Oxidative Damage and Post-COVID Syndrome: A Cross-Sectional Study in a Cohort of Italian Workers

Abstract

In addition to the acute symptoms after infection, patients and society are also being challenged by the long-term effects of COVID-19, known as long COVID. Oxidative stress, as a pivotal point in the pathophysiology of COVID-19, could potentially be also involved in the development of the post-COVID syndrome. The aim of the present study was to evaluate the relationship between changes in oxidative status and the persistence of long-COVID symptoms in workers with a previous mild COVID-19 infection. A cross-sectional study was conducted among 127 employees of an Italian university (80 with a previous COVID-19 infection, and 47 healthy subjects). The TBARS assay was used to detect malondialdehyde serum levels (MDA), while total hydroperoxide (TH) production was measured by a d-ROMs kit. A significant difference in mean serum MDA values was found between previously infected subjects and healthy controls and (4.9 µm vs. 2.8 µm, respectively). Receiver–operating characteristic (ROC) curves showed high specificity and good sensibility (78.7% and 67.5%, respectively) for MDA serum levels. A random forest classifier identified the hematocrit value, MDA serum levels, and IgG titer against SARS-CoV-2 as features with the highest predictive value in distinguishing 34 long-COVID from 46 asymptomatic post-COVID subjects. Oxidative damage persists in subjects with previous COVID-19 infection, suggesting a possible role of oxidative stress mediators in the pathogenesis of long COVID.

Pre-Infection Nutritional Status, Oxidative Stress, and One-Year-Long COVID Persistence in Patients Undergoing Hemodialysis: A Prospective Cohort Study

“…Our previous report also demonstrated significantly increased oxidative stress and decreased antioxidant markers in patients undergoing HD with long COVID compared to fully recovered patients [ 34 ]. Additionally, in line with our findings, Stufano et al proposed MDAs as an independent predictor of long COVID in Italian workers [ 35 ], and Restea et al demonstrated decreased ceruloplasmin levels in patients with type 2 diabetes and severe COVID-19 [ 36 ].…”

Pulmonary redox imbalance drives early fibroproliferative response in moderate/severe coronavirus disease-19 acute respiratory distress syndrome and impacts long-term lung abnormalities

“…The more convincing explanation at present is that pulmonary neovascularization plays a beneficial effect in abnormal lung recovery in some patients [ 31 , 47 ]. Recent studies have reported a potential role for peripheral circulating redox imbalance in the pathogenesis of long COVID, yet the relationship between pulmonary redox imbalance and long-term lung abnormalities in COVID-19 survivors has rarely been reported [ 65 , 66 ]. A common sequela of COVID-19 is pulmonary fibrosis [ 67 ].…”

Neurofilament light chain and glial fibrillary acid protein levels are elevated in post-mild COVID-19 or asymptomatic SARS-CoV-2 cases

“…We enrolled a cohort of workers from the University of Bari (Apulia, Italy), who requested to be assessed by the University Occupational Health Unit physicians, following an asymptomatic SARS-CoV-2 infection or a mild COVID-19 diagnosed by molecular test (COVID-19 patients), according to the internal procedure for returning to work. The calculation of the minimum sample size was performed a priori considering the prevalence of long COVID in a previous study in a similar population 20 and taking into account the results of the Global Burden of Disease analysis 21 accepting a 2% margin of error and a 95% confidence interval. Mild COVID-19 individuals were those who presented any of the several signs and symptoms of COVID-19 (e.g.…”

“…Mild COVID-19 individuals were those who presented any of the several signs and symptoms of COVID-19 (e.g. fever, sore throat, cough, malaise, migraine, muscular pain, vomiting, nausea, diarrhea, and loss of taste and smell), but without shortness of breath, dyspnoea or abnormal chest images 20 . Asymptomatic infected individuals were those with a positive SARS-CoV-2 virological test but without symptoms consistent with COVID-19 22 .…”