status increased with increased severity of COVID-19 [ 87 ].…”

“…In other articles, the earlier sampling time was used: Yaghoubi et al collected samples upon hospital admission [ 84 ], Martín-Fernández et al at 9 am the morning after hospitalization [ 32 ], Çakırca et al [ 85 ], and Žarković et al [ 95 ] on the first day from hospital admission. As the levels of oxidative stress and antioxidant capacity may depend on the course of disease [ 82 ], the sampling times could have influenced the results of Karkhanei et al [ 87 ]. Some studies found no difference in antioxidant capacities between evaluated groups.…”

Redox medicine in viral infections: focus on AIDS and COVID-19

“…Also, serum-free thiol concentrations have been analyzed and correlated with the disease severity: hospitalized subjects had significantly lower levels of serum-free thiols compared to non-hospitalized subjects and healthy controls (van Eijk et al, 2021). Lastly, oxidative damage to lipids has also been detected in plasma samples from patients at admission (Zendelovska et al, 2021). Indeed, physiological serum levels of 7-ketocholesterol and 7-hydroxycholesterol in SARS-CoV-2 positive subjects were significantly increased compared to healthy subjects (Marcello et al, 2020).…”