Thiol level and total oxidant/antioxidant status in patients with COVID-19 infection

Abstract

Background Accumulating evidence suggests that oxidative stress is closely related to the pathogenesis and severity of COVID-19 infection. Here, we attempted to compare thiol, total oxidant status (TOS), total antioxidant status (TAS), and oxidative stress index (OSI) levels between COVID-19 patients who need and do not need intensive care unit (ICU) support, and determine whether these markers could be used as predictors of ICU admission. Methods We recruited 86 patients with COVID-19 infection and classified them into two groups according to the level of care: ICU group ( n = 40) and non-ICU group ( n = 46). Thiol, TAS, TOS, and OSI levels were determined and compared between the two groups. Results The levels of thiol and TAS in serum were markedly lower in ICU patients than in the non-ICU patients. On the contrary, TOS and OSI levels were markedly higher. Inflammatory markers, including white blood cell, neutrophil, C-reactive protein, procalcitonin, and ferritin, were negatively correlated with the thiol and TAS, and positively correlated with the TOS and OSI. We determined that areas under the ROC curve for thiol, TAS, TOS, and OSI were 0.799, 0.778, 0.713, and 0.780, respectively. Conclusions Our results revealed that the increase in oxidative stress and decrease in antioxidant levels in COVID-19-infected patients were associated with worsening of disease. Thiol, TAS, TOS, and OSI parameters can be used to distinguish between ICU patients and those who do not, among which thiol was the best predictor of ICU requirement.

Oxidative stress and inflammatory markers in patients with COVID-19: Potential role of RAGE, HMGB1, GFAP and COX-2 in disease severity

“…A wide range of biomolecules associated with the inflammatory and immune cell response, which are used as predictors of organ failure and severity in other diseases, are also being studied in patients with COVID-19 [38] , [39] . It has been found that several inflammatory and oxidative mediators are misregulated in COVID-19 and are associated with multiorgan damage and poor disease prognosis [40] , [41] .…”

The potential role of COVID-19 in the induction of DNA damage

“…Moreover, chronic inflammation is associated with the production of reactive oxygen species that can promote the development of some types of cancer, insulin resistance and vascular lesions [ [77] , [78] , [79] ]. In COVID-19 patients, serum levels of glutathione and total thiol are decreased, while levels of superoxide dismutase, catalase, malondialdehyde (a marker of oxidative stress and lipoperoxidation) and the total oxidant status are increased [ 57 , [80] , [81] , [82] ]. Oxidative stress levels correlated with blood oxygen saturation levels, disease severity, prognosis, and with the virus variant that was causing the infection [ 57 , 80 , 82 , 83 ].…”

“…In COVID-19 patients, serum levels of glutathione and total thiol are decreased, while levels of superoxide dismutase, catalase, malondialdehyde (a marker of oxidative stress and lipoperoxidation) and the total oxidant status are increased [ 57 , [80] , [81] , [82] ]. Oxidative stress levels correlated with blood oxygen saturation levels, disease severity, prognosis, and with the virus variant that was causing the infection [ 57 , 80 , 82 , 83 ]. Mechanistically, an analysis of transcriptome changes observed in different data sets from blood cells, lung biopsies or leukocytes from healthy subjects and COVID-19 patients showed that there is a significant upregulation of pro-oxidant genes, principally the myeloperoxidase and calprotectin genes [ 84 ].…”

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

“…Lower levels of vitamin D, higher levels of peroxides in plasma, and higher oxidative stress index were found in severe compared to moderate COVID-19 hospitalized patients [ 73 ]. Moreover, significantly higher total oxidant status and oxidative stress index were observed in ICU compared to non-ICU patients [ 85 ]. Nevertheless, some studies found no correlation between oxidative stress markers’ levels at admission to ICU and COVID-19 outcome [ 86 ].…”

“…At the moment of hospitalization, levels of native thiol and total thiol were significantly lower in COVID-19 patients compared to healthy controls [ 69 , 89 ] and in severe compared to mild to moderate adults [ 88 , 89 ] and pediatric patients [ 88 ]. In hospitalized patients, thiol levels were decreasing with increasing disease severity [ 90 ], in COVID-19 patients with acute respiratory distress syndrome (ARDS) compared to those without ARDS [ 92 ], and in ICU admitted compared to non-ICU COVID-19 patients [ 85 ].…”