Oxidative Stress Biomarkers and Their Association with Mortality among Patients Infected with SARS-CoV-2 in Mexico

Abstract

Background. Activation of the immune system response is associated with the generation of oxidative stress (OS). Several alterations are involved in OS, such as excessive production of reactive oxygen species (ROS) and decreased antioxidant activity, which together lead to an imbalance in redox status. The role of OS during SARS-CoV-2 infection is not fully understood. The aim of this study was to determine OS biomarkers and assess their usefulness as a predictor of mortality in COVID-19 patients. Methods. Baseline characteristics and serum samples were collected from hospitalized COVID-19 patients and compared with healthy controls. The serum OS biomarkers, including malondialdehyde (MDA) and total antioxidant capacity (TAC), were assessed by spectrophotometric and oxygen radical absorbance capacity (ORAC) methods, respectively. Results. A total of 152 individuals were analyzed (COVID-19 patients vs. healthy controls). Compared with healthy controls ( n = 76 ), patients infected with SARS-CoV-2 ( n = 76 ) presented higher levels of MDA ( p < 0.001 ) and decreased TAC ( p < 0.001 ). A total of 37 (49%) patients with COVID-19 died. The area under the receiver operating characteristic (ROC) curve (AUC) estimated that the combination of the OS biomarkers (MDA+TAC) ( AUC = 0.6394 , p = 0.037 ) was a significant predictor of mortality. A higher level of MDA was associated with mortality (HR, 1.05, 95% CI, 1.00–1.10, p = 0.045 ). Conclusion. This study concludes that OS is increased in patients with COVID-19 and is associated with mortality. To our knowledge, this is the first evidence of the expression of OS biomarkers and their association with mortality among the Mexican population.

Hematological, Inflammatory, Coagulation, and Oxidative/Antioxidant Biomarkers as Predictors for Severity and Mortality in COVID-19: A Prospective Cohort-Study

“…This result was in concordance with the findings of Shakaroun et al 52 Oxidative imbalance in COVID-19 patients can be determined by measuring oxidative stress biomarkers such as MDA and antioxidant biomarkers. Our study shows a higher level of MDA in the critical group than in HCs, this is consonance with the published work by Avila-Nava et al, 25 Mehri et al 53 The reason for increasing MDA may be due to high levels of free radicals in COVID-19 that accelerate the rate of lipid peroxidation.…”

“…Several studies have stated the high level of OS and deficient antioxidant biomarkers in COVID-19 patients. 25–27 However, these investigations do not provide adequate justification for the use of antioxidant parameters as diagnostic and prognostic biomarkers. Therefore, the goals of the current study are to determine the impact of OS on COVID-19 sufferers through the measurement of hematological, inflammatory, coagulation, and oxidative/antioxidant biomarkers.…”

Selenium Status and Oxidative Stress in SARS-CoV-2 Patients

“…Several studies confirmed a decrease in Se and associated components in patients with COVID-19 disease [ 27 , 28 , 29 , 30 ]. The results of our study indicate that hospitalized COVID-19 patients had reduced levels of Se in their blood plasma, which were lower than the European healthy adult reference ranges of 70–130 μg/L (median 87 μg/L) for Se concentration, with concentrations below 70 μg/L considered deficient [ 6 ].…”

Can circulating oxidative stress-related biomarkers be used as an early prognostic marker for COVID-19?

“…Strong positive correlations between lipid peroxides and Cu and the negative correlation between γ-tocopherol and Cu highlighted the role played by copper in increased oxidative stress in COVID-19 patients. Oxidative stress is increased in patients with COVID-19 and is associated with mortality ( 21 ).…”