Oxidative Stress and Inflammatory Status in COVID-19 Outpatients: A Health Center-Based Analytical Cross-Sectional Study

Abstract

The antioxidant system can be critical in reducing exacerbated inflammation in COVID-19. This study compared the antioxidant and inflammatory responses between COVID-19 outpatients and seemingly healthy individuals. This descriptive-analytical cross-sectional study was conducted on 53 COVID-19 outpatients and 53 healthy individuals as controls. The serum concentrations of amyloid A (SAA), total antioxidant capacity (TAC), superoxide dismutase (SOD), and glutathione peroxidase (GPx) were measured and compared between COVID-19 patients and controls using the independent sample t-test before and after controlling for dietary supplement use. A generalized estimating equation (GEE) regression model, limited to COVID-19 patients, was used to evaluate the odds ratios (ORs) and 95% confidence intervals (95% CIs) of disease symptoms on days 1, 7, 14, 21, and 28 after the disease onset. Serum concentrations of SOD (p ≤ 0.001) and GPx (p = 0.001) were significantly higher in COVID-19 patients than in controls before adjustment for dietary supplement use. GPx remained significantly higher among COVID-19 patients than in controls after adjustment for all dietary supplements (p = 0.005). Moreover, serum concentrations of GPx (p = 0.003), SOD (p = 0.022), and TAC (p = 0.028) remained significantly higher among COVID-19 patients than in controls after adjustment for vitamin D supplementation. This study showed higher GPx in COVID-19 outpatients than in controls after adjustment for dietary supplement use. Moreover, elevated SOD, GPx, and TAC concentrations were shown in COVID-19 outpatients compared to controls after adjusting for vitamin D supplementation. These results may provide a useful therapeutic target for treating oxidative stress in COVID-19 disease, which may help ameliorate the pandemic.

Glutathione deficiency in the pathogenesis of SARS-CoV-2 infection and its effects upon the host immune response in severe COVID-19 disease

“…The value of selenium upon glutathione peroxidase 1 activity and oxidative stress mitigation in SARS-CoV-2 infection and COVID-19 disease has been clearly emphasized recently ( Seale et al, 2020 ; Fakhrolmobasheri et al, 2021 ) and can prevent atherosclerosis progression in SARS-CoV-2 infection. The recent demonstration of elevated superoxide dismutase, GSH peroxidase, and total antioxidant capacity in COVID-19 outpatients compared to controls could be interpreted as a response to excessive COVID-19-related oxidative stress ( Golabi et al, 2022 ). Adequate levels and function of GSH and selenoproteins can prevent worsening of acute respiratory distress syndrome and atherosclerosis, two main causes of morbimortality in SARS-CoV-2 infection and COVID-19 disease.…”

Bone fragility during the COVID-19 pandemic: the role of macro- and micronutrients

“…16,17 In this scenario, adequate intake of nutrients is essential for an optimal immune response able to prevent infections, and to counteract inflammatory state and oxidative stress, strengthening a relationship between nutrition and individual response to disease burden. 18,19 Consistent with this concept, a recent cross-sectional study showed the importance of adequate levels of vitamin D and zinc for their immunomodulatory and direct antiviral effects during SARS-CoV-2 infection. Similarly, these nutrients are noteworthily required for normal skeletal growth and bone homeostasis, 20,21 further supporting their adequate intake during COVID-19 to prevent bone loss.…”

Cancer and COVID-19: A Double Burden on the Healthcare System

“…Furthermore, the virus also targets and disrupts the body's antioxidant defense mechanisms, leading to an even greater increase in oxidative stress. Therefore, managing oxidative stress may be an important therapeutic strategy for COVID-19 treatment, and antioxidants such as vitamin C and N-acetylcysteine have been studied for their potential benefits in this regard (34).…”